The frequency of <i>Candida parapsilosis</i> in onychomycosis. An epidemiological survey in Israel

Segal, Ricardo; Kimchi, A.; Kritzman, A.; Inbar, Roy; Segal, Zvi

doi:10.1046/j.1439-0507.2000.00582.x

Cited by 36 publications

(26 citation statements)

References 14 publications

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“…Our findings are in line with those of the study by Segal et al [23] and other studies performed in Spain and Hong Kong, which reported C. parapsilosis as the predominant species [24, 25]. The inconsistency among the results may be associated with the use of different identification tools and demographic groups as well as the fact that C. parapsilosis is a complex of closely related species, which require further studies.…”

Section: Discussionsupporting

confidence: 88%

Molecular identification and in-vitro antifungal susceptibility testing of Candida species isolated from patients with onychomycosis

et al. 2015

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Background and Purpose: Candida species are the most opportunistic fungi affecting the nails and resulting in onychomycosis. In this study, we identified and evaluated in-vitro susceptibility of the recovered isolates against fluconazole (FLC), voriconazole (VRC), and clotrimazole (CLT) using the Clinical and Laboratory Standards Institute (CLSI) M27-A3 document.Materials and Methods:From patients with either clinically or mycologically proven onychomycosis, 97 isolates comprising of seven Candida species were isolated, which were identified by both conventional and molecular techniques such as polymerase chain reaction-restriction fragment length polymorphism. In addition, Candida dubliniensis was confirmed by restriction endonuclease analysis. Antifungal susceptibility of each isolate against the three azoles applied in this study was determined using the CLSI microdilution reference method M27-A3. Results: Candida parapsilosis (C. parapsilosis) was the most frequently isolated species (n=44), followed by C. albicans (n=23), C. tropicalis (n=13), C. glabrata (n=7), C. krusei (n=6), C. guilliermondii (n=3), and C. dubliniensis (n=1). All the isolates were susceptible to CLT. VRC had lower minimum inhibitory concentration (MIC) values for the isolates compared to FLC. Geometric mean MIC values of VRC, FLC, and CLT for C. parapsilosis isolates were 0.07 μg/ml, 0.8 μg/ml, and 0.35 μg/ml, respectively. Collectively, all species exhibited greater susceptibility to VRC in comparison to C. albicans (P≤0.001).Conclusion:This study showed that non-albicans Candida species were the most common etiologic agents of non-dermatophyte onychomycosis. The major antifungal agents used in clinics to empirically treat yeast onychomycosis are FLC and CLT. Our data suggested that CLT is a better choice for the treatment of Candida onychomycosis, especially in drug resistant cases.

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Section: Discussionsupporting

confidence: 88%

Molecular identification and in-vitro antifungal susceptibility testing of Candida species isolated from patients with onychomycosis

et al. 2015

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“…According to some investigators, onychomycoses can comprise 30% of all superficial fungal infections and up to half of all nail disorders (251). Onychomycosis predominantly affects adults, especially persons Ͼ50 years of age, as an increase in nail plate thickness and a decrease in nail growth rate make these individuals more susceptible to infection, although infections have also occurred in neonates (141).…”

Section: Onychomycosismentioning

confidence: 99%

“…Risk factors for C. parapsilosis nail infection include previous traumatic dystrophy of the nail and exposure to soil during activities such as gardening (100). General clinical manifestations of Candida nail infections include total dystrophic onychomycosis (seen mostly in chronic mucocutaneous candidiasis), proximal and lateral nail dystrophy (secondary to chronic paronychia), and distal and lateral nail dystrophy (associated with onycholysis and peripheral vascular disease) (111,251). Further clinical manifestations are hyperkeratosis of the nail plate with distortion of the normal curvature and distal erosion, chronic proximal paronychia with irregular transverse grooves and ridges and discoloration of the lateral margin, and isolated distal and lateral onycholysis (48,100).…”

Section: Onychomycosismentioning

confidence: 99%

“…Further clinical manifestations are hyperkeratosis of the nail plate with distortion of the normal curvature and distal erosion, chronic proximal paronychia with irregular transverse grooves and ridges and discoloration of the lateral margin, and isolated distal and lateral onycholysis (48,100). Clinical observations specific to reports of C. parapsilosis nail infections are associated with distal nail disease, in contrast to the case for C. albicans which is more prominent in proximal subungal onychomycosis or total dystrophic onychomycosis (182,251,301). A rare case of C. parapsilosis onychomycosis in which melanonychia was present has also been described (100).…”

Section: Onychomycosismentioning

confidence: 99%

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Candida parapsilosis, an Emerging Fungal Pathogen

2008

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SUMMARY Candida parapsilosis is an emerging major human pathogen that has dramatically increased in significance and prevalence over the past 2 decades, such that C. parapsilosis is now one of the leading causes of invasive candidal disease. Individuals at the highest risk for severe infection include neonates and patients in intensive care units. C. parapsilosis infections are especially associated with hyperalimentation solutions, prosthetic devices, and indwelling catheters, as well as the nosocomial spread of disease through the hands of health care workers. Factors involved in disease pathogenesis include the secretion of hydrolytic enzymes, adhesion to prosthetics, and biofilm formation. New molecular genetic tools are providing additional and much-needed information regarding C. parapsilosis virulence. The emerging information will provide a deeper understanding of C. parapsilosis pathogenesis and facilitate the development of new therapeutic approaches for treating C. parapsilosis infections.

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“…However, C. parapsilosis was the most commonly isolated fungus in toenail onychomycosis in our prospective study. Other researchers also reported that C. parapsilosis is the most common yeast in toenail infections [12,31]. The much greater proportion of Candida species compared to dermatophytes and moulds could be due to Candida contamination in the altered nail.…”

Section: Groups Of Isolated Fungimentioning

confidence: 90%

Successive mycological nail tests for onychomycosis: a strategy to improve diagnosis efficiency

Meireles¹,

Rocha²,

Brilhante³

et al. 2008

Braz J Infect Dis

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Onychomycosis is a fungal infection of nails caused by dermatophytes, yeasts and moulds, accounting for about 50% of onychopathies. A high frequency of onychomycosis caused by Candida species has been reported during the last few years in northeast Brazil, as well as in other regions of the world. A clinical diagnosis of onychomycosis needs to be confirmed through laboratory exams. We evaluated the importance of serial repetition of direct microscopic exams and fungal culture for the diagnosis of onychomycosis in the city of Fortaleza, Ceará, in northeast Brazil. We first made a retrospective study of 127 patients with onychomycosis, identifying the fungi that had been isolated from fingernails and toenails. We then made a prospective study of 120 patients, who were submitted to three successive mycological examinations. Ungual residues were scraped off and directly examined with a microscope and fungal cultures were made. In the retrospective study, in which only one sample was analyzed, the incidence of onychomycosis was 25.0%. In our prospective study, in which we had data from successive mycological examinations, 37.8% had onychomycosis. The most commonly isolated fungi in both studies were yeasts from the genera Candida, especially C albicans, C. parapsilosis and C. tropicalis. We found a high proportion of onychomycosis caused by Candida species. We also concluded that serial repetition of direct microscopic examination and fungal culture, with intervals of 2-5 days improved the diagnosis of onychomycosis. We suggest that this laboratorial strategy is necessary for accurate diagnosis of this type of mycosis, especially when the standard procedures fail to diagnose fungal infection, despite strong clinical suspicion.

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The frequency of Candida parapsilosis in onychomycosis. An epidemiological survey in Israel

Cited by 36 publications

References 14 publications

Molecular identification and in-vitro antifungal susceptibility testing of Candida species isolated from patients with onychomycosis

Molecular identification and in-vitro antifungal susceptibility testing of Candida species isolated from patients with onychomycosis

Candida parapsilosis, an Emerging Fungal Pathogen

Successive mycological nail tests for onychomycosis: a strategy to improve diagnosis efficiency

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