In-vitro activity of 10 antifungal agents against 320 dermatophyte strains using microdilution method in Tehran

Dermatophyte fungi are the etiologic agents of skin infections commonly referred to as ringworm. These infections are not dangerous but as a chronic cutaneous infections they may be difficult to treat and can also cause physical discomfort for patients. They are considered important as a public health problem as well. No information is available regarding the efficacy of antifungal agents against dermatophytes in Tehran. Therefore, in this study we evaluated the efficacy of 10 systemic and topical antifungal medications using CLSI broth microdilution method [M38-A]. The antifungal agents used included griseofulvin, terbinafine, itraconazole, ketoconazole, fluconazole, voriconazole, clotrimazole, ciclopiroxolamine, amorolfine and naftifine.Fifteen different species of dermatophytes which were mostly clinical isolates were used as follows; T. mentagrophytes, T. rubrum, E. floccosum, M. canis, T. verrucosum, T. tonsurans,M. gypseum, T. violaceum, M. ferruginum,M. fulvum, T. schoenleinii, M. racemosum, T. erinacei,T.eriotriphon and Arthrodermabenhamiae. The mean number of fungi particles [conidia] inoculated was 1.25 x 10[4] CFU/mL. Results were read after 7 days of incubation at 28 °C. According to the obtained results,itraconazole and terbinafine showed the lowest and fluconazole had the greatest MIC values for the most fungi tested. Based on the results, it is necessary to do more research and design a reliable standard method for determination of antifungal susceptibility to choose proper antibiotics with fewer side effects and decrease antifungal resistance and risk of treatment failure

molecular epidemiological survey of clinically important dermatophytes in Iran based on specific RFLP profiles of betatubulin gene

Surveillance of dermatophytosis is essential to determine the likely changes in etiological trends and distribution profile of this infection. In this study beta tubulin gene [BT2], was used as the first time in a PCR-RFLP format to clarify the distribution of dermatophytosis agents in some parts of Iran. A total of 603 clinical isolates was obtained from 500 patients in Tehran, Isfahan, Mazandaran and Guilan provinces. The isolates were identified using macro/micro-morphological criteria and electrophoretic patterns of PCR amplicons of BT2 after digestion with each of the restriction enzymes. FatI, Hpy CH4V, MwoI and Alw21L. Among the patients, 59.2% were male and 40.8% female. The most prevalent clinical form was tinea pedis [42.4%], followed by tinea cruris [24.2%], tinea unguium [12.3%], tinea corporis [10.8%], tinea faciei [4%], tinea manuum [3.14%], tinea capitis [3%] and tinea barbae [0.16%], respectively. Trichophyton interdigitale ranked the first, followed by T.rubrum, Epidermophyton floccosum, Microsporum canis, T. tonsurans, T. erinacei and T. violaceum [each 0.49%] and the less frequent species were T. schoenleinii, M. gypseum and T. anamorph of Arthroderma benhamiae [each 0.16%]. A case of scalp infection by E. floccosum was an exceptional event in the study. No case of T.verrucosum was found. Trichophyton species and E. floccosum are yet the predominant agents of infection in Iran, while Microsporum species are decreasing. T.interdigitale and Tinea pedis remain as the most causal agent and clinical form of dermatophytosis, respectively. it seems that BT2 can be a useful genetic marker for epidemiological survey of common pathogenic dermatophytes