Isolation, identification, and antifungal susceptibility of dermatophytes from patients in a tertiary care hospital
DOI:
https://doi.org/10.18203/2320-6012.ijrms20252027Keywords:
Dermatophytes, Antifungal drugs, Antifungal susceptibility, Tertiary care hospitalAbstract
Background: Fungal infections affecting the body's surface are common in tropical and subtropical climates worldwide. Many antifungal medicines can treat the illness, although the dermatophytes that respond vary by time and site. The study aimed to isolate, identify and analyse the antifungal susceptibility patterns of dermatophytes obtained from patients visiting the dermatology department of a tertiary care hospital.
Methods: This 3-month trial included 200 clinically diagnosed individuals with skin and nail dermatophytosis from a tertiary care hospital's Dermatology outpatient clinic.
They consulted the Department of Microbiology to isolate, cultivate and test for fungal sensitivity.
Results: Results show that persons aged 21-30 were most profoundly affected. Tinea corporis was the most common clinical symptom at 49.5%, followed by tinea cruris at 24.5%. The most common dermatophytes were Trichophyton species (82.4%). About 67.6% of our isolates had MICs (>1 μg/ml) for fluconazole, regardless of species. The MIC of luliconazole and amorolfine hydrochloride was<0.004 μg/ml for all dermatophytes isolates, while other antifungals had MICs of ≥0.25 μg/ml. The narrowest MIC range was for luliconazole and amorolfine hydrochloride (0.002-0.128 μg/ml), whereas fluconazole and itraconazole had the greatest range (0.125-64 and 0.0321-16) respectively.
Conclusions: The study found that luliconazole and amorolfine hydrochloride were the most effective medications against all dermatophytes isolates, followed by itraconazole and fluconazole. Some of our isolates have greater and wider MIC values for itraconazole and fluconazole, which may increase resistance.
Metrics
References
Sharma V, Kumawat TK, Sharma A, Seth R, Chandra S. Distribution and prevalence of dermatophytes in semi-arid region of India. Adv Microbiol. 2015;5(2):93-106. DOI: https://doi.org/10.4236/aim.2015.52010
Simpanya MF. Dermatophytes: their taxonomy, ecology and pathogenicity. Rev Iberoam Micol. 2000;17:1-2.
Kushwaha RK, Guarro J. Biology of dermatophytes and other keratinophilic fungi. 2000.
Weitzman I, Summerbell RC. The dermatophytes. Clin Microbiol Rev. 1995;8(2):240-59.
Richardson MD, Warnock DW: Fungal infection: diagnosis and management. 4th edn. Oxford (ed): Wiley- Blackwell. 2008: 256−258.
Forbes BA, Sahm DF, Weissfeld AS: Diagnostic microbiology. 12th edn. St Louis. Mosby. 2005 :288- 302.
Chander J: Textbook of medical mycology. 4th edn. JP Medical. 2009: 161-162.
Drake LA, Dinehart SM, Farmer ER, et al.: Guidelines of care for superficial mycotic infections of the skin: tinea corporis, tinea cruris, tinea faciei, tinea manuum and tinea pedis. Guidelines/Outcomes Committee. American Academy of Dermatology. J Am Acad Dermatol. 1996;1:282-6. DOI: https://doi.org/10.1016/S0190-9622(96)80135-6
Seebacher, Claus & Bouchara, jean-philippe & Mignon, Bernard. (2008: Updates on the Epidemiology of Dermatophyte Infections. Mycopathologia. 2008;166:335-52. DOI: https://doi.org/10.1007/s11046-008-9100-9
Murtaza M, Rajainthran S, George B. A Mycological Study of Superficial Mycoses at the Skin Clinic in Sabah, Malaysia. International J Pharma Sci Inv. 2014;2:45-8. DOI: https://doi.org/10.9790/6718-02034548
Sudha M, Ramani CP, Anandan H. Prevalence of dermatophytosis in patients in a tertiary care centre. Int J Contemp Med Res. 2016;3(8):2399-401.
Weitzman I, Summerbell RC. The dermatophytes. Clinical Microbiol Rev. 1995;8(2):240-59. DOI: https://doi.org/10.1128/CMR.8.2.240
Ameen M. Epidemiology of superficial fungal infections. Clin Dermatol. 2010;28(2):197-201. DOI: https://doi.org/10.1016/j.clindermatol.2009.12.005
Islam TA, Majid F, Ahmed M, Afrin S, Jhumky T, Ferdouse F. Prevalence of dermatophytic infection and detection of dermatophytes by microscopic and culture methods. J Enam Med Coll. 2018;8(1):11-5. DOI: https://doi.org/10.3329/jemc.v8i1.35429
Bitew A: Dermatophytosis: Prevalence of Dermatophytes and Non-Dermatophyte Fungi from Patients Attending Arsho Advanced Medical Laboratory, Addis Ababa, Ethiopia. Dermatol Res Pract. 2018;3:8164757. DOI: https://doi.org/10.1155/2018/8164757
Taufik Kakande, Yonah Batunge, Emmanuel Eilu, et al.: Prevalence of Dermatophytosis and Antifungal Activity of Ethanolic Crude Leaf Extract of Tetradenia riparia against Dermatophytes Isolated from Patients Attending Kampala International University Teaching Hospital, Uganda. Dermatol Res Pract. 2019;11:9328621. DOI: https://doi.org/10.1155/2019/9328621
Khan S, Singhal S, Mathur T, Upadhyay DJ, Rattan A: Antifungal susceptibility testing method for resource constrained laboratories. Indian J Med Microbiol. 2006;24:171-6. DOI: https://doi.org/10.1016/S0255-0857(21)02345-8
Gupta AK, Kohli Y. In vitro susceptibility testing of ciclopirox, terbinafine, ketoconazole and itraconazole against dermatophytes and nondermatophytes and in vitro evaluation of combination antifungal activity. Br J Dermatol. 2003;149:296-305. DOI: https://doi.org/10.1046/j.1365-2133.2003.05418.x
Ardakani ME, Ghaderi N, Kafaei P. The diagnostic accuracy of potassium hydroxide test in dermatophytosis. J Basic Med Clin. 2016;5(2):4-6.
Dhib I, Fathallah A, Yaacoub A, Hadj Slama F, Said MB, Zemni R. Multiplex PCR assay for the detection of common dermatophyte nail infections. Mycoses. 2014;57(1):19-26. DOI: https://doi.org/10.1111/myc.12096
Behzadi P, Behzadi E, Ranjbar R. Dermatophyte fungi: infections, diagnosis and treatment. SMU Med J. 2014;1(2):50-9.
Kumar M. Study of Clinico-Mycologic Profile and Antifungal Susceptibility Pattern of Dermatophytic Infection in the North-Western Zone of Rajasthan. International J Curr Microbiol Applied Sci. 2018;7:762-5. DOI: https://doi.org/10.20546/ijcmas.2018.701.092
Gupta AK, Leonardi C, Stoltz RR, Pierce PF, Conetta B; Ravuconazole onychomycosis group. A phase I/II randomized, double-blind, placebo-controlled, dose-ranging study evaluating the efficacy, safety and pharmacokinetics of ravuconazole in the treatment of onychomycosis. J Eur Acad Dermatol Venereol. 2005;19(4):437-43. DOI: https://doi.org/10.1111/j.1468-3083.2005.01212.x
Clinical Laboratory Standards Institute: Reference Method for Broth Dilution Antifungal Susceptibility Testing of Filamentous Fungi; Approved Standard. CLSI Document No. M38- A2. Wayne, PA, USA: Clinical and Laboratory Standards Institute. 2008.
Dabas Y, Xess I, Singh G, Pandey M, Meena S: Molecular Identification and Antifungal Susceptibility Patterns of Clinical Dermatophytes Following CLSI and EUCAST Guidelines. J Fungi. 2017;23:3. DOI: https://doi.org/10.3390/jof3020017
Konda C, Surekha JK, Jahnavi I. Isolation and Identification of Dermatophytes in a Tertiary Care Hospital. International J Cur Microbiol Appl Sci. 2018;6:4088-101. DOI: https://doi.org/10.20546/ijcmas.2017.612.470