A Study on the Pattern of Fungi Causing Onychomycosis in a Tertiary Care Hospital in Imphal

Abstract

BACKGROUND Onychomycosis is a fungal infection of the nails. It is caused by dermatophytes, non-dermatophytes and yeasts. In spite of improved personal hygiene and living condition, it continues to persist and poses a major clinical challenge regarding its treatment due to its chronicity. The present study was conducted to identify the fungi causing onychomycosis in our region. MATERIALS AND METHODS This descriptive study was carried out in the Department of Microbiology at a tertiary healthcare centre in Manipur from August 2016 to August 2017. A total of 166 cases of clinically diagnosed cases of onychomycosis were taken up for study. After disinfecting the nails with 70% alcohol, collected nail samples were subjected to 20% KOH and culture was done on Sabouraud's Dextrose Agar (SDA) with chloramphenicol. Identification of the isolates was done by microscopic and macroscopic examination. RESULTS Out of 166 samples KOH is positive in 54 samples (32.54%), of which culture is positive in 30 samples (18.07%) and 24 is culture negative (14.45%). Total culture positivity is seen in 52 samples (31.32%), of which 30 samples (18.07%) is KOH positive and 22 samples (13.25%) is KOH negative. Females are predominantly affected (64.45%). F: M is 1.8: 1. Most affected age group is 21-30 yrs. (30.12%). Candida species are the commonest species isolated (46.15%) and non-albicans Candida are more predominant (30.76%) followed by dermatophytes (28.84%). Trichophyton rubrum is the commonest dermatophyte isolated (15.38%). CONCLUSION The study showed the genus Candida as the main pathogen causing onychomycosis in our region. So, clinical onychomycosis should be confirmed both by KOH and fungal culture to prescribe specific antifungal drugs for optimal outcome.