The molecular identification of clinical mucorales using the ITS region has been successfully demonstrated in recent years.[9, 14, 18, 19, 21, 22] However, ITS sequencing failed with the strains of

the genus Syncephalastrum. This is in concordance with Walther et al. [21] who reported that direct ITS sequencing could not be achieved in strains of genera Syncephalastrum and Absidia. Furthermore, S. racemosum isolates characterised by LSU region in this study revealed at least two distinct clades. Further studies based on the multilocus sequence typing may suggest different genotypes in S. racemosum strains. Therefore, the need of detailed taxonomic studies for this genus can hardly be emphasised. The problem of overlapping Palbociclib clinical trial of S. racemosum with other species of Syncephalastrum was also pointed out by Vitale et al. [14]. Notably, the type strain of S. racemosum is not yet available. Rhizopus was the most common mucorales identified from mucormycosis cases

involving lungs, sinuses, cutaneous and other sites. Currently accepted Rhizopus species have been shown to be well recognisable in the ITS tree.[18] The three strains of R. stolonifer in the present study originated from two cases of cutaneous and one from rhino-cerebral mucormycosis. Abe et al. [18] used genealogical concordance phylogenetic species recognition Etoposide in vitro (GCPSR) to reclassify R. oryzae and proposed division of R. oryzae into R. arrhizus and R. delemar. The ITS tree in the present study clearly subdivided varieties

of R. arrhizus into two groups viz. R. arrhizus var. delemar in group 1 and R. arrhizus var. arrhizus in group 2. Furthermore, AFLP clearly revealed marked genotypic diversity within the Indian isolates of R. arrhizus and demarcated five distinct subgroups (group I–V), suggesting that AFLP could be explored in future studies to examine the relatedness of varieties within R. arrhizus isolates from different sources. In the present study 3.7% of cases of mucormycosis were due to Lichtheimia species which is in concurrence with Roden et al. [34] who reviewed 25 well documented cases of Lichtheimia and reported that 5% of the cases of mucormycosis are caused by this fungus. According to Alastruey-Izquierdo et al. [11] the genus Lichtheimia contains five species. Of Doxacurium chloride these only L. corymbifera and L. ramosa have been reported from human infections. However, L. ramosa was more common in the previous studies and similar dominance of this species was observed in our settings.[11] The three isolates of L. ramosa identified in the present study originated from pulmonary (n = 2) and cutaneous (n = 1) mucormycosis cases. The previous studies based on sequence analysis of ITS, LSU, translation elongation factor 1α have established L. ramosa as separate species from L. corymbifera.[35, 36] Mucor is the polyphyletic genus and is the most clinically relevant genus after Rhizopus.