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Tahiliani S, Saraswat A, Lahiri AK, Shah A, Hawelia D, Shah GK, Girdhar M, Rao PN, Raghav PA, Agarwal P, Kharkar RD, Gupta RP, Udare S, Hegde S, Haldar S. Etiological prevalence and antifungal sensitivity patterns of dermatophytosis in India - A multicentric study. Indian J Dermatol Venereol Leprol 2021; 87:800-806. [PMID: 34160163 DOI: 10.25259/ijdvl_1025_19] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2019] [Accepted: 12/01/2020] [Indexed: 11/04/2022]
Abstract
BACKGROUND The prevalence of dermatophytes varies with season, geographical area, socio-economic factors and effective management strategies. AIMS The aim of the study was to assess the prevalence of pathogenic dermatophytes, clinical types of dermatophyte fungal infection, and in vitro antifungal drug susceptibility testing against dermatophytes. METHODS Three hundred and ninety five patients with dermatophytosis were enrolled from five cities (Mumbai, Delhi, Lucknow, Kolkata and Hyderabad) across India. All patients were subjected to clinical examination and investigations, including potassium hydroxide microscopy, fungal culture and antifungal drug susceptibility testing. RESULTS Trichophyton rubrum was the most common species identified (68.4%), followed by T. mentagrophytes (29.3%). Within species, T. mentagrophytes was prevalent in humid environmental conditions (Mumbai and Kolkata), whereas T. rubrum was prevalent in noncoastal areas (Delhi, Lucknow and Hyderabad). Tinea corporis (71.4%) and tinea cruris (62.0%) were the common clinical types observed. antifungal drug susceptibility testing data indicated that minimum inhibitory concentration required to inhibit the growth of 90% of organisms (MIC-90) was lowest for griseofulvin (0.25-3.0 μg/mL). Among oral antifungals, the mean MIC of itraconazole was within the range (0.84 [0.252] μg/ mL), whereas high mean MIC values were reported for terbinafine (0.05 [0.043] μg/mL). Among topical agents, lowest mean MIC values were reported for luliconazole (0.29 [0.286] μg/mL), eberconazole (0.32 [0.251]) μg/mL and amorolfine (0.60 [0.306]) μg/mL. LIMITATIONS Lack of correlation between in vitro antifungal susceptibility and clinical outcome and absence of defined MIC breakpoints. CONCLUSION T. rubrum was the most common, followed by T. mentagrophytes as an emerging/codominant fungal isolate in India. Tinea corporis was the most common clinical type of dermatophytosis. Mean MIC of terbinafine was above the reference range, while it was within the range for itraconazole; griseofulvin had the lowest mean MIC. Luliconazole presented the lowest mean MIC values across cities.
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Affiliation(s)
- Sushil Tahiliani
- Dr. Tahiliani's Clinic, A 201/202, Gasper Enclave Ambedkar Road, Pali Market, Next to Gold's Gym, Bandra West, Mumbai, Maharashtra, India
| | - Abir Saraswat
- Indushree Skin Clinic, Near Hotel Bandhan, Faizabad Road, Indiranagar Colony, Lucknow, Uttar Pradesh, India
| | - A K Lahiri
- Skin and Laser Clinic, 204, Amsri Plaza, Sarojini Devi Road, Near to Domino's Pizza, Secunderabad, Telangana, India
| | - Avani Shah
- Dr. Miskeen's Central Clinical Microbiology Laboratory, Nirmal, 1st Floor, Behind Amrapali Hotel, Near Gadkari Rangayatan, Old Mumbai-Pune Road, Thane (West), Thane, Maharashtra, India
| | - Dinesh Hawelia
- Dr.Hawelia's Skin Clinic, 1st Floor, 245A, Chittaranjan Avenue, Kolkata, West Bengal, India
| | - G K Shah
- Skin Zone, No. 404, Vini Elegance, Above Tanishq Jewellers, L. T. Road, Borivali (West), Mumbai, Maharashtra, India
| | - Mukesh Girdhar
- Dr Mukesh Girdhar's Skin Clinic, 101, 1st Floor, Rishab Tower, Community Centre, Karkardooma, Anand Vihar, Delhi, India
| | - P Narasimha Rao
- Comprehensive Dermatology Clinic, Plot No 4, Satya Apartment, Masab Tank, Opposite Polytechnic College, Beside Golconda Hotel, Hyderabad, Telangana, India
| | - Potharaju Arun Raghav
- Comprehensive Dermatology Clinic, Plot No 4, Satya Apartment, Masab Tank, Opposite Polytechnic College, Beside Golconda Hotel, Hyderabad, Telangana, India
| | - Pramod Agarwal
- Yuva Skin and Laser Center, A-1031, A-Block, Indira Nagar, Lucknow, Uttar Pradesh, India
| | - R D Kharkar
- Dr. Kharkar's Skin Clinic, Room No 55 , 5th Floor, Dattani Chambers, S V Road, Opposite Shantinath Shopping Centre, Malad West, Mumbai, Maharashtra, India
| | - R P Gupta
- GNH Excel Medical Centre, BN-56, Jhulelal Mandir Marg, Shalimar Bagh, Block BN, Poorbi Shalimar Bag, Shalimar Bagh, Delhi, India
| | - Satish Udare
- Sparkle Skin and Aesthetic Centre, Shanti Center Building, Sector 17, Vashi, Navi Mumbai, India
| | - Sudha Hegde
- Dr. Sudha Hegade Clinic, 101, 1st Floor, Eknath Apartment, Near Paanch Rasta, Above Real Pharmacy, M G Road, Mulund (West), Mumbai, Maharashtra, India
| | - Susmit Haldar
- Calcutta Skin Institute, 169, Scheme 6 M, C I T Road, Kankurgachi, Kolkata, West Bengal, India
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Markantonatou AM, Samaras K, Zachrou E, Vyzantiadis TA. Comparison of Four Methods for the in vitro Susceptibility Testing of Dermatophytes. Front Microbiol 2020; 11:1593. [PMID: 32760372 PMCID: PMC7371995 DOI: 10.3389/fmicb.2020.01593] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2020] [Accepted: 06/18/2020] [Indexed: 12/05/2022] Open
