Clinico-mycological profile and Antifungal Susceptibility Testing of Dermatophytic Fungi isolated from Clinical Samples in Zagazig University Hospital, Egypt

Document Type : New and original researches in the field of Microbiology.

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Department of Medical Microbiology & Immunology, Faculty of Medicine, Zagazig University, Egypt

Abstract

Background. Dermatophytes encompass over 40 species in three genera: Trichophyton Microsporum, as well as Epidermaphyton. Infections due to dermatophytes are generally known as “tinea” or “ring-worm” infections because of characteristic ringed lesions. Many antifungal agents can be used to treat these infections. Unfortunately, drug resistance can lead to treatment failure. Objectives of this study is exploration of clinico-mycