Determinación de la concentración mínima inhibitoria de lotes de OLEOZON® tópico frente a Trichophyton rubrum, Trichophyton mentagrophytes y Epidermophyton floccosum

Introducción: En la actualidad las infecciones por hongos afectan entre el 20 y el 25 % de la población. Objetivo: Determinar la concentración mínima inhibitoria de dos lotes de OLEOZON® almacenados a temperaturas de 5 y 30°C en envases de vidrio y polietileno de alta densidad, durante 24 meses como parte del estudio de estabilidad del OLEOZON® tópico. Métodos: Mediante el método dilución en agar fueron evaluadas cinco concentraciones del producto frente a los dermatofitos trichophyton rubrum, trichophyton mentagrophytes y epidermophyton floccosum. Resultados: Se obtuvo que el 8,9 mg/mL fue el valor de la CMI para las cepas evaluadas en el estudio "vida de estante"; se observó en el estudio acelerado el mismo valor frente a las cepas de trichophyton mientras que para epidermophyton floccosum fue de 17,8 mg/mL a excepción del envase frasco de vidrio del lote 803295 donde se obtuvo 8,9 mg/mL. El análisis estadístico, tanto del estudio acelerado como en vida de estante, mostró que existe diferencia estadísticamente significativa entre el primer y el último mes de ensayo, estas son las diferencias más apreciables en los lotes almacenados en frasco de vidrio. El OLEOZON® tópico almacenado en frasco de polietileno de alta densidad presentó mejores valores de actividad frente a los dermatofitos. Conclusiones: Todos los valores de la concentración mínima inhibitoria encontrados, independiente del tipo de envase, el tiempo o la temperatura de almacenamiento, muestran que el producto mantiene su actividad antifúngica. Se evidenció una similitud entre las cepas del género trichophyton en comparación con el género epidermophyton.

Introduction: Currently fungal infections affect between 20 and 25% of the population. Objective: To determine the minimum inhibitory concentration of two batches of OLEOZON® stored at temperatures of 5 and 30 0C in glass and high-density polyethylene containers, for 24 months as part of the stability study of topical OLEOZON®. Methods: Using the agar dilution method, five concentrations of the product were evaluated against the dermatophytes Trichophyton rubrum, Trichophyton mentagrophytes and Epidermophyton floccosum. Results: It was found that 8.9 mg/mL was the MIC value for the strains evaluated in this shelf life study; and the same value was observed in the accelerated study against the trichophyton strains, while for epidermophyton floccosum it was 17.8 mg/mL with the exception of the glass bottle container of batch 803295 where 8.9 mg/mL was obtained. The statistical analysis, both in the accelerated study and in shelf life, showed that there is a statistically significant difference between the first and the last month of the trial, these are the most appreciable differences in the batches stored in glass jars. Topical OLEOZON® stored in a high-density polyethylene bottle presented better activity values against dermatophytes. Conclusions: All the values of the minimum inhibitory concentration found, regardless of the type of container, the time or the storage temperature, show that the product maintains its antifungal activity during the months of study. A similarity was apparent between the strains of the genus trichophyton compared to the genus epidermophyton.

Study of Clinico-mycological profile of onychomycosis at a tertiary carehospital

Introduction: Onychomycosis (OM) is a common nail disorder caused by dermatophytes, non-dermatophyte moulds and yeasts. The increased prevalence of OM along with the wide range of associated fungi necessitates the accurate laboratory isola?on and iden?fica?on of the causa?ve fungus for op?mal management strategies. The aim of the study was to evaluate clinical, epidemiological and mycological characteris?cs of OM at a ter?ary care hospital in Karimnagar. Materials and Methods: The study was conducted at Department of Microbiology for a period of one year. 109 pa?ents clinically diagnosed as OM were subjected to detailed history, clinical examina?on and inves?ga?ons. Nail clippings and subungual debris of OM pa?ents were subjected to KOH prepara?on and culture. Isolates were iden?fied by colony characters, pigment produc?on, microscopic morphology. Results: The maximum number of OM cases belonged to the age group 21-30 years with a male preponderance. Higher incidence was noted in males (71.5%) than females (28.4%). Direct microscopy of the nail clippings in 40% KOH solu?on was posi?ve in 56.8% and culture was posi?ve in 75.2% cases. The common e?ological agent was dermatophytes (45.12% cases) followed by yeasts (34.14% and non dermatophyte molds (20.7% cases). T.rubrum was the commonest among dermatophytes and Candida albicans among the yeasts. Conclusions: Although onychomycosis is not life threatening, it can cause a significant nega?ve impact on the quality of life of infected pa?ents. Early diagnosis and treatment is important to prevent distor?on of the nails which can prevent loss of working efficiency of the commonly affected popula?on.

