Identification of fungi species in the onychomycosis of institutionalized elderly

Abstract

BACKGROUND Superficial fungal infections are caused by dermatophytes, yeasts or filamentous fungi. They are correlated to the etiologic agent, the level of integrity of the host immune response, the site of the lesion and also the injured tissue. OBJECTIVE The purpose of this study is to isolate and to identify onychomycosis agents in institutionalized elderly (60 years old +). METHODS The identification of the fungi relied upon the combined results of mycological examination, culture isolation and micro cultures observation under light microscopy from nail and interdigital scales, which were collected from 35 elderly with a clinical suspicion of onychomycosis and a control group (9 elderly with healthy interdigital space and nails). Both groups were institutionalized in two nursing homes in Sao Bernardo do Campo, SP, Brazil. RESULTS The nail scrapings showed 51.40% positivity. Of these, dermatophytes were found in 44.40% isolates, 27.78% identified as Trichophyton rubrum and 5.56% each as Trichophyton tonsurans, Trichophyton mentagrophytes and Microsporum gypseum. The second more conspicuous group showed 38.89% yeasts: 16.67% Candida guilliermondii, 11.11% Candida parapsilosis, 5.56% Candida glabrata, and 5.56% Trichosporon asahii. A third group displayed 16.70% filamentous fungi, like Fusarium sp, Aspergillus sp and Neoscytalidium sp (5.56% each). The interdigital scrapings presented a positivity rate of 14.29%. The agents were coincident with the fungi that caused the onychomycosis. In the control group, Candida guilliermondii was found at interdigital space in one person. CONCLUSION Employing a combination of those identification methods, we found no difference between the etiology of the institutionalized elderly onychomycosis from that reported in the literature for the general population.

Onychomycosis in Israel: epidemiological aspects

“…Our Age analysis did not show a marked difference in prevalence of T. rubrum in patients of the over 60‐year group, but did show the dominance of T. rubrum in toenails. Dominance of T. rubrum was shown as well by other investigators from different geographic areas …”

Onychomycosis: a review

“…Onychomycosis can occur at any age though it becomes increasingly common in the elderly, in whom prevalence continues to increase with age. [2][3][4][5][6] Those with persistent trauma to the nail, psoriasis, diabetes, poor peripheral circulation, HIV, immunosuppression and smokers are especially susceptible as well. 7,8 Tinea pedis plantaris and tinea pedis interdigitalis are risk factors for nail infections and commonly co-occur with onychomycosis.…”

Instituições de Longa Permanência para Idosos no Brasil: revisão integrativa da literatura

“…A prevalência de incontinência urinária e os fatores associados (Melo, et al, 2017;Jerez-Roig, Santos, Souza, Amaral, & Lima, 2016), bem como a incontinência fecal , também foi objeto de investigação dos estudos agentes infecciosos e desordens clínicas associadas em idosos institucionalizados (Silva, & Garbaccio, 2016;Torres, et al, 2016;Vasconcellos, et al, 2013).…”