Epidemiology, Causative Agents and Clinical Features of Onychomycosis in El-Gharbia Governorate

Bedaiwy, Mohamed Yasser; Metwally, Metwally Abd El-Azeem; El-Zawawy, Nessma; Saba, Heba allah E.

doi:10.21608/ejbo.2017.965.1080

Cited by 13 publications

(19 citation statements)

References 15 publications

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“…A similar prevalence was reported in previous studies. 16 However, other studies reported that C. parapsilosis is the second to C. albicans. 5,11 The variation of Candida species isolated from onychomycosis is well reported.…”

Section: Discussionmentioning

confidence: 98%

“…A similar finding is reported in previous studies. 9,16,21 Previously infrequently isolated Candida species are now increasingly reported from the different geographic regions, indicating a change in the epidemiology of Candida species. 11 This epidemiological variation of Candida species is related to a few variables like geological locale, immunosuppression, prematurity, experimental utilize of the wide range of antimycotics.…”

Section: Discussionmentioning

confidence: 99%

“…14 The prevalence of Candida species is ranging between 3.5% to 58.5% 11,15 and in some literature, it is reported up to 71.4%, in onychomycosis. 16 The epidemiology of Candida species varies in the geographic region and some species are intrinsically resistant to some antifungal agents. This will result in failure of treatment and recurrence of the onychomycosis.…”

Section: Introductionmentioning

confidence: 99%

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Prevalence of Candida species in onychomycosis at a Tertiary Care Hospital Karachi

Kashif¹,

Khan²,

Kumar³

et al. 2021

JRMC

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Objective: This study was designed to determine the frequency of Candida in clinically diagnosed cases of onychomycosis. Study Design: It was a cross-sectional study.Setting: It was conducted in the Department of Microbiology, BMSI, JPMC, Karachi, in a period of one year with the collaboration of the Department of Dermatology, JPMC, Karachi.Materials and Methods: A total of 328 clinical samples have been collected. The fungal isolates were identified according to standard microbiological procedures. Samples were processed for primary screening microscopic test by KOH 20% (potassium hydroxide solution) wet mount. Processing for mycological culture was done by using Sabouraud's dextrose agar (cycloheximide and chloramphenicol), without antibiotics and Dermatophytes test medium. Candida species identification will be achieved through the commercial test of the API ID 32C system.Results: Prevalence of fungal species that isolated from the 328 samples, 14.33% were dermatophytes, 6.40% were non-dermatophytes mould, 23.70% were Candida, 4.87% were mixed growth and 50.30% were negative for growth. Among the 16 mixed isolates, 15 were Candida species, accounting for a total of 28.4% Candida isolates. Out of 93, Candida albicans were 52.68%. Of the 47.32%, 26.88%, 11.82%, 4.30%, 2.15% and1.07%, Candida non albicans C. tropicalis C. parapsilosis, C. glabrata, C. krusei, C. guilliermondii, and Candida utilis respectively.Conclusion: A significant number of onychomycosis cases result from the Candida spp. and Candida albicans were the main species. However, Candida non-albicans species are emerging in onychomycosis. In this manner, legitimate conclusion of the pathogens of onychomycosis is vital for focused treatment.

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Section: Discussionmentioning

confidence: 98%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Prevalence of Candida species in onychomycosis at a Tertiary Care Hospital Karachi

Kashif¹,

Khan²,

Kumar³

et al. 2021

JRMC

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“…In recent studies, Candida spp . were detected as the commonest pathogens in patients with onychomycosis, followed by dermatophytes and then molds 22,23 …”

Section: Discussionmentioning

confidence: 99%

In vitro antifungal susceptibility testing of fungi in patients with onychomycosis

El‐Hamd

Elhameed

Shalaby

et al. 2020

Dermatologic Therapy

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Onychomycosis is the most common nail disorder. To examine in vitro antifungal susceptibility of fungi among onychomycosis patients. The study included 68 patients with onychomycosis. Nail specimens were cultured on Sabouraud dextrose agar and Dermasel agar base‐media. Isolated fungi were subjected to antifungal susceptibility tests against terbinafine, itraconazole, fluconazole, and griseofulvin. Candida species (Candida spp.) were detected in 32.4% of the cases of candidal onychomycosis (n = 37), 23.5% of the cases of distal and lateral subungual onychomycosis (n = 17), and 21.4% of the cases of total dystrophic onychomycosis (n = 14). Candida spp. were sensitive to fluconazole in 73.5%, itraconazole in 58.8%, and terbinafine in 5.9% of the cases. Aspergillus spp. were sensitive to itraconazole in all cases, and terbinafine in 87.5% of cases. Penicillium spp. were sensitive to itraconazole and terbinafine in 88.9% and 77.8% of cases, respectively. Trichophyton spp. were sensitive to terbinafine and resistant to itraconazole. Microsporum spp. were sensitive to itraconazole and resistance to terbinafine. All isolated fungi were resistant to griseofulvin. An increasing proportion of Candida spp. was observed among patients with different clinical varieties of onychomycosis. Candida spp. were highly sensitive to fluconazole and a lesser extent to itraconazole.

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“…Onychomycosis may affect either fingernails or toenails or both, 43 however, toenail involvement is much more common than fingernail involvement. For toenails, the great or second toenail is most frequently affected.…”

Section: Clinical Presentationmentioning

confidence: 99%

Updated Perspectives on the Diagnosis and Management of Onychomycosis

Falotico¹,

Lipner²

2022

CCID

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Onychomycosis is the most common nail disease encountered in clinical practice and can cause pain, difficulty with ambulation, and psycho-social problems. A thorough history and physical examination, including dermoscopy, should be performed for each patient presenting with nail findings suggestive of onychomycosis. Several approaches are available for definitive diagnostic testing, including potassium hydroxide and microscopy, fungal culture, histopathology, polymerase chain reaction, or a combination of techniques. Confirmatory testing should be performed for each patient prior to initiating any antifungal therapies. There are several different therapeutic options available, including oral and topical medications as well as device-based treatments. Oral antifungals are generally recommended for moderate to severe onychomycosis and have higher cure rates, while topical antifungals are recommended for mild to moderate disease and have more favorable safety profiles. Oral terbinafine, itraconazole, and griseofulvin and topical ciclopirox 8% nail lacquer, efinaconazole 10% solution, and tavaborole 5% solution are approved by the Food and Drug Administration for treatment of onychomycosis in the United States and amorolfine 5% nail lacquer is approved in Europe. Laser treatment is approved in the United States for temporary increases in clear nail, but clinical results are suboptimal. Oral fluconazole is not approved in the United States for onychomycosis treatment, but is frequently used off-label with good efficacy. Several novel oral, topical, and over-the-counter therapies are currently under investigation. Physicians should consider the disease severity, infecting pathogen, medication safety, efficacy and cost, and patient age, comorbidities, medication history, and likelihood of compliance when determining management plans. Onychomycosis is a chronic disease with high recurrence rates and patients should be counseled on an appropriate plan to minimize recurrence risk following effective antifungal therapy.

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Epidemiology, Causative Agents and Clinical Features of Onychomycosis in El-Gharbia Governorate

Cited by 13 publications

References 15 publications

Prevalence of Candida species in onychomycosis at a Tertiary Care Hospital Karachi

Prevalence of Candida species in onychomycosis at a Tertiary Care Hospital Karachi

In vitro antifungal susceptibility testing of fungi in patients with onychomycosis

Updated Perspectives on the Diagnosis and Management of Onychomycosis

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