In vitro Susceptibility Studies of the Extract, Fraction and Cream Formulation of the Leaf of Musa paradisiaca Linn against Known Dermatophytes

Aim: This study was aimed at investigating the in vitro susceptibility of known dermatophytes to Musa paradisiaca leaf extract. Methodology: The antifungal activity of the methanol extract, aqueous fraction and cream formulation of Musa paradisiaca leaf was established by agar well diffusion method while minimum inhibitory concentration (MIC) was determined by broth microdilution and broth macrodilution methods respectively. Results: Results obtained show that all the test organisms had varying degrees of susceptibility which is comparable to that of a standard drug, ketoconazole. Microsporum audounii exhibited the lowest MIC of 25 mg/mL for the aqueous fraction and 50 mg/mL for the cream formulation. The MFC/MIC ratio determined indicates the fungicidal potential of the plant. Conclusion: The in vitro susceptibility of M. paradisiaca leaf extract to known dermatophytes is an indication of the possible use of the leaf as a potential for the treatment of skin infections due to the tested organisms.

Evaluation of antifungal susceptibility pattern of dermatophytes isolated in a tertiary care hospital

Background: Superficial fungal infections are extremely common in the tropical and subtropical regions all over the world. Although numerous antifungal drugs are available for the treatment, the pattern of susceptibility to the drugs being used for dermatophytes varies with time and place. Aims and Objectives: The objective of the study was to isolate, identify, and determine antifungal susceptibility pattern in dermatophytes isolated from patients attending dermatology OPD in a tertiary care hospital. Materials and Methods: This study was conducted on 150 dermatophytes isolated from clinically diagnosed patients with dermatomycosis of skin and nail attending the Department of Dermatology Outpatient Clinic of JJM Medical College over a period of 1 year. These cases were referred to the Department of Microbiology for fungal isolation, culture and sensitivity testing. Results: The most frequently affected age group was 21–30 years. The most common clinical manifestation was tinea corporis (52.56%) followed by tinea cruris (26%). The most common dermatophytes implicated were Trichophyton species in 88%. Irrespective of the species, about 96% of our isolates exhibited high minimum inhibitory concentration (MIC) (>1 ?g/ml) to fluconazole. The MIC of luliconazole was < 0.004 ?g/ml to all the dermatophytes isolates tested, compared to other antifungal agents that were ?0.25 ?g/ml. The MIC range was narrowest for luliconazole 0.002–0.128 ?g/ml and the widest for fluconazole, itraconazole, and ketoconazole (0.125–64, 0.0321–16, and 0.0321–16, respectively). Conclusion: Our study showed that luliconazole was the most active drug against all dermatophytes isolates, followed by itraconazole, ketoconazole, and fluconazole. The higher and wider range in MIC values for itraconazole, ketoconazole, and fluconazole found for some of our isolates raise the possibility of increasing resistance to these drugs.

Trichophyton benhamiae, un dermatofito zoofílico emergente en Argentina con reservorio en cobayos: descripción de 7 casos en un hospital de la Ciudad Autónoma de Buenos Aires / Trichophyton benhamiae, an emergent zoonotic pathogen in Argentina associated with Guinea pigs: Description of 7 cases in Buenos Aires

Resumen Trichophyton benhamiae es un dermatofito zoofílico. Puede causar tinea corporis, tinea faciei y tinea capitis. Se caracteriza por producir lesiones inflamatorias, sobre todo en niños. El objetivo de esta publicación es describir 7 casos clínicos de pacientes pediátricos atendidos entre julio del 2019 y enero del 2020 en nuestra institución. A los pacientes se les solicitó estudio micológico convencional, con posterior confirmación con MALDI-TOF MS y secuencia-ción del ADN ribosomal. Se aisló e identificó T. benhamiae como agente etiológico; el nexo epidemiológico fue el contacto con cobayos. Estas son las primeras descripciones de infecciones causadas por T. benhamiae en Argentina. Al realizar estudios micológicos convencionales, este agente puede confundirse con otros dermatofitos, por lo tanto, se requieren herramientas como MALDI-TOF MS o la secuenciación para llegar a un diagnóstico definitivo. Es importante contar con datos epidemiológicos, como el contacto con mascotas no tradicionales, para una presunción diagnóstica adecuada.

Trichophyton benhamiae is a zoonotic dermatophyte that can cause tinea corporis, tinea faciei and tinea capitis, producing inflammatory lesions, especially in children. In this publication, we describe 7clinical cases of pediatric patients that occurred in our institution between July 2019 and January 2020. All patients underwent a conventional mycological study. The identification of fungi isolates was confirmed by MALDI-TOF MS and sequencing of the ribosomal DNA. T. benhamiae was identified as the etiological agent, whose epidemiological link in all cases was the contact with Guinea pigs. This is the first description of infections caused by T. benhamiae in Argentina. This dermatophyte can be misidentified as other more frequent dermatophytes when performing conventional studies. Molecular technology should be used to reach a definitive diagnosis. It is important to have epidemiological data from patients such as contact with non-traditional pets, especially Guinea pigs, for an adequate presumptive diagnosis of this dermatophytosis.

