Asymptomatic carrier is defined as an individual who has dermatophyte-positive scalp culture without signs or symptoms of tinea capitis. The prevalence of asymptomatic carriage differs from region to region with a rate of 0.1-49%. Anthropophilic dermatophytes, Trichophyton tonsurans and Trichophyton violaceum, have been generally associated with high rates of asymptomatic carriage. Hence, the presence of dermatophytes on healthy scalp hairs of children may be a potential source of infection for schoolmates, playmates and/or households. Although it was also reported in adults, most carriage has been observed in children especially among those between 4 and 8 years of age, while male to female ratios vary between studies. It is still unclear, whether carriers should be treated with topical antifungal shampoos or oral antifungals or both, as some studies indicate that some untreated cases become culture-negative after 2-12 months. This review provides details on related dermatophyte fungi, laboratory diagnosis, epidemiology, ways of spreading as well as treatment and follow-up results of asymptomatic carriage. An integration into the school health programs is proposed, which will render the possible dealing of the subject in a comprehensive and reasonable manner.
Chromogenic Candida agar (OCCA) is a novel medium facilitating isolation and identification of Candida albicans, C. tropicalis, and C. krusei, as well as indicating polyfungal population in clinical samples. We compare the performance of OCCA, to CHROMagar Candida (CAC) and Sabouraud chloramphenicol agar (SCA). Vaginal swab samples from 392 women were simultaneously inoculated onto three study media. A total of 161 (41.1%) were found to be positive for fungi of which 140 (87%) were monofungal, and 21 (13%) polyfungal. One-hundred and fifty-seven samples (97.5%) were positive on CAC, 156 (96.9%) on OCCA, 148 (91.9%) on SCA and 144 (89.4%) samples were positive on all three media. The yeasts were identified by conventional methods including germ tube test, microscopic morphology on cornmeal-Tween 80 agar, and the commercial API 20C AUX. The 182 isolates were C. albicans (n = 104), C. glabrata (n = 51), C. krusei (n = 7), C. tropicalis (n = 5), C. famata (n = 3), C. kefyr (n = 3), C. zeylanoides (n = 3), C. colliculosa (n = 2), and other species of Candida (n = 4). Among the 21 polyfungal populations, 20 (95.2%) were detected in OCCA, 14 (66.7%) in CAC, and 13 (61.9%) in CAC and OCCA (P <0.05). Most polyfungal populations (47.6%) yielded C. albicans + C. glabrata. The efficiency of both chromogenic media for C. albicans was >or=92.9% at 72 h. OCCA is more efficient and reliable for rapidly identifying C. albicans and polyfungal populations than CAC. However, CAC is more efficient for identifying C. krusei and C. tropicalis. A chromogenic agar with a higher isolation rate of yeasts and better detection of polyfungal populations than SCA, is suggested as a medium of first choice when available.
This study aimed to determine the prevalence of yeast fungi in samples from the glans penis and prepuce of circumcised and uncircumcised children. Impression preparations were made on modified Dixon and Leeming-Notman agar without cycloheximide. The isolates were identified by morphological and physiological characteristics. The yeasts were detected in 32 (28.6%) of 112 children, 12 (18.2%) being among 66 circumcised and 20 (43.5%) among 46 uncircumcised children. The most common species was Malassezia globosa (40.6%) followed by, Malassezia furfur (31.3%), Malassezia slooffiae (15.6%), Candida albicans (6.3%), Candida tropicalis (3.1%) and Candida parapsilosis (3.1%). The colonization with yeasts, and especially lipophilic species was more frequently observed among uncircumcised versus circumcised children. While age was not found to be a factor (P > 0.05), circumcision was responsible for increasing the colonization rate by 4.8 times (95% CI: 1.6-14.5) (P < 0.01). The circumcision status was not found to effect the distribution of Malassezia spp.
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