The prevalence of Candida onychomycosis in Southeastern Serbia from 2011 to 2015

Abstract

Despite the increasing of onychomycosis caused by Candida spp., in referent literature, there is still data insufficiency about this nail infection. The objectives of this retrospective study were to determine epidemiological characteristics of Candida onychomycosis, the antifungal susceptibility of isolated species in vitro, and to compare the results of antifungal susceptibility testing with conducted treatment in period from 2011 to the end of March 2015. Out of 761 patients who were underwent clinical and mycological examinations, 137 had Candida species isolated from nails. The dominant species was Candida albicans (C. albicans) (36.59%) followed by C. parapsilosis (23.78%), C. krusei (9.76%), and C. guilliermondii (6.71%). Antifungal susceptibility in vitro testing showed good susceptibility to antimycotics, except C. krusei, which was resistance to fluconazole (FCZ) and isolates of C. tropicalis and C. glabrata which were dose dependent to itraconazole (ITZ) and fluconazole. Evaluation of medical histories determined that combined therapy, which included pulsed systemic regimen of ITZ with topical application of clotrimazole, had better clinical outcomes regarding the proscribed only topical application of clotrimazole. Multidisciplinary approach of dermatologists and mycologists is required in solving the problem of onychomycosis, which is the dominant nail disease.

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

“…We were unable to correlate in vitro antifungal data to in vivo response according to 90/60 rule [32] and it was not in the scope of this study to attempt to correlate in-vitro antifungal data to in-vivo response. The data can aid physicians to choose an effective potential drug for treating onychomycosis patients.…”

Global perspectives for the management of onychomycosis

“…The high prevalence of fungal infections in North America is largely due to the immigration of dermatophytes from other areas of the world such as West Africa and Southeast Asia. The global prevalence of onychomycosis is estimated to be around 5.5%, attributing to 50.0% of all nail disease cases . The risk of onychomycosis increases with age due to poor peripheral circulation, diabetes, repeated nail trauma, longer exposure to pathogenic fungi, suboptimal immune function, inactivity, and/or the inability to maintain good foot care .…”

A practical application of onychomycosis cure – combining patient, physician and regulatory body perspectives

“…Onychomycosis is a fungal infection of the nail unit commonly caused by dermatophytes . Recent studies suggest that onychomycosis has a worldwide prevalence of 5.5%, with a 8.9% prevalence in hospital‐based studies and 4.3% in population‐based studies . Recurrence and relapse are frequently (10–53%) associated with this infection despite the use of treatment, with relapse likely to occur within 2.5 years after successful treatment .…”