SPECTRUM OF SUPERFICIAL MYCOSIS IN A TERTIARY CARE HOSPITAL- A MATTER OF CONCERN

BACKGROUND : Superficial mycosis has been recognized as a common fungal condition worldwide, including India. It refers to fungal infection of skin and its appendages. AIM & OBJECTIVES : 1) To determine the frequency of fungal agents isolated from clinically suspected cases of superficial mycoses, in a tertiary health care hospital. 2) To access the risk factors associated with it. 3) To analyse the demographic profile associated with superficial mycosis. MATERIAL & METHODS: The prospective study was carried out, over a period of 12 months (January 2021 to December 2021), samples such as skin scarping, hair plugs and nail clipping obtained from patients were submitted to Department of Microbiology for the fungal etiology. Samples were subjected to direct microscopy by KOH mount and fungal culture as per standard convectional technique. RESULTS: A total of 63 clinically suspected cases of superficial mycosis were enrolled in the study. Among the isolates recovered the most common were Dermatophytes(41.26%) followed by Candida(14.28%), Aspergillus(6.3%), Mucor(3.1%) and remaining 23.80% were sterile. Among the Dermatophytes, T.rubrum 42.30% was the predominant pathogen followed by T.mentagrophytes 34.61%. The most common age group affected was 21-40 years of age with male predominance of male to female ratio of 1.5:1. Out of total of 48 samples of superficial mycosis 26 were positive by direct microscopy and 48 samples were positive both by microscopy and culture. Most of the positive cases were recovered from immunocompromised individuals suffering from diabetes (37.5%) followed by prolonged antibiotic therapy (25.02%), long steroid therapy (12.5%) and chemotherapeutic agents (10.41%). The cases were mainly seen in the months between April to July which correlates the infection with the humid season. CONCLUSION: The study pinpointed dermatophytes as the most common clinical pattern of superficial mycosis with a male predominance. Dermatophytic infection is one of the emerging fungal disease along with non dermatophytic molds, especially in immunocompromised individuals prompt treatment and management can herald the onset of ensuing complications, thereby limiting the morbidity and thus improving the quality of life.

Anti-dermatophyte activity of the aqueous extracts of Thai medicinal plants / Atividade antidermatófita dos extratos aquosos de plantas medicinais tailandesas

Medicinal plants have long been prescribed in Thailand for centuries. Different constituents of extracts have been used for treating of various infectious diseases. However, there is even less information available regarding the use in fungal skin infection. In order to assess traditional Thai claims about the therapeutic potential, this study is focused on exploring the anti-dermatophyte property of the plants that are currently used as traditional medicines. The potential of four different plant species were selected for investigate in vitro anti-dermatophyte activity. Ethanolic extracts of Chromolaena odorata (L.), Ageratina adenophora (Spreng.), Eclipta prostrate (Linn.), and Acorus calamus (L.). were analysed for their total phenolic content as well as total flavonoid content and were then subjected to test of their anti-dermatophyte properties using agar well diffusion method. Qualitative flavonoids and phenolics analysis of the extracts showed their biologically active constituents. Among the species examined, the result indicated that most of the extracts demonstrated anti-dermatophyte activity. In particular, A. calamus showed the highest efficacy against test organisms. The experiment confirmed the chemical constituents and efficacy of some selected plants and provides a scientific confirmation of the use of Thai plants in traditional medicine for fungal skin infections.

As plantas medicinais são prescritas há muito tempo na Tailândia, há séculos. Diferentes constituintes de extratos têm sido usados para o tratamento de várias doenças infecciosas. No entanto, existem ainda menos informações disponíveis sobre o uso em infecções fúngicas da pele. A fim de avaliar as alegações tradicionais tailandesas sobre o potencial terapêutico, este estudo está focado em explorar a propriedade antidermatófita das plantas que são usadas atualmente como medicamentos tradicionais. O potencial de quatro espécies de plantas diferentes foi selecionado para investigar a atividade antidermatófita in vitro. Extratos etanólicos de Chromolaena odorata (L.), Ageratina adenophora (Spreng.), Eclipta prostrate (Linn.) e Acorus calamus (L.) foram analisados quanto ao seu conteúdo fenólico total, bem como ao conteúdo de flavonoides totais. E então submetidos ao teste de suas propriedades antidermatófitas usando o método de difusão em ágar bem. A análise qualitativa de flavonoides e fenólicos dos extratos mostrou seus constituintes biologicamente ativos. Entre as espécies examinadas, o resultado indicou que a maioria dos extratos demonstrou atividade antidermatófita. Em particular, A. calamus mostrou a maior eficácia contra organismos de teste. O experimento confirmou os constituintes químicos e a eficácia de algumas plantas selecionadas e fornece uma confirmação científica do uso de plantas tailandesas na medicina tradicional para infecções fúngicas da pele.

Anti-dermatophyte activity of the aqueous extracts of Thai medicinal plants

Abstract Medicinal plants have long been prescribed in Thailand for centuries. Different constituents of extracts have been used for treating of various infectious diseases. However, there is even less information available regarding the use in fungal skin infection. In order to assess traditional Thai claims about the therapeutic potential, this study is focused on exploring the anti-dermatophyte property of the plants that are currently used as traditional medicines. The potential of four different plant species were selected for investigate in vitro anti-dermatophyte activity. Ethanolic extracts of Chromolaena odorata (L.), Ageratina adenophora (Spreng.), Eclipta prostrate (Linn.), and Acorus calamus (L.). were analysed for their total phenolic content as well as total flavonoid content and were then subjected to test of their anti-dermatophyte properties using agar well diffusion method. Qualitative flavonoids and phenolics analysis of the extracts showed their biologically active constituents. Among the species examined, the result indicated that most of the extracts demonstrated anti-dermatophyte activity. In particular, A. calamus showed the highest efficacy against test organisms. The experiment confirmed the chemical constituents and efficacy of some selected plants and provides a scientific confirmation of the use of Thai plants in traditional medicine for fungal skin infections.

