A study on the etiological agent and clinico-mycological correlation of fingernail onychomycosis in eastern India

Valorization of pineapple peel waste for fungal pigment production using Talaromyces albobiverticillius: Insights into antibacterial, antioxidant and textile dyeing properties

The present study explores natural pigments as sustainable alternatives to synthetic textile dyes. Due to their therapeutic applications and easy production, fungal pigments have gained attention. However, data on pigment production using solid-state fermentation and optimization is limited. Milk whey was used to grow Talaromyces sp., followed by an evaluation of pigment production in solid and liquid media. Pineapple peels were used as a cost-effective substrate for pigment production, and a one-factor-at-a-time approach was used to enhance pigment production. Pineapple peel-based media produced 0.523 ± 0.231 mg/g of pigment after eight days of incubation. The crude pigment had promising antibacterial and significant antioxidant properties. The extraction fungal pigment's possible use as an eco-friendly textile dye was assessed through fabric dyeing experiments with different mordants. This work contributes to the valorization of agricultural waste and provides insight into using fungal pigments as sustainable alternatives to synthetic textile dyes.

Clinical and Microbiological Characteristics of Aspergillosis at a Chinese Tertiary Teaching Hospital

BACKGROUND

Aspergillus spp. infection in immunocompromised patients results in increasing morbidity and mortality. This study investigated clinical and microbiological characteristics of aspergillosis in a Chinese tertiary teaching hospital.

METHODS

A total of 114 patients with aspergillosis were included over a 5-year period at Ruijin Hospital. In sum, 114 Aspergillus strains were isolated and identified at species level using matrix-assisted laser desorption ionization time-of-flight mass spectrometry, confirmed by ITS gene region and β-tubulin (BenA) gene sequencing. Sensititre YeastOne was used in vitro to test susceptibility to antifungal drugs: amphotericin B, itraconazole, voriconazole, posaconazole, isavuconazole, micafungin, anidulafungin, and caspofungin.

RESULTS

The median age of the patients was 61 (19) years, men accounted for 53.5% (n=61) of the sample, about 64% were immunocompromised, and 36% had underlying diseases. Pulmonary diseases accounted for 27.2%. Aspergillus isolates were mainly isolated from sputum (n=42, 36.8%). Antifungal therapy was administered to 106 (93.0%) patients and voriconazole (n=76, 66.7%) was the most frequently used as empirical therapy. Aspergillus fumigatus (n=69, 60.5%) was the most common species. There was a 73.7% concordance between MALDI-TOF MS and molecular identification. All Aspergillus isolates showed good susceptibility to anidulafungin and caspofungin.

CONCLUSION

Immunocompromised patients are an at-risk population for aspergillosis, and voriconazole was used as empirical therapy in Ruijin Hospital, China. A. fumigatus was the predominant Aspergillus species causing aspergillosis, and A. flavus - as non-A. fumigatus species are increasing - the second-leading cause of aspergillosis. Anidulafungin and caspofungin were the most active in vitro against the Aspergillus isolates tested. The MALDI-TOF MS method showed good accuracy for identification of common Aspergillus spp. In vitro antifungal-susceptibility testing is crucially important for decisions on effective therapy with aspergillosis.

Identification and in vitro antifungal susceptibility of causative agents of onychomycosis due to Aspergillus species in Mashhad, Iran

Aspergillus species are emerging causative agents of non-dermatophyte mold onychomycosis. In this study, 48 Aspergillus isolates were obtained from patients with onychomycosis in Mashhad, Iran, during 2015–2018. The aim is to identify the Aspergillus isolates to the species level by using partial calmodulin and beta-tubulin gene sequencing and MALDI-TOF MS, and to evaluate their in vitro susceptibility to ten antifungal drugs: terbinafine, itraconazole, voriconazole, posaconazole, ravuconazole, isavuconazole, caspofungin, micafungin, anidulafungin and amphotericin B according to CLSI M38-A3. Our results indicate that A.flavus (n = 38, 79%) is the most common Aspergillus species causing onychomycosis in Mashhad, Iran. Other detected species were A. terreus (n = 3), A. tubingensis (n = 2), A. niger (n = 1), A. welwitschiae (n = 1), A. minisclerotigenes (n = 1), A. citrinoterreus (n = 1) and A. ochraceus (n = 1). Aspergillus flavus, A. terreus and A. niger isolates were correctly identified at the species level by MALDI-TOF MS, while all cryptic species were misidentified. In conclusion, A. flavus is the predominant Aspergillus species causing onychomycosis due to Aspergillus spp. in Mashhad, Iran. MALDI-TOF MS holds promise as a fast and accurate identification tool, particularly for common Aspergillus species. It is important that the current database of reference spectra, representing different Aspergillus species is expanded to increase the precision of the species-level identification. Terbinafine, posaconazole and echinocandins were in vitro most active against the studies Aspergillus isolates and terbinafine could be the first choice for treatment of onychomycosis due to Aspergillus.

Current mycological profile of onychomycosis in Kashmir valley: A hospital-based study

INTRODUCTION

Onychomycosis is a common nail ailment associated with significant physical and psychological morbidity. It is caused by dermatophytes, nondermatophytic molds, and yeasts. Increased prevalence in the recent years is attributed to enhanced longevity, comorbid conditions such as diabetes, avid sports participation, and emergence of HIV.

AIMS AND OBJECTIVES

This study was undertaken to identify the mycological profile and etiological agents associated with this infection.

MATERIALS AND METHODS

One hundred and twenty-nine cases of clinically suspected onychomycosis were included in this study. Clinical patterns were noted, and samples collected from most severely affected nail. They were subjected to direct microscopy and culture.

RESULTS

The microscopic and/or culture examination was positive in 64.34% of cases. The most common clinical type was distal lateral subungual onychomycosis in 42 (50.60%) Candida sp. was the most common fungal agent among yeasts, followed by Trichophyton sp among dermatophytes and Aspergillus among nondermatophytic molds. Females were affected more than males and fingernails were affected more frequently than toenails.

CONCLUSION

Onychomycosis is a significant and important disease which can cause many physical, physiological, and occupational problems, considerably impairing patient quality of life. Hence, fungal cultures are of paramount importance in all suspected cases of onychomycosis because the antifungal agent with an appropriate spectrum of activity can only be used if the underlying fungal pathogen is identified correctly.

Role of tinea unguium and other factors in chronic and recurrent dermatophytosis: A case control study

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Conclusions:

A Review of Onychomycosis Due to Aspergillus Species

Aspergillus spp. are emerging causative agents of non-dermatophyte mould onychomycosis (NDMO). New Aspergillus spp. have recently been described to cause nail infections. The following criteria are required to diagnose onychomycosis due to Aspergillus spp.: (1) positive direct microscopy and (2) repeated culture or molecular detection of Aspergillus spp., provided no dermatophyte was isolated. A review of 42 epidemiological studies showed that onychomycosis due to Aspergillus spp. varies between < 1 and 35% of all cases of onychomycosis in the general population and higher among diabetic populations accounting for up to 71% and the elderly; it is very uncommon among children and adolescence. Aspergillus spp. constitutes 7.7-100% of the proportion of NDMO. The toenails are involved 25 times more frequently than fingernails. A. flavus, A. terreus and A. niger are the most common aetiologic species; other rare and emerging species described include A. tubingensis, A. sydowii, A. alliaceus, A. candidus, A. versicolor, A. unguis, A. persii, A. sclerotiorum, A. uvarum, A. melleus, A. tamarii and A. nomius. The clinical presentation of onychomycosis due to Aspergillus spp. is non-specific but commonly distal-lateral pattern of onychomycosis. A negative culture with a positive KOH may point to a NDM including Aspergillus spp., as the causative agent of onychomycosis. Treatment consists of systemic therapy with terbinafine or itraconazole.

Etiology of Onychomycosis in Patients in Turkey

BACKGROUND

Onychomycosis is a chronic nail infection caused by dermatophytes, Candida, nondermatophyte molds, and Trichosporon. The purpose of this study was to identify the underlying pathogen in patients with onychomycosis in our region.

METHODS

A retrospective analysis of 225 cases with onychomycosis, diagnosed over a 27-month period at the Department of Dermatoveneorology, Bezmialem Vakif University, Istanbul, Turkey, and confirmed with culture, was performed.

RESULTS

Patient age ranged from 2 to 87 years (mean ± SD, 41.59 ± 17.61), and female patients were more commonly affected (120 cases, 53.3%) than male patients. Lateral and distal subungual onychomycosis was detected in 180 cases (80%). Etiologic agents were as follows: Trichophyton rubrum, 77 cases (34.2%); Trichophyton mentagrophytes, 30 cases (13.3%), Candida albicans, 28 cases (12.4%); Candida parapsilosis, 25 cases (11.1%); Acremonium species, one case (0.4%); Aspergillus species, two cases (0.9%); Fusarium species, four cases (1.3%); and Trichosporon species, three cases (1.3%).

