Are polar extracts and essential oil from Origanum vulgare Linn. (oregano) an alternative against itraconazole-resistant dermatophytes from veterinary cases?

Although the conventional therapy against dermatophytosis is based on antifungal drugs and environmental disinfection, the emergence of itraconazole(ITZ)-resistant dermatophytes has encouraged the search for active compounds, such as Origanum vulgare L. (oregano) essential oil (EO). However, little is known about its effect in polar extracts or the mechanism of action of these extracts and EO. We investigated the antifungal activity of four polar extracts and one EO from oregano against ITZ-susceptible and ITZ-resistant dermatophytes and their action mechanism. Polar extracts were prepared as infusions at 10 (INF10) and 60 (INF60) minutes, decoction (DEC) and hydroalcoholic extract (HAE); EO was purchased. All extracts and itraconazole were tested against Microsporum gypseum, M. canis, M. nanum, Trichophyton mentagrophytes and T. verrucosum isolated from cats, dogs and cattle (n = 28), and humans (n = 2) (M38-A2, CLSI). Among polar extract, DEC stood out as antifungal, followed by INF10 and INF60; HAE was little active. For EO, all isolates were susceptible, including ITZ-resistant dermatophytes. EO was selected for action mechanism assays, and acted in cell wall and plasmatic membrane by complexing with fungal ergosterol. By chromatographic analysis, 4-hydroxibenzoic acid was the most prevalent compound in all polar extracts, followed by syringic acid and caffeic acid; luteolin was present only in HAE. For EO, carvacrol was the major compound (73.9%); followed by γ-terpinene (3.6%) and thymol (3.0%). These findings showed that the extract type of oregano has influenced the antifungal action on dermatophytes, highlight EO and DEC, that are promising as antifungal agent, including against ITZ-resistant dermatophytes.

Common dermatophytes and in vitro anti-fungal susceptibility testing in patients attending the Dermatological Clinic at the Hospital for Tropical Medicine, Bangkok.

Dermatophytes comprising the genera Trichophyton, Microsporum, and Epidermophyton are important causes of superficial mycoses. The number of infected patients and the distribution of species of these organisms in our hospital were unknown. We therefore aimed to investigate the clinical pattern of dermatophyte infections and to identify the species of these dermatophytes at the Dermatological Clinic of the Hospital for Tropical Medicine, Faculty of Tropical Medicine, Mahidol University, Bangkok in a 1-year period. Twenty-six patients who had typical dermatophytosis lesions were recruited (27 specimens); 17 were female (65.38%) and 9 (34.62%) were male. The age range of the patients was 16-92 years. In total, nine dermatophyte isolates were identified by macroscopic and microscopic morphological characteristics. We found Microsporum canis (four isolates), Trichophyton mentagrophytes complex (one), Trichophyton rubrum (two), Trichophyton verrucosum (one), and Trichophyton tonsurans (one). The in vitro susceptibility profiles of seven antifungal agents against the nine dermatophytes were as follows (minimum inhibitory concentration ranges in µg/ml): The results were as follows (MIC ranges in µg/ml): ciclopirox, ≤0.06-0.5, griseofulvin ≤0.06-0.5, itraconazole ≤0.002-0.06, posaconazole ≤0.015-0.03, voriconazole ≤0.02-≥1, fluconazole ≤0.08-8, and terbinafine ≤0.01-0.125. This study represents the current state of dermatophyte infections in a metropolitan area of Bangkok, Thailand.

Topical and systemic antifungals in dermatology practice.

INTRODUCTION: Dermatophytosis is generally defined as an infection of the hair, nails, or glabrous skin. These infections are caused by the keratinophilic fungi Trichophyton spp., Microsporum spp., and Epidermophyton, which have been recovered from both symptomatic and asymptomatic individuals. Although dermatophytosis is generally not a life-threatening condition, these types of infections are among the most common infections worldwide, and their incidence has continued to increase consistently in recent years. Area covered: This article provides an overview of the general characteristics of dermatophytes, including their taxonomy and epidemiology, as well as the different clinical forms and laboratory diagnostics of dermatophytosis. We further classify the topical and systemic antifungal compounds currently used to treat dermatophyte infections. Expert commentary: Antifungal therapy is a central component of patient management for dermatophytosis, and depending on the strategy chosen, topical and/or systemic drugs can be used. However, for effective treatment, it is important to correctly determine the causal agents at the species level, which will enable administration of suitable therapeutics and initiation of appropriate management strategies.

Performance of the Real Fungus-ID kit based on multiplex RT-PCR assay for the rapid detection and identification of Trichophyton spp. and Microsporum spp. in clinical specimens with suspected dermatophyte infection.