Resumo As plantas medicinais são prescritas há muito tempo na Tailândia, há séculos. Diferentes constituintes de extratos têm sido usados para o tratamento de várias doenças infecciosas. No entanto, existem ainda menos informações disponíveis sobre o uso em infecções fúngicas da pele. A fim de avaliar as alegações tradicionais tailandesas sobre o potencial terapêutico, este estudo está focado em explorar a propriedade antidermatófita das plantas que são usadas atualmente como medicamentos tradicionais. O potencial de quatro espécies de plantas diferentes foi selecionado para investigar a atividade antidermatófita in vitro. Extratos etanólicos de Chromolaena odorata (L.), Ageratina adenophora (Spreng.), Eclipta prostrate (Linn.) e Acorus calamus (L.) foram analisados quanto ao seu conteúdo fenólico total, bem como ao conteúdo de flavonoides totais. E então submetidos ao teste de suas propriedades antidermatófitas usando o método de difusão em ágar bem. A análise qualitativa de flavonoides e fenólicos dos extratos mostrou seus constituintes biologicamente ativos. Entre as espécies examinadas, o resultado indicou que a maioria dos extratos demonstrou atividade antidermatófita. Em particular, A. calamus mostrou a maior eficácia contra organismos de teste. O experimento confirmou os constituintes químicos e a eficácia de algumas plantas selecionadas e fornece uma confirmação científica do uso de plantas tailandesas na medicina tradicional para infecções fúngicas da pele.

Dermatophytoses in patients attended from a private clinical analysis laboratory in João Pessoa-PB, between 2015 to 2019 / Dermatofitoses em pacientes atendidos em um laboratório privado de João Pessoa-PB, entre 2015 a 2019

Introduction: dermatophytoses or "tineas" are characterized by being mycoses caused by fungi of the genera Epidermophyton, Trichophyton and Microsporum. These mycotic infections can present themselves as a form of lesions that affect the skin, hair and nails of individuals of both genders and all ages. Objective: to elucidate the epidemiological profile of dermatophytoses in patients examined by a private clinical analysis laboratory in João Pessoa-PB, between 2015 and 2019. Methodology: this is an epidemiological, analytical, retrospective and documentary study, in which data collection took place at the Clinical Pathology Laboratory ­ "HEMATO", located in João Pessoa ­ PB. Results: the profile of those affected was predominantly female (58.5%), 18 to 59 years old (38.4%), white (53.6%) and with lesions, mainly in skin glabrous (38.5%), feet (33.3%) and nails (12.8%). When relating the age group to the injury site, it was noticed that injuries on glabrous skin, feet and nails, were more frequent in individuals aged 18 to 59 years, while injuries to the scalp were mostly found in individuals younger than 18 years old. The most prevalent species were M. canis (31.9%) and T.rubrum (31.9%). When correlating the fungal species with the lesion site, it was noted that M. canis was the main agent responsible for lesions in glabrous skin, scalp and hands, while T. rubrum was predominantly observed in nails and T. mentagrophytes in feet. Conclusion: it is concluded that the data present in this research can promote the development of indicators and public policies for the population most susceptible to dermatophytosis.

Introdução: dermatofitoses ou tineas se caracterizam por serem micoses causadas por fungos dos gêneros Epidermophyton, Trichophyton e Microsporum. Essas infecções micóticas podem se apresentar na forma de lesões que acometem pele, pelo e unhas de indivíduos de ambos os gêneros e todas as idades. Objetivo: elucidar o perfil epidemiológico de dermatofitoses de pacientes atendidos por um laboratório privado de análises clínicas em João Pessoa-PB, entre 2015 a 2019. Metodologia: trata-se de um estudo epidemiológico, analítico, retrospectivo e documental, em que a coleta de dados ocorreu no Laboratório de Patologia Clínica ­ HEMATO, localizado em João Pessoa ­ PB. Resultados: o perfil de acometidos foi predominantemente de indivíduos do sexo feminino (58,5%), com 18 a 59 anos de idade (38,4%), brancos (53,6%) e com lesões, principalmente, em pele glabra (38,5%), pés (33,3%) e unhas (12,8%). Ao relacionar a faixa etária com o local da lesão, percebeu-se que lesões em pele glabra, pés e unhas, foram mais frequentes em indivíduos de 18 a 59 anos, enquanto que lesões no couro cabeludo foram majoritariamente encontradas em indivíduos menos de 18 anos. As espécies mais prevalentes foram M. canis (31,9%) e T. rubrum (31,9%). Ao correlacionar a espécie fúngica com o local da lesão, notou-se que M. canis foi o principal agente responsável por lesões em pele glabra, couro cabeludo e mãos, enquanto T. rubrum foi predominantemente observado em unhas e T. mentagrophytes em pés. Conclusão: os dados obtidos nesta pesquisa podem fomentar o desenvolvimento de indicadores e políticas públicas para a população mais susceptível às dermatofitoses.

