Laboratory‐based epidemiological study of superficial fungal infections

Abstract

Dermatophytosis continues to be a worldwide problem, constituting a large bulk of cases attending the dermatology outpatient's department in tropical countries. Variable climatic conditions and multiple etiological agents, whose individual prevalence varies with time, prompted an attempt to define the current pattern and etiologic prevalence in our locality, and compare them with earlier studies from different centers. Of consenting patients clinically diagnosed to have superficial fungal infections, 1975 were investigated in the laboratory. All the specimens collected from patient skin, hair or nails were subjected to direct microscopy examination in 10% potassium hydroxide (KOH) and fungal culture. Confirmed diagnosis was made only if specimen was KOH and/or culture positive. Male : female ratio was 1.65 : 1. Tinea corporis (21.4%), onychomycoses (14.7%) and tinea capitis (6.2%) were the most common laboratory-confirmed infections. Only 909 patients (47%) out of 1035 clinically suspected patients had evidence of fungal infection by either microscopy and/or culture. Of these 909 patients, 787 (86.5%) were both KOH and culture positive, 25 (2.7%) were KOH negative and culture positive, while 97 (10.6%) were KOH positive but culture negative. In 1051 patients (53%), no evidence of fungal infection was seen. Trichophyton rubrum was the most commonly isolated dermatophyte (55.2%) followed by Trichophyton mentagrophytes (19.6%) and Trichophyton tonsurans (2.9%). Candida sp. accounted for 16% of all isolates. Non-dermatophyte moulds (NDM) were isolated only in patients with onychomycoses. Our study revealed a male preponderance, tinea corporis as the commonest clinical type, and dermatophytes as the commonest mycological isolates, which is in agreement with earlier studies. Relying on clinical diagnosis alone without laboratory confirmation may result in overestimation of the problem as evidenced in other studies as compared to our study. Rarely reported NDM appear to be important etiological agents of onychomycoses.

A clinico-mycological study of onychomycosis at a tertiary care center

“…In this T. rubrum was commonest isolate followed by T. Verrucosum and E.floccosum Candida albicans was isolated from 24.2% and NDM in 29 patients. 25 T. rubrum as commonest etiological agents was noted also by Perea followed by T. mentagrophytesvarinterdigitale and T. tonsurans. 11 Das et al also reports high prevalence of dermatophtic fungi in 22/44 number of cases.…”

Study of Skin and Nail Candida Species as a Normal Flora Based on Age Groups in Healthy Persons in Tehran-Iran (2016)

“…Two of the most factors influencing the complex of inhabitants on the skin are gender [4] and age [5,6]. There are more data concerning bacterial cutaneous flora than fungal flora, and among fungal flora, Candida species may be one of the important opportunistic agents residing on the skin with the potential to create different kinds of candidiasis [7,8].…”

Evaluation of Antifungal Activities of Myrtus communis L. by Bioautography Method

“…It can be caused by keratinophilic and keratinolytic dermatophytes, particularly Microsporum canis, M. gypseum and Trichophyton mentagrophytes (10,14,15,16). During the last decades, many antifungal agents have been developed and have become available for the treatment of dermatophytosis, which are confined to a relatively few number of chemical groups.…”