CONCLUSIONS

The most frequent isolated etiologic agents were T rubrum for toenails and C albicans for fingernails.

A Study of Onychomycosis at a Tertiary Care Hospital in Eastern Bihar

Background:

Onychomycosis (OM) is a major public health problem which is increasing worldwide. It is associated with high morbidity and causes physical, psychological, and occupational problems in patients.

Aims:

This study aims to study the pattern of etiological agents, clinical features, and severity assessment of OM in this part of India.

Materials and Methods:

Sixty eight clinically suspected patients with positive potassium hydroxide and fungal culture were studied.

Results:

Males were infected more often than females (1.61:1). The most common age group affected was 21–40 years. Finger nails were affected more frequently than toe nails. Distal and lateral subungual OM was the most common (48 cases, 70.59%) clinical pattern. For most of the patients (66.18%), nail involvement was severe. Discoloration was the most common (67 cases, 98.53%) change, followed by subungual hyperkeratosis (51 cases, 75%). Principal causative agents were dermatophytes (55 cases, 80.88%) with Trichophyton rubrum being the most common one (35 cases, 51.47%). In 9 (13.23%) cases, Candida albicans, in 6 (8.82%) Aspergillus niger and in 1 (1.47%) case Acremonium sp. (AC) have been isolated as the sole causative agent. In 2 (2.94%) cases, mixed infection with dermatophyte and Aspergillus and in 1 (1.47%) case dermatophyte and Candida were noted.

Conclusion:

Although dermatophytes were the most common causative agent of OM, nondermatophytic molds, and yeasts were also encountered. The genus and species identification helps in the proper diagnosis and management. Morphological changes in nail may help in presumptive diagnosis of OM.

Mycological Pattern of Dermatomycoses in a Tertiary Care Hospital

Background. Dermatomycoses are not diseases requiring compulsory notifications; rather they cause cosmetic defacements. Indian subcontinent with a varied topography is favorable for various fungal infections. Objective. To look for the epidemiological and mycological profile of superficial mycoses in North India. Methods. Three hundred and fifty-one clinical samples of skin, hair, and nail were examined to find the fungal etiology of the dermatomycoses. Results. Dermatomycoses were seen in 215/351 (61.2%) of cases. Most common isolates obtained were nondermatophyte molds (NDMs) (36.1%), followed by dermatophytes (13.8%) and yeasts (8.6%). Aspergillus niger (9%) was the most common mold. Trichophyton rubrum (4.6%) was the most common dermatophyte isolated, while amongst the yeasts Non-albicans Candida (NAC) species were more common (6%). Many other NDMs like Syncephalastrum spp., Cunninghamella spp., Rhodotorula spp., A. terreus, Scytalidium spp. and Scopulariopsis spp. were also isolated. Conclusion. Our study reflects an increasing role of NDMs (thought to be normal laboratory or environmental contaminants) as a causative agent of dermatomycoses, replacing the dermatophytes. Clinician's awareness of the demographic profile of the population involved along with more studies on dermatomycoses can help in understanding the etiological profile in area, leading to prevention of disease occurrence and cosmetic disfigurement.

The prevalence of fungi in fingernail onychomycosis

BACKGROUND

Fingernail onychomycosis is a fungal infection of the finger nails. It is mainly produced by yeasts, dermatophytes and molds and sometimes it shows a mixed infection. It is a cosmetic issue rather than a medical problem.

AIMS

This study was conducted with the aim of exposing the fungal concept in nail diseases, to introduce nail testing which was underutilized as a diagnostic tool despite being involved in many dermatological conditions, as well as to introduce microbiological techniques in the diagnosis of nail diseases, based on the clinical parameters only.

MATERIALS AND METHODS

A total of 45 samples were tested in our laboratory by using 20% KOH and culture plates of Sabouraud's Dextrose Agar (SDA) which were mixed with chloramphenicol and cycloheximide.

RESULTS

A total of 37.78% samples were identified as positive by culture, among which 17.78% were KOH positive and 20.00% were KOH negative. 62.22% were culture negative. The predominant pathogen was yeast (64.71%), followed by dermatophytes (17.65%). A mixed infection was identified in 11.76%. Scytalidium hyalinum was identified in 5.88% of the cases. Fungi commonly presented in the middle age, between 31-40 years of age, due to trauma at the work site and in women, due to their wet work.

CONCLUSION

This study highlighted the yeast, genus Candida as the main pathogen which caused fingernail onychomycosis in our region. So, it is imperative to diagnose it properly by using microbiological techniques and to treat it properly.