Isolation and Molecular Characterization of Trichophyton rubrum from Siddi Tribal Community Residing in North Karnataka Region, India.

Siddi community is the tribal community of African origin living in north Karnataka region since many generations. Few studies have shown the presence of rare dermatophytes of African origin in the Siddi tribal community. This study was performed to detect the presence of such dermatophytes of African origin in the Siddi community. MethodsA total of 1004 samples were collected from 937 patients with superficial infections out of which 102 samples have shown the dermatophytic growth on culture media. All the dermatophytes were identified by phenotypic and physiological characters. ResultsTinea unguium was the prevalent clinical condition and Trichophyton mentagrophytes was the commonest etiological agent to cause dermatophytosis. Two isolates have shown similar macroscopic and microscopic features of as dermatophyte of African origin species (Trichophyton soudanense) and subjected to sequencing of internal transcribed spacer region (ITS) and identified as Trichophyton rubrum. ConclusionsTherefore, presence of rare African species was not seen in the migrated tribal community may be due to the existence of community since more than 5 generations and have adapted to local social and religious practices.

Study of onychomycosis

Background: Onychomycosis is one of the most common fungal nail infections caused by Dermatophytes, Non-Dermatophytic Molds (NDM) and Yeast. Though it is not life-threatening, can cause pain, discomfort, and disfigurement. It decreases the nail growth rate. Objectives: This study was carried out to document the clinico-mycological pattern and antifungal susceptibility pattern of onychomycosis.Methods: The study group included 130 consecutive patients with suspected fungal nail infections, attending Dermatology outpatient department of King George Hospital, Visakhapatnam, Andhra Pradesh during November 2012 to August 2014. The nail clippings of the patients were collected and subjected to KOH mounts for direct microscopy and fungal culture and antifungal susceptibility tests.Results: Onychomycosis was common among males (66.92%) than females (33.08%) with highest incidence was in age group 31-40 years (41.37%). Finger or toenails were exclusively involved in 32.18% and 55.18% patients respectively while these were involved concurrently in the rest of the 12.65% patients. Distal and lateral subungual onychomycosis seen in 64.36% of the patients was the most common clinical type. KOH and culture positivity were recorded in 56.92% and 48.46% cases respectively. Dermatophytes (50.58%) were predominant isolate followed by NDM (27.58%) and yeast (21.84%). Clotrimazole and ketoconazole were most effective antifungals against dermatophytes. For NDM, itraconazole, nystatin and amphotericin B and for yeast fluconazole and itraconazole were effective.Conclusions: The present study gives an insight about the aetiological agents causing onychomycosis and their anti-fungal susceptibility pattern in this region. Thus, it can help in taking adequate control measures to prevent it.

Onicomicosis en pediatría: actualización y tratamiento / Pediatric onychomycosis: update and management

Resumen: La onicomicosis (OM) es una infección fúngica de las uñas, cuyo principal agente causal es el Tricophytum rubrum. Si bien es una patología infrecuente en niños, se ha observado un aumento en la prevalencia en el último tiempo. Hasta la fecha, existen diversos estudios y guías clínicas de OM en adultos. Sin embargo, la literatura en edad pediátrica es escasa, lo que dificulta el tratamiento en pediatría. En el presente articulo se revisa la literatura actual, los métodos diagnosticos de OM, datos epidemiológicos locales y globales, y se presentan las opciones de tratamiento disponibles conside rando su eficacia y perfil de seguridad en población pediátrica.

Abstract: Onychomycosis (OM) is a fungal infection of the nails, whose main etiologic agent is Trichophytum rubrum. Although, it is an unusual pathology in children, in the last years an increase in its preva lence has been observed. To date, there are several studies and clinical guidelines for OM in adults. However, literature in children is scarce, which makes pediatric treatment difficult. The objective of this publication was to review the current literature in order to establish diagnostic methods for OM, national and international epidemiological data, and to provide treatment options taking into account their efficiency and safety profile in the pediatric population.

Clinico-Mycological Study of dermatophytosis in a Tertiary Care Hospital

Dermatophytes are fungi that infects the skin, hair and nails. They are hyaline septate moulds with more than hundred species described. Of these, 42 species are considered as valid and less than half are associated with human diseases. Dermatophytoses are infections produced by these and are common in tropical and subtropical areas of the country with high humidity.1 We wanted to speciate dermatophytes using phenotypic methods, analyze the risk factors, and study their clinical correlation.METHODSThe study was conducted in a tertiary care hospital in South India over a period of one year. All newly suspected cases of dermatophytosis attending Dermatology Outpatient Department were selected for the study. Thus, a total of 113 patients were enrolled in the study. Samples from these patients were subjected to direct microscopy and culture was done on Sabouraud Dextrose Agar with antibiotics. Potato dextrose agar was used for enhancement of pigment production. Culture confirmation and speciation were done by tease mount, slide culture and supplemental tests like urease test and hair perforation test. RESULTSThe present study was carried out on 113 clinically diagnosed cases of dermatophytoses. Maximum number of cases occurred in the 11-20 years age group and slight female preponderance was noted. Tinea corporis was the most common type of dermatophytosis, 68 cases (60.2%) followed by mixed type (tinea corporis + tinea cruris) 14 cases (12.4%) and tinea cruris 13 cases (11.5%). Overall positivity by culture was 39% and by direct microscopy 96%. Trichophyton rubrum was the most predominant species - 18 isolates (38.3%) and most of them were isolated from tinea corporis. Trichophyton verrucosum (25.5%) and Trichophyton mentagrophyte (21.3%) were also obtained as major isolates.CONCLUSIONSThis study highlighted that tinea corporis is the commonest clinical type. Trichophyton rubrum is the most predominant species. But we got a fairly good number of Trichophyton verrucosum and Trichophyton mentagrophyte also. Exposure to predisposing factors were present in almost half of the cases. Dermatophytosis is a trivial disease and antifungal agents are the drugs of choice for treatment but identification of predisposing factors and avoidance of these can decrease the incidence of the disease to some extent

Dermatofitos y hongos levaduriformes causantes de micosis superficiales de piel lampiña en un centro dermatológico, San Lorenzo-Paraguay / Dermatophytes and levaduriform fungi causing superficial mycoses of skin in a dermatological center, San Lorenzo-Paraguay

Introducción: las micosis superficiales o dermatomicosis se encuentran entre las enfermedades infecciosas de piel más comunes. Se localizan en las capas superficiales de la piel y sus anexos (pelo y uñas), por esta razón son motivo de consulta dermatológica. De estas micosis, las dermatofitosis, las malasseziosis y las candidiasis cutáneas son las más frecuentes. Objetivo: describir las características epidemiológicas de las micosis superficiales de piel lampiña. Metodología: estudio observacional, retrospectivo y de corte transverso, donde se analizaron fichas epidemiológicas de pacientes que acudieron al Centro de Especialidades Dermatológicas en el periodo comprendido entre julio del 2017 hasta agosto del 2019, con diagnóstico presuntivo de micosis superficiales de piel lampiña. Resultados: se observaron 341 casos de micosis superficiales de piel lampiña. Entre los agentes causales, los dermatofitos fueron los responsables del 56 % (190/341) de los casos; Malassezia spp. 42 % (142/341) y Candida spp. 2 % 9/341. Se observaron 3 casos de micosis mixtas, donde Candida spp. y dermatofitos fueron los agentes causales. Conclusión: entre las micosis superficiales que afectan piel lampiña, se encuentran en primer lugar los dermatofitos seguidos por las malasseziosis. Este reporte constituye un aporte importante para el conocimiento de la epidemiología de las micosis superficiales en nuestro país.

Introduction: superficial mycoses or dermatomycosis are among the most common skin infectious diseases. These are located in the superficial layers of the skin and its annexes (hair and nails), for this reason it´s a frecuent cause of medical consult. Of these mycoses, dermatophytosis, malasseziosis and cutaneous candidiasis are the most frequent. Objectives: describe the epidemiological characteristics of superficial mycoses of skin. Methodology: observational, retrospective and cross-sectional study, where epidemiological records of patients who were attended at the Dermatological Specialties Center were analyzed in the period from July 2017 to August 2019, with presumptive diagnosis of superficial mycoses of skin. Results: 341 cases of superficial mycosis of skin were observed. Among the causative agents, dermatophytes were responsible for 56 % (190/341) of the cases; Malassezia sp. 42 % (142/341) and Candida sp. 2 % (9/341). Three cases of mixed mycosis were observed; Candida spp. and Dermatophytes were the causative agents. Conclusion: among the superficial mycoses of skin, dermatophytes followed by malaseziosis are in the first places. This report constitutes an important contribution to the knowledge of the epidemiology of superficial mycoses in our country.

Tiña de la cabeza: características epidemiológicas de 132 casos / Tinea capitis: epidemiological characteristics of 132 cases

Introducción: la tiña de la cabeza es una micosis superficial producida por dermatofitos, más común en niños y excepcional en los adultos. Objetivo: conocer las características epidemiológicas y micológicas de la tiña de la cabeza en pacientes que acudieron al Centro de Especialidades Dermatológicas en la ciudad de San Lorenzo. Metodología: estudio observacional retrospectivo de corte transverso, donde se analizaron fichas y registros de todos los pacientes con sospecha clínica de tiña de la cabeza remitidos al laboratorio del Centro de Especialidades Dermatológicas en el periodo julio 2017 - agosto 2019. Los pacientes fueron sometidos a estudios micológicos directos y cultivos para la confirmación del diagnóstico e identificación del agente etiológico. Se consideró el sexo, edad, residencia, posesión de mascotas domésticas y agente etiológico aislado. Resultados: se estudiaron 132 pacientes con diagnóstico de tiña de la cabeza, 69 (52.3 %) varones y 63 (47.7 %) mujeres. La edad de presentación fue desde 1 año hasta 14 años, con una media de 5 años. El principal agente etiológico aislado fue Microsporum canis 99/132 (75 %) seguido de Trichophyton tonsurans 29/132 (22 %). Conclusiones: los hallazgos epidemiológicos obtenidos coinciden con otros trabajos científicos, destacándose M. canis y T. tonsurans como los principales agentes etiológicos.

