Background & objectives: Leishmania major and L. tropica are the main pathogens of cutaneous leishmaniasis (CL) in several rural and some urban regions of Iran, respectively. The aim of this study was to detect Leishmania species, and update the distribution data of these species in humans suspected to CL in two endemic foci in southern Iran.
Methods: From March 2016 to March 2017, 276 positive samples from of 350 suspected cases were diagnosed and compared by different diagnostic methods, viz. microscopy, culture, and PCR. In PCR assay, four different gene identifications were performed including minicircle kDNA, and cysteine protease B genes for Leishmania detection, and glyceraldehyde-3-phosphate dehydrogenase, and internal transcribed spacer 1 genes for Crithidia detection.
Results: In total, 68% (235/350) and 65.3% (177/271) of patients suspected of leishmaniasis were positive by microscopy and cultivation methods. In PCR assay, L. major, and L. tropica were detected in 86.2% (238/276), and 13.1% (36/276) of CL cases, respectively. Also, dermal L. infantum strain was isolated from 0.7% (2/276) of post-kala-azar dermal leishmaniasis patients. In addition, Crithidia fasciculata was detected in two CL patients chronically infected with L. major.
Interpretation & conclusion: It appears that the epidemiology of CL has changed during the last decades and can complicate the control strategy aspects of CL in southern Iran. Therefore, more epidemiological, ecological, and gene polymorphism studies are needed to understand the pathogenic role of these species in human, as a main host of leishmaniasis in Iran.

中文翻译：

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基于 DNA 检测从伊朗南部设拉子和哈拉梅的皮肤和黑热病后皮肤利什曼病中分离出的利什曼原虫和 Crithidia 物种

背景与目的：大利什曼原虫和热带利什曼原虫分别是伊朗几个农村和部分城市地区皮肤利什曼病 (CL) 的主要病原体。本研究的目的是检测利什曼原虫物种，并更新这些物种在伊朗南部两个地方性疫区中疑似 CL 的人类中的分布数据。
方法：从2016年3月至2017年3月，由350疑似病例276个阳性样本进行诊断和不同的诊断方法相比，即。显微镜检查、培养和 PCR。在 PCR 测定中，进行了四种不同的基因鉴定，包括小环kDNA和利什曼原虫的半胱氨酸蛋白酶 B基因检测、3-磷酸​​甘油醛脱氢酶和用于Crithidia检测的内部转录间隔区1 基因。结果：总共有68%（235/350）和65.3%（177/271）的疑似利什曼病患者通过显微镜和培养方法呈阳性。在PCR测定，硕大利什曼原虫，和L. tropica分别86.2％（276分之238），以及CL例13.1％（276分之36），进行检测。此外，从 0.7% (2/276) 的黑热病后皮肤利什曼病患者中分离出皮肤婴儿乳杆菌菌株。此外，在两名慢性感染L. Major 的CL 患者中检测到Crithidia fasciculata。

解释和结论：在过去的几十年里，CL 的流行病学似乎发生了变化，可能使伊朗南部 CL 的控制策略方面变得复杂。因此，需要更多的流行病学、生态学和基因多态性研究来了解这些物种在人类中的致病作用，人类是伊朗利什曼病的主要宿主。