Onychomycosis: clinical, mycological and in vitro susceptibility testing of isolates of Trichophyton rubrum

Azambuja, Christiane Venske de Almeida; Pimmel, Luciana Alves; Klafke, Gabriel Baracy; Xavier, Melissa Orzechowski

doi:10.1590/abd1806-4841.20142630

Cited by 28 publications

(29 citation statements)

References 25 publications

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“…FLU showed the reduced susceptibility values in comparison with all tested antifungals. These findings were in line with previous studies [10,[38][39][40][41][42][43][44]46], indicating the low potency of FLU against all dermatophyte species. In our study, the Gm MIC data of GRZ also seem to be higher [9,[39][40][41]44] and/or lower than previous reports [38,42].…”

Section: Discussionsupporting

confidence: 93%

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Molecular Characterization and In Vitro Antifungal Susceptibility of 316 Clinical Isolates of Dermatophytes in Iran

et al. 2015

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Dermatophytosis is a common mycotic infection of the skin, nail, and hair, associated with major public health concern worldwide. Various species of dermatophytes show significant differences in susceptibility to antifungals. Here, we present the antifungal susceptibility of a large collection of molecularly identified dermatophyte isolates obtained from tropical region of south of Iran. A total of 9485 patients clinically suspected to have cutaneous fungal infections were examined. Dermatophytosis was confirmed in 1502 cases by direct microscopy and culture. Three hundred and sixteen isolates recovered in culture were identified to species level using PCR sequencing of ITS region and RFLP. Tinea corporis was the most prevalent type of clinical manifestation (35.2 %), followed by tinea cruris (17 %), tinea capitis (12.8 %), tinea pedis (11.3 %), tinea manuum (11 %), tinea unguium (6.9 %), and tinea barbae (5.8 %). Trichophyton interdigitale was the most common isolate (49.36 %), followed by Trichophyton rubrum (18.98 %), Epidermophyton floccosum (13.29 %), Microsporum canis (9.17 %), Arthroderma benhamiae (T. anamorph of A. benhamiae; 5.38 %), and Trichophyton tonsurans (3.79 %). Overall, irrespective of the geographical region, terbinafine was the most potent antifungal against all isolates, with an MIC range of 0.002-0.25 μg/mL, followed by itraconazole (0.004-0.5 μg/mL), griseofulvin (0.125-8 μg/mL), and fluconazole (4-128 μg/mL). Analysis of our data revealed a significant increase in the frequency of A.benhamiae, which definitely warrants further investigation to explore source of this infection in south of Iran. Moreover, terbinafine was the most effective antifungal against all isolates, in vitro.

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Section: Discussionsupporting

confidence: 93%

“…Up until now, few reports have evaluated in vitro activity of some antifungal agents against dermatophyte species in Iran [35][36][37][38]. Our results show similarity to some previous studies [9,[39][40][41][42][43] and also in contrast to some other reports [38,44].…”

Section: Discussionsupporting

confidence: 89%

Molecular Characterization and In Vitro Antifungal Susceptibility of 316 Clinical Isolates of Dermatophytes in Iran

et al. 2015

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“…Therefore, we wanted to determine what types of changes occur in the fungus after ICZ pulse therapy for 3–4 months in vivo , whether the fungi are completely destroyed, and why tinea unguium recurs or fails to heal. Although there have been a large number of reports on the in vitro susceptibility testing of fungi to ICZ, the antifungal effects of ICZ in vivo remain unclear. In vitro , several ultrastructural changes of ICZ‐treated fungus have been shown by scanning electron microscopy (SEM) and transmission electron microscopy (TEM) .…”