Introduction: tinea capitis is a superficial mycosis produced by dermatophytes, more common in children and exceptional in adults. Objectives: to know the epidemiological and mycological characteristics of tinea capitis in patients who were attended in the Dermatological Specialties Center of San Lorenzo. Methodology: retrospective, observational and cross-sectional study, in which the files and records of all patients with clinical suspicion of tinea capitis, referred to the laboratory of the Dermatological Specialties Center in the period july 2017 - august 2019 were analyzed. The patients underwent direct mycological studies and cultures for confirmation of the diagnosis and identification of the etiologic agent. The sex, age, residence, possession of domestic pets and isolated etiological agent were considered. Results: 132 patients with a diagnosis of tinea capitis, 69 (52.3 %) men and 63 (47.7 %) women were studied. The age of presentation was from 1 year to 14 years, with an average of 5 years. The main etiological agent isolated was Microsporum canis 99/132 (75 %) followed by Trichophyton tonsurans 29/132 (22 %). Conclusions: the epidemiological findings obtained are agree with other scientific studies, highlighting M. canis and T. tonsurans as the main etiological agents.

Prevalência de infecções fúngicas em um laboratório de análises clínicas da cidade de Veranópolis, Rio Grande do Sul / Prevalence of the fungal infecctions in a clinical analysis laboratory in the city of Veranópolis, Rio Grande do Sul

Objetivo: As infecções fúngicas, atualmente, constituem um problema de saúde pública, devido à elevada prevalência e frequência com que acometem a população. Fatores predisponentes como condições climáticas, região geográfica e características culturais e socioeconômicas favorecem a ocorrência destas infecções. O objetivo do presente estudo foi determinar a prevalência das infecções fúngicas em pacientes atendidos em um laboratório de análises clínicas na cidade de Veranópolis, Rio Grande do Sul (RS). Métodos: Foi realizado um estudo retrospectivo, por meio da consulta ao banco de dados, de 403 laudos de exames micológicos, direto e cultural, realizados no laboratório durante o período de abril de 2014 a abril de 2017. Resultados: Dentre os laudos analisados no estudo, houve positividade em 251 (62,28%) exames micológicos diretos (EMD) e em 226 (56,08%) exames culturais. As micoses superficiais e cutâneas constituíram as principais infecções diagnosticadas, sendo os fungos dermatófitos os agentes etiológicos mais isolados (69,47%), representados majoritariamente pela espécie Trichophyton mentagrophytes, seguidos por leveduras (20,35%), especialmente as pertencentes ao gênero Candida. Houve predomínio de infecções em pacientes do sexo feminino (64,54% EMD e 61,5% cultura) e adultos de 31 a 60 anos foram os mais acometidos pelas micoses diagnosticadas (58,96% EMD e 60,62% cultura). Conclusão: O conhecimento do perfil epidemiológico pode servir como guia na correta identificação do patógeno no diagnóstico laboratorial, influenciando diretamente no prognóstico e na escolha da conduta terapêutica adequada.

Objective: The fungal infections are a public health issue, because ofthe high prevalence and frequency that they victimize the population. Predisposal factors as bioclimatic conditions, geographic region and cultural and socioeconomic characteristics favor the occurrence of this infections, generating, this way, variation in the prevalence of species in each region. The goal of the present study was to determinate the prevalence of fungal infections in patients in a clinical analysis laboratory in the city of Veranópolis, Rio Grande do Sul (RS). Methods: A retrospective study was made, using the consult of data basis, of 403 direct and culture mycological examination reports made in the laboratory during the period of April 2014 to April 2017. Results: In the analyzed examination reports in the study, there was positivity in 251 (62,28%) mycological direct exams (EMD) and, in 226 (56,08%) cultural exams. The superficial and cutaneous mycosis constituted the mainly diagnosed infections, being the dermatophytic fungi the most isolated etiological factors (69,47%), represented mainly, by the Trichophyton mentagrophytes species, followed by yeasts (20,35%), especially those who belong to the Candida genre. There was prevalence of infections in women patients (64,54% EMD and 61,5% culture). Adults among 31 and 60 years old were the most victimized by the diagnosed mycosis (58,96% EMD e 60,62% cultural). Conclusion: Knowledge of the epidemiological profile can serve as guide in the correct identification of the pathogen in the laboratory diagnosis, influencing directly in the prognosis and in the choice of the right therapeutic conduct

Padronização de uma PCR para diagnóstico molecular de Microsporum canis em amostras de pelos e crostas de cães e gatos / Standardization of a pcr for molecular diagnosis of microsporum canis in samples of fur and crusts of dogs and cats

