Background: There has been increase in cases of Dermatophytosis in recent past with emergence of antifungal resistant strains due to inappropriate use of antifungals and poor antifungal policy. There is limited data in literature on antifungal susceptibility testing (AFST). The present study determines the profile and AFST of dermatophytosis.Methods and materials: A prospective study was conducted on patients with superficial fungal infections over a period of 11 months (October 2018 to August 2019). Skin scrapings, hair, and nail clippings were processed by standard fungal culture methods. AFST was performed by using E-test strips (HiMedia) of fluconazole, itraconazole and terbinafine on Sabouraud's Dextrose Agar plates and interpreted according to CLSI (M38A).Results: A total of 29 dermatophytes were isolated from 115 (skin = 63, Nail = 43, scales = 12, Hair = 7) samples (positivity = 25.2%). Out of 29 culture positive patients, 20 presented as tinea corporis, 4 as tinea cruris, 2 as tinea capitis, 1 as tinea incognito and 3 as onychomycosis. T. tonsurans was the most common dermatophyte, 42% (N=12), followed by T. rubrum, 35% (N = 10), T. mentagrophytes, 17% (N = 5) and M. canis, 3% (N=1) and T. megninii, 3% (N=1). AFST of all 29 isolates revealed that 25 isolates showed MIC in susceptible range for itraconazole (0.023 to 0.75 mcg/ml), while, one isolate of T. rubrum and one of T. tonsurans showed higher MICs. Two isolates of T. tonsurans showed lower MICs for itraconazole (0.023mcg/ml.). For terbinafine, (0.002-0.008mcg/ml), 18 isolates showed higher MICs. For fluconazole (range 0.5-4 mcg/ml) only four isolates showed MIC in range while rest 25 showed higher MICs (>256mcg/ml) .The results were communicated to the dermatologists and appropriate changes were made in patient's therapy. Conclusion:The emergence of drug-resistant dermatophytes highlights the need of AFST, antifungal stewardship and development of strong antifungal policy to aid clinicians for instituting appropriate antifungals empirically and to change, if needed, after antifungal sensitivity testing results become available.

Background: Cryptococcus neoformans is an encapsulated fungal pathogen that causes severe complications primarily in immunocompromised populations. Monocytes and macrophages serve as first line of innate immune defence in tackling Cryptococcus neoformans infection.Nevertheless, the interplay between Cryptococcus neoformans with macrophages remain elusive. In this study, we investigated the interaction between C. neoformans and THP-1 monocyte derived macrophages, emphasising on the role of cryptococci capsule and the host cytoskeleton remodelling upon interactions.Methods and materials: Cryptococcus neoformans encapsulated H99 (ATCC 208821), Cap64 (ATCC 52816, acapsular mutant of B-3501) and B-3501 (ATCC 34873) strains were used in this study. THP-1 (TIB-202, human acute monocytic leukemia cell line) was induced into adherent, macrophage-like cells in the presence of phorbol myristate acetate. The association of Cryptococcus neoformans Cap64, B-3501 and H99 with THP-1 monocyte derived macrophage, particularly adherence and internalisation events, host actin and microtubule changes were examined using differential fluoresence assay. The images were acquisited using inverted epifluorescence microscope. Association indexes (adherence or internalised yeasts/100 host cells) from three independent experiments were calculated. Additionally, the role of actin and complement receptor type-3 (CR3) in the interaction between C.neoformans Cap64 and THP-1 monocyte derived macrophage were studied upon treatment of infected THP-1 monocyte derived macrophage with cytochalasin D and with a combination of anti-CD18 and anti-CD11b, respectively.Results: Acapsular C. neoformans cells were able to efficiently adhere to and become internalised into THP-1 cells without opsonisation and macrophage activation; while presence of capsule reduced the host-pathogen association. Infection by C. neoformans generally led to localised actin but not microtubule remodelling at the host-pathogen interface. Treatment with Cytochalasin D, an actin polymerisation inhibitor, confirmed that the integrity of actin microfilament is required for both adherence and internalisation of cryptococci into macrophage cells. We further demonstrated that antibody inhibition of complement receptor type 3 (CR3) in THP-1 reduced the association of acapsular cryptococci to the host cells. Conclusion:The results presented new insights on how C. neoformans co-opts professional phagocytic cells during primary infection.

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Fonsecaea pedrosoi (F. pedrosoi) is dematiaceous fungus and is the most common cause for chromoblastomycosis. It affects the exposed skin, mostly of the lower extremities. Arare case of mycotic keratitis was diagnosed in our hospital caused by F. pedrosoi. Corneal sample received in the laboratory was processed by standard mycological methods, F. pedrosoi was isolated, patient was started on antifungals his condition improved and there was no relapse. This case report shows that F. pedrosoi can infect cornea. Further, a prompt diagnosis and vigorous treatment improves patient's clinical condition.