Abstract
Objectives Infections caused by dermatophytes affect a high percentage of the population. Antifungal susceptibility testing (AST) can offer useful information about the susceptibility profiles of the pathogens as well as the concomitant documentation of the appropriate treatment. However, the slow growth rate of these fungi and their poor sporulation are factors that can delay and affect the performance of the AST. The proposed methods by the CLSI or the EUCAST are both laborious for the everyday routine. There are alternative applications which propose the use of an inoculum, consisting of a conidia-mycelium mixture or even plain mycelia, as well as the use of resazurin in order to facilitate the reading. The aim of this study was to compare these approaches to the EUCAST method and evaluate their performance. Methods Three alternative methods were compared to the EUCAST proposed methodology for conidia forming molds. The last was defined as the reference method. The methods under evaluation were (a) a fragmented mycelia method, (b) the EUCAST method with the addition of resazurin sodium salt solution and (c) the fragmented mycelia method with the addition of resazurin sodium salt solution. Twenty-two isolates (8 Trichophyton interdigitale, 8 T. rubrum, and 6 Microsporum canis) were tested against the antifungal agents of griseofulvin, terbinafine, fluconazole, and itraconazole. Results The essential agreement between the methods was calculated in percentages and a statistical analysis of the results was performed. Data evaluation revealed sufficient overall agreement of the methods with the addition of resazurin to the initial “uncolored” methods (98.9 and 97.5% for the EUCAST and the fragmented mycelia methods, respectively). The fragmented mycelia method exhibited a relatively sufficient overall agreement in comparison to the EUCAST method (90%) and not a satisfactory correlation, probably as a result of various issues of standardization. Conclusion The EUCAST method was found to be the more reliable one, whereas the addition of resazurin sodium salt solution facilitates the reading and provides a reliable and objective evaluation. The fragmented mycelia method could serve as an alternative that should be applied only in cases of poor or no sporulating dermatophytes.
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Affiliation(s)
- Anthi-Marina Markantonatou
- First Department of Microbiology, Medical School, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Konstantinos Samaras
- First Department of Microbiology, Medical School, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Evaggelia Zachrou
- First Department of Microbiology, Medical School, Aristotle University of Thessaloniki, Thessaloniki, Greece
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Velázquez-Dávila LA, Galindo-Rodríguez SA, Pérez-López LA, González-González MG, Álvarez-Román R. In vitro and in vivo Methods for the Evaluation of Natural Products against Dermatophytes. Nat Prod Commun 2017. [DOI: 10.1177/1934578x1701200239] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Dermatomycoses are infections caused by fungi called dermatophytes; these affect 20–25% of the world population and the incidence continues to grow each year. Recently, an alternative for the treatment of these diseases is the use of natural products, thanks to the fact that they possess great chemical diversity and thus biological activity. However, to understand the therapeutic potential of natural products, their microbiological assessment presents certain limitations. Currently, there is no established reference method to determine the antifungal capacity in vitro and in vivo of natural products (i.e., essential oils). This review focuses on describing the various microbiological methods as well as the many adaptations used to evaluate the antifungal activity of natural products both in vitro and in vivo. In addition, the antifungal evaluation of natural products formulated in creams, gels, nanoemulsions, nanocapsules and solid lipid nanoparticles is included.
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Affiliation(s)
- Lily A. Velázquez-Dávila
- Universidad Autónoma de Nuevo León, Facultad de Ciencias Biológicas, Departamento de Química Analítica, Pedro de Alba y Manuel L. Barragán s/n, Cd. Universitaria, C.P. 66451, San Nicolás de los Garza, Nuevo León, México
| | - Sergio A. Galindo-Rodríguez
- Universidad Autónoma de Nuevo León, Facultad de Ciencias Biológicas, Departamento de Química Analítica, Pedro de Alba y Manuel L. Barragán s/n, Cd. Universitaria, C.P. 66451, San Nicolás de los Garza, Nuevo León, México
| | - Luis A. Pérez-López
- Departamento de Química Analítica, Universidad Autónoma de Nuevo León, Facultad de Medicina, C.P. 64460, Monterrey, Nuevo León, México
| | - M. Gloria González-González
- Universidad Autónoma de Nuevo León, Facultad de Medicina, Departamento de Microbiología, Av. Fracisco I. Madero y Dr. Eduardo Aguirre Pequeño s/n, Col. Mitras Centro, C.P. 64460, Monterrey, Nuevo León, México
| | - Rocío Álvarez-Román
- Departamento de Química Analítica, Universidad Autónoma de Nuevo León, Facultad de Medicina, C.P. 64460, Monterrey, Nuevo León, México
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