Section: Introductionmentioning

confidence: 99%

Ultrastructural changes of Trichophyton rubrum in tinea unguium after itraconazole therapy in vivo observed using scanning electron microscopy

et al. 2018

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Summary Background Tinea unguium is a dermatophyte infection of the nails. Itraconazole is a broad‐spectrum antifungal drug used to treat this disease. It works by interfering with the synthesis of ergosterol in the cell membrane, thus causing changes that can be seen under scanning electron microscopy (SEM). Aim To observe under SEM the in vivo ultrastructural changes of tinea unguium caused by Trichophyton rubrum before and after itraconazole (ICZ) therapy, and to explore the in vivo antifungal effect of ICZ. Methods Ten outpatients diagnosed by mycology and SEM as having with tinea unguium caused by T. rubrum were recruited. They received ICZ pulse therapy (200 mg twice/day for 1 week, stop for 3 weeks, repeated for 3–4 months). Clinical change, mycology and SEM results were obtained after therapy. Results After ICZ therapy, 3 of the 10 cases were positive by both mycology and SEM; the latter showed completely dry, shrivelled, curved and folded hyphae with a relatively smooth surface or local destruction. Several hyphae remained intact with only some local bumps or crimps. The other cases were negative by SEM, but two were positive by mycology. Conclusion In vivo ultrastructural changes of hyphae of T. rubrum in tinea unguium after ICZ treatment could be seen under SEM, demonstrating that ICZ fungistasis was effective and that SEM is a good tool for evaluating the effectiveness of ICZ in vivo. To our knowledge, this study is the first to show by SEM ICZ permeates the affected nail plate via the nail bed capillaries.

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“…This may have been due to emergence of antifungal resistance. [18,19] This in turn, may have been caused by irrational use of antifungal agents, especially when combined with steroids. Use of the latter results in alleviation of…”

Section: Resultsmentioning

confidence: 99%

A Clinico- Epidemiological Study Superficial Cutaneous Fungal Infection in Elderly Patients

Achar¹,

Ghoshal²,

Samanta³

et al. 2017

Ann. Int. Med. Den.Res.

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Background: The proportion of elderly population keeps on increasing. The number of dermatoses, and fungal infections, in turn continues to increase. There has been a recent upsurge of superficial cutaneous fungal infections. This observational cross sectional study aims to describe the clinico epidemiological pattern of patients presenting with the same, with some investigation as KOH mount and culture (in some cases) In total, 156 patients (103 males 53 females) of age between 60 and 84 years were evaluated, with mean duration of 10.3 months (male) and 12.9 months (female). Most patients came from farming families. The commonest coexisting disease was diabetes mellitus (type 2), followed by hypertension. The commonest site of infection was the body (tinea corporis, 56.4%), followed by onychomycosis (37.8%). This was followed respectively by tinea pedis (16.6%), tinea cruris (7.6%), tinea mannum (5%), tinea faciei (2.5%) balanoposthitis and oral candidiasis (0.6% each). It was seen that 86 patients (55.1%) had history of self/ non dermatologist prescribed medication. Most 62 (39.8%) of them had received over the counter steroid combinations (OTC, combination mixtures containing a mild to moderate potency steroid with clotrimazole/ miconazole and gentamycin/ ofloxacin). Most of the patients had extensive involvement as evident from the pattern of infection. Here, the scope of treating a patient with only topical therapy is excluded. Even then, an average patient (more than half as in the current study) attends the specialist after having received some or the other nonspecific therapy. Thus, proper referral and treatment with adequate drugs is pertinent. Methods: ?. Results: ?. Conclusion: ?

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Onychomycosis: clinical, mycological and in vitro susceptibility testing of isolates of Trichophyton rubrum

Cited by 28 publications

References 25 publications

Molecular Characterization and In Vitro Antifungal Susceptibility of 316 Clinical Isolates of Dermatophytes in Iran

Molecular Characterization and In Vitro Antifungal Susceptibility of 316 Clinical Isolates of Dermatophytes in Iran

Ultrastructural changes of Trichophyton rubrum in tinea unguium after itraconazole therapy in vivo observed using scanning electron microscopy

A Clinico- Epidemiological Study Superficial Cutaneous Fungal Infection in Elderly Patients

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