AIMS: The aim of this study was to evaluate the performance of a commercially available multiplex RT-PCR assay for the rapid detection and identification of dermatophytes directly from clinical samples and cultures. METHODS AND RESULTS: The multiplex RT-PCR assay was used to evaluate 118 clinical isolates from various specimen types and a total of 140 known specimens were compared with both conventional methods, commercially available PCR-REBA, and ITS sequence analysis. In this study, multiplex RT-PCR assay yield significantly more positive results than culture (91·9 vs 39·5%) and conventional methods including KOH microscopy (91·9 vs 71·3%). Although the results among the multiplex RT-PCR, PCR-REBA and ITS sequence analysis were concordant (100%) in 118 clinical isolates, concordant results between multiplex RT-PCR assay and culture were at 66% (78/118). The overall positive rates for the PCR-REBA, multiplex RT-PCR assay and ITS sequence analysis were 98·8, 91·9, and 52·9% respectively. In addition, the concordance rate of multiplex RT-PCR assay and the PCR-REBA assay was 93% (95% confidence interval (CI), 89·9-96·1, P < 0·0001), 93·7% (95% CI, 90·5-96·4, P < 0·0001) sensitivity, 100% (95% CI, 80·0-100, P < 0·0001) specificity, and 99·6% positive and 81% negative predictive values, respectively. Among the 258 samples, the most frequently identified dermatophyte species were Trichophyton rubrum (n = 199, 77·1%) and Trichophyton mentagrophytes (n = 28, 10·9%). CONCLUSIONS: The entire multiplex RT-PCR procedure takes about 3 h, while results from culture can take up to 2-3 weeks. The use of the multiplex RT-PCR molecular diagnostic assay was rapid and reliable for detecting pathogen infections. SIGNIFICANCE AND IMPACT OF THE STUDY: Even though the use of molecular diagnostic technology is more expensive than conventional methods, the clinical and economic benefit of saving time relative to expense remains to be elucidated. Therefore, the multiplex RT-PCR assay may provide the essential information to accelerate therapeutic decisions for earlier and adequate antibiotic treatment in the acute phase of fungal pathogen infections.

Epidemiological studies on Dermatophytosis in human patients in Himachal Pradesh, India.

Dermatophytes are among the common fungal agents implicated in superficial skin infections worldwide. They include species of Trichophyton, Microsporum and Epidermophyton. In hot and humid climates of tropical and subtropical regions, the incidence of these pathogens is higher. We present in this article, the epidemiological data regarding the prevalence of different dermatophyte species involved in superficial mycoses in human patients in the state of Himachal Pradesh (India) and different clinical conditions, age and sex of the patients. A total of 202 samples in the form of skin and nail scrapings, hair follicles were collected from different ringworm/tinea conditions which included: Tinea corporis, T. capitis, T. cruris, T. pedis, T. unguium, T. faciei, T. manuum and T. gladiatorum. On culturing, 74 samples (36.6%) were found positive for dermatophyte spp. Trichophyton spp. was the predominant one (98.65% cases) followed by Microsporum gypseum (1.35% cases). However, we did not recover any Epidermophyton spp. Among the Trichophyton spp., T. mentegrophyte was the predominant spp. (63.5%) followed by T. rubrum (35.1%). The male to female ratio of the positive cases was recorded as 63:11. The most effected age group was 21-50 years (64.9%) followed by 1-20 years (28.4%) and above 50 years (6.8%).

Epidemiologia e etiologia das dermatofitoses em Pernambuco 2005-2010 / Epidemiology and etiology of the dermatophytosis in Pernambuco, 2005-2010

A presente pesquisa teve como objetivos detectar, isolar e identificar espéciesdermatófitos em amostras de pele, pêlos e unhas de 5.590 pacientes oriundos de hospitais públicos de Pernambuco. Os resultados apontaram o Trichophyton rubrum como a espécie de dermatófito mais incidente. O gênero masculino e faixa etária entre 0-20 anos prevaleceram...

Evaluation of therapeutic efficacy of medical shampoo containing terbinafine hydrochloride and chlorhexidine in dogs with dermatophytosis complicated with bacterial infection / 동물의과학연구지

This study evaluated the efficacy and safety of medical shampoo containing terbinafine hydrochloride and chlorhexidine gluconate in dogs with dermatophytos is complicated with bacterial infection. Although several studies in dogs and cats with fungal dermatitis have found that oral administration of terbinafine is effective for controlling clinical signs, the topical form of terbinafine has rarely been studied in dogs and cats. Therefore, this study evaluated the efficacy of medical shampoo containing terbinafine hydrochloride and chlorhexidine gluconate in dogs with dermatophytos is complicated with bacterial infection. Eight dogs infected with Microsporum spp. complicated with bacterial infection were enrolled in this study. These dogs were further blindly divided into Group 1 (no treatment, fourdogs) and group 2 (treated with medical shampoo with terbinafine/chlorhexidine, four dogs). Clinical improvement was evaluated using bacterial and fungal cultural evaluation combined with clinical evaluation. This study found that the medical shampoo has sufficient efficacy to treat varying degrees of dermatophytosis complicated with bacterial infection in dogs, although the speed of improvement differed according to the degree and type of infection. Our study also found that combined therapy using antifungal and antibacterial agents can improve clinical signs more effectively and rapidly, suggesting that concurrent bacterial infection plays a significant role in the development of dermatitis.

Epidemiologia, etiologia e formas clínicas das dermatofitoses em Pernambuco, 1995-2005 / Epidemiology, etiology and clinical presentation of dermatophytosis in Pernambuco, 1995-2005

Num total de 1.238 casos de dermatofitoses, ocorridas na Cidade de Recife /PE, observou-se predomínio das tinhas de couro cabeludo (33,7 por cento) e Trichophyton tonsurans (25,5 por cento), entre 1995 e 1999, enquanto as tinhas de pele glabra (35,5 por cento) e Trichophyton rubrum (34 por cento) foram mais freqüentes entre 2000 e 2005. Detectou-se importante redução do Trichophyton mentagrophytes, no último período.

Out of a total of 1,238 cases of dermatophytosis in the city of Recife (Pernambuco), lesions of the scalp (33.7 percent) and Trichophyton tonsurans (25.5 percent) predominated between 1995 and 2000, while lesions of the hairless skin (35.5 percent) and Trichophyton rubrum (34 percent) were the most frequent between 2000 and 2005. A significant reduction in Trichophyton mentagrophytes was detected in the second of these periods.