Antifungal Susceptibility Pattern of Non - Dermatophytic Fungi Causing Onychomycosis

Authors

  • Apurva Kaushal FAIZABAD, Uttar Pradesh
  • Pratik Gahalaut Shri Ram Murti Smarak Institute of Medical Sciences, Bareilly
  • R K Goyal Shri Ram Murti Smarak Institute of Medical Sciences, Bareilly
  • Neni Agarwal Shri Ram Murti Smarak Institute of Medical Sciences, Bareilly
  • Nitin Mishra Shri Ram Murti Smarak Institute of Medical Sciences, Bareilly
  • Madhur Kant Rastogi Shri Ram Murti Smarak Institute of Medical Sciences, Bareilly

DOI:

https://doi.org/10.3126/njdvl.v18i1.27120

Keywords:

Antifungal Agents, Fluconazole, Itraconazole, Onychomycosis, Terbinafine

Abstract

Introduction: Non-dermatophytic molds (NDM) are filamentous fungi or yeast, commonly found in nature as saprophytes and plant pathogens. The incidence of onychomycosis due to NDM is 1.45 – 16.6%. NDMs are usually resistant to conventional antifungal treatment.

Objective: To know the anti-fungal susceptibility pattern of non-dermatophyte fungi causing onychomycosis. 

Materials and Methods: A prospective hospital based cross-sectional study was done on non - dermatophytic isolates from patients with clinical suspicion of onychomycosis. All non – dermatophytic isolates were subjected to anti-fungal susceptibility against terbinafine, itraconazole, fluconazole and griseofulvin by micro broth dilution method. 

Results: NDM were isolated in 20.2% cases of clinically suspected onychomycosis, among which Fusarium species was the most common followed by Aspergillus species and Candida species. MIC50 (Mean Inhibitory Concentration) for overall non - dermatophytic isolates for terbinafine, itraconazole, fluconazole and griseofulvin was 0.25μg/mL, 0.5μg/mL, 32μg/mL and 2μg/mL respectively and the order of sensitivity was Itraconazole (74.7%) > terbinafine (68%) > Fluconazole (60%) > Griseofulvin (51.6%) of the study samples. For Fusarium species, the  sensitivity for terbinafine was (73.5%) > itraconazole (67.6%) > fluconazole (64.7%) and griseofulvin (64.7%). For Aspergillus species, the sensitivity for itraconazole was 79.1% > fluconazole (58.3%) > terbinafine (54.1%) > griseofulvin (50%). For Candida species, the sensitivity was fluconazole (83.3%) > itraconazole (75%) > terbinafine (41.6%), while no candida species was found sensitive to griseofulvin. 

Conclusion: Non-dermatophytes play a significant role in onychomycosis. On in vitro estimation, Itraconazole was the most sensitive drug, followed by terbinafine, fluconazole and griseofulvin.

Downloads

Download data is not yet available.
Abstract
140
PDF
186

Author Biographies

Apurva Kaushal, FAIZABAD, Uttar Pradesh

Consultant Dermatologist 

Pratik Gahalaut, Shri Ram Murti Smarak Institute of Medical Sciences, Bareilly

Professor and HOD,Department of Dermatology, Venereology & Leprosy

R K Goyal, Shri Ram Murti Smarak Institute of Medical Sciences, Bareilly

Professor, Department of Microbiology

Neni Agarwal, Shri Ram Murti Smarak Institute of Medical Sciences, Bareilly

Senior Resident, Department of Dermatology, Venereology & Leprosy

Nitin Mishra, Shri Ram Murti Smarak Institute of Medical Sciences, Bareilly

Professor, Department of Dermatology, Venereology & Leprosy

Madhur Kant Rastogi, Shri Ram Murti Smarak Institute of Medical Sciences, Bareilly

Associate Professor, Department of Dermatology, Venereology & Leprosy

Downloads

Published

2020-10-08

How to Cite

Kaushal, A., Gahalaut, P., Goyal, R. K., Agarwal, N., Mishra, N., & Rastogi, M. K. (2020). Antifungal Susceptibility Pattern of Non - Dermatophytic Fungi Causing Onychomycosis. Nepal Journal of Dermatology, Venereology &Amp; Leprology, 18(1), 28–36. https://doi.org/10.3126/njdvl.v18i1.27120

Issue

Section

Original Articles