Aspergillus species: An emerging pathogen in onychomycosis among diabetics

Wijesuriya, T.M.; Kottahachchi, J; Gunasekara, T.D.C.P.; Bulugahapitiya, Uditha; Ranasinghe, K. N. P.; Fernando, S.S.N.; Weerasekara, M.M.

doi:10.4103/2230-8210.167565

Cited by 23 publications

(3 citation statements)

References 16 publications

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“…Some investigations reported that A. fumigatus is more common in the Western countries, whereas A. flavus is more prevalent in the Asia and Middle East. 31 , 32 In the present work, 33.3% of cases with onychomycosis were recognized; while, Veer et al, 33 and Wijesuriya et al, 34 reported 48.885% of onychomycosis from India and Sri Lanka, respectively. Naghibzadeh et al, 35 detected 1.2% of Aspergillus sinusitis in Tehran, Iran, from 2007 to 2009, whereas 15.9% of Aspergillus sinusitis was reported in the present research.…”

Section: Discussionsupporting

confidence: 43%

A 9-Year Experience of Aspergillus Infections from Isfahan, Iran

Chadeganipour

Mohammadi

2020

IDR

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Purpose Aspergillosis is an important fungal disease affecting millions of individuals worldwide. The genus of Aspergillus consist of various complexes, causing a wide spectrum of diseases from superficial infections in immunocompetent hosts to life-threatening disseminated infections among immunocompromised patients. This study aimed to identify Aspergillus species by phenotypic (total isolates) and molecular tests (35 isolates), obtained from patients in Isfahan (the third-largest city of Iran) between 2010 and 2018, and determine the susceptibility of 35 clinical isolates to itraconazole (ITR), amphotericin-B (AMB), and voriconazole (VOR). Patients and Methods Based on clinical signs, a total of 2385 suspected cases were included in this retrospective study from January 2010 to December 2018. Direct microscopic examination with potassium hydroxide, sabouraud dextrose agar with chloramphenicol, and czapekdox agar media was applied to identify etiologic agents. Thirty-five Aspergillus species collected from January 2016 to December 2018 were identified by PCR-sequencing of ITS1-5.8SrDNA-ITS2 region, and their susceptibility to ITR, AMB, and VOR was determined using E-test. Results Based on direct microscopy and positive culture, 132 out of 2385 suspected cases had Aspergillus infection (5.5%). Fifty-four patients were male, and 78 patients were female. Patients in the age groups of 41–50 and 21–30 years had the highest and lowest frequencies, respectively. Aspergillus flavus/oryzae (n=54), A. fumigatus (n=24), A. niger (n=15), and A. terreus (n=12) were the most prevalent Aspergillus species, respectively. Among 35 Aspergillus species, the MIC ranges of AMB, ITR, and VOR for A. flavus/oryzae, A. niger , and A. terreus were (0.5–4 μg/mL; 0.5–16 μg/mL; 0.25–8 μg/mL), (1 μg/mL, 1 μg/mL, 1 μg/mL), and (4–4 μg/mL, 0.5–1 μg/mL, 0.5–1 μg/mL), respectively. Conclusion Aspergillus infections have a wide spectrum of clinical manifestations and often occur in immunocompromised patients. Accurate identification at the species level is essential since the emergence of cryptic species is connected to different patterns of AFST that affect patient treatment outcomes. Azole-resistant Aspergillus spp. is a global concern, and the detection of the route of resistance is pivotal to prevent and control infection.

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Section: Discussionsupporting

confidence: 43%

A 9-Year Experience of Aspergillus Infections from Isfahan, Iran

Chadeganipour

Mohammadi

2020

IDR

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“…The latter is an emerging onychomycosis pathogen among diabetics, and the risk of having Aspergillus nail disorders among patients being treated for diabetes increases with the duration of the disease [ 64 ]. In a study conducted in India among patients who were involved in agricultural activities, 77% were diabetic and were confirmed to have Aspergillus onychomycosis [ 64 ]. Nail damage can be noticed in HIV patients and in patients with hormonal imbalance induced by Cushing’s syndrome and hypothyroidism.…”

Section: Risk Factorsmentioning

confidence: 99%

Aspergillus Genus and Its Various Human Superficial and Cutaneous Features

Merad¹,

Derrar²,

Belmokhtar

et al. 2021

Pathogens

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Superficial and cutaneous aspergillosis is a rare fungal disease that is restricted to the outer layers of the skin, nails, and the outer auditory canal, infrequently invading the deeper tissue and viscera, particularly in immunocompromised patients. These mycoses are acquired through two main routes: direct traumatic inoculation or inhalation of airborne fungal spores into paranasal sinuses and lungs. Lesions are classified into three categories: otomycosis, onychomycosis, and cutaneous aspergillosis. Superficial and cutaneous aspergillosis occurs less frequently and therefore remains poorly characterized; it usually involves sites of superficial trauma—namely, at or near intravenous entry catheter site, at the point of traumatic inoculation (orthopaedic inoculation, ear-self-cleaning, schizophrenic ear self-injuries), at surgery incision, and at the site of contact with occlusive dressings, especially in burn patients. Onychomycosis and otomycosis are more seen in immunocompetent patients, while cutaneous aspergillosis is widely described among the immunocompromised individuals. This paper is a review of related literature.

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“…7 Fungal species, mainly yeasts and Aspergillus species, are commonly associated with patients with diabetes mellitus. 8 C. albicans accounts for > 90% of oral and systemic candida infections followed by C. tropicalis, C. parapsilosis, C. glabrata and C. krusei. 9,10 Ayurvedic rasayana consisting of Amulaki/Nelli (Emblica officinalis), Bibhitaki/Bulu(Terminalia bellirica) and Halituki/Aralu (Terminalia chebula) commonly known as "Triphala" is effectively used in Ayurveda.…”

Section: Introductionmentioning

confidence: 99%