Objetivou-se neste estudo padronizar um protocolo de reação em cadeia da polimerase (PCR) para detecção de Microsporum canis em amostras de pelos e/ou crostas de cães e gatos. Foram selecionadas 48 amostras previamente identificadas por meio de cultura. Destas, 23 foram positivas para dermatófitos no cultivo. Padronizou-se a PCR a partir de primers desenhados para o alvo M. canis. Sessenta e um por cento (14/23) das amostras positivas para dermatófitos foram identificadas como M. canis em cultura. Desse total, 71,4% (10/14) apresentaram um fragmento de 218pb compatível com o esperado para a espécie fúngica alvo dessa reação. Observou-se uma sensibilidade de 71,4% e especificidade de 100% na PCR, além de uma boa concordância entre essas técnicas de diagnóstico (Kappa: 0,78; P<0,0001). O protocolo utilizado neste estudo apresentou alta especificidade na detecção de M. canis diretamente de amostras de pelos e/ou crostas de cães e gatos, viabilizando um diagnóstico mais rápido e específico, podendo esse protocolo ser empregado como um método confirmatório para agilizar a detecção de M. canis.(AU)

The aim of this study was to standardize a Polymerase Chain Reaction protocol (PCR) for the detection of Microsporum canis in fur and/or crusts of dogs and cats. 48 samples previously identified by culture were selected. Of these, 23 were positive for dermatophytes in culture. PCR was standardized from drawn primers whose target is M. canis. A total of 61% (14/23) of the dermatophyte positive samples were identified as M. canis in culture. Of this total, 71.4% (10/14) presented a fragment of 218bp compatible with that expected for the fungal species target of the reaction. A sensitivity of 71.4% and specificity of 100% in the PCR were observed, in addition to a good agreement between the techniques (Kappa: 0.78; P<0.0001). The protocol used in this study showed high specificity in the detection of M. canis directly from fur and/or crusts of dogs and cats, making possible a faster and more specific diagnosis. This protocol could be used as a confirmatory method, speeding the detection of M. canis.(AU)

In vitro susceptibility of dermatophytes to oral antifungal drugs and amphotericin B in Uttar Pradesh, India

Background: Dermatophytosis is a major public health problem in our country. Although resistance to conventional oral and topical antifungal agents is being increasingly encountered, the sensitivity pattern of dermatophytes has not been systematically analysed. Aims: We aimed to determine the sensitivity pattern of dermatophyte isolates to amphotericin B and six oral antifungal drugs. Materials and Methods: Patients with dermatophytosis attending the outpatient department of dermatology were enrolled in the study. Samples were collected for mycological examination and in vitro antifungal sensitivity testing was done by broth microdilution as per the Clinical and Laboratory Standard Institute M38-A standards. Results: A total of 804 patients were enrolled. Specimens from 185 patients (23%) were both KOH and culture positive, and 44 of these isolates (41 Trichophyton mentagrophytes and 3 Trichophyton rubrum) were subjected to sensitivity testing. Minimum inhibitory concentrations (MIC) of itraconazole, ketoconazole, voriconazole and amphotericin B were comparable. The median MIC to fluconazole was higher than the other tested drugs. Dermatophytes were most susceptible to ketoconazole and voriconazole, followed by itraconazole, amphotericin B, fluconazole and griseofulvin. A high incidence of resistance was found to terbinafine and the difference was statistically significant in comparison to fluconazole, itraconazole, voriconazole, ketoconazole (P = 0.001) and griseofulvin (P = 0.003). The strains were more sensitive to amphotericin B as compared to griseofulvin (P = 0.02) and terbinafine (P < 0.001). Limitations: This was a hospital-based study and may not reflect the true pattern in the community. Only a few of the isolates were selected for study. The clinical response of patients, whose isolates were studied for in vitro sensitivity of the antifungals, was not studied. Conclusions: The sensitivity pattern of dermatophytes to various antifungals including amphotericin B, ketoconazole, voriconazole and itraconazole were determined. The studied isolates were least susceptible to terbinafine.

Prevalence of dermatophytic infections including antifungal susceptibility pattern of dermatophytes in a tertiary care hospital

Background: Dermatophytosis is a commonly encountered superficial fungal infection in the tropical and subtropical countries. The present study was undertaken to study the clinicomycological profile of dermatophytosis and perform antifungal susceptibility testing for the isolated dermatophytes.Methods: This is 2 years cross- sectional observational study including 433 clinically suspected cases of dermatophytoses. Skin, hair and nails were collected, subjected to direct microscopy by Potassium hydroxide (KOH) mount and culture on Sabouraud’s Dextrose Agar (SDA) with chloramphenicol and cycloheximide. Positive growth on culture media was further identified by LPCB mount, slide culture test, growth on Dermatophyte Test Medium, pigment production in corn meal agar with 1% dextrose, urease test and hair perforation test. The isolated dermatophytes were subjected to antifungal susceptibility testing by agar based disc diffusion method.Results: Out of 433 samples, fungal filaments were seen in 308 (71.1%) samples by KOH mount, 259 (59.8%) dermatophytes were isolated from culture. Males (60.5%) were more commonly affected than females (39.5%). Most common age group affected was 21-30 years. Trichophyton mentagrophytes (57.5%) was the most common isolate followed by Trichophyton rubrum (30.1%). Tinea corporis was the most common clinical presentation (52.7%) followed by Tinea unguium (14.1%). Antifungal susceptibility testing showed itraconazole as the most sensitive antifungal agent, while fluconazole was least sensitive.Conclusions: This study provides a scope for assessment of prevalence and clinicomycological profile, which could help in estimation of the problem and hence prevent spread of dermatophytoses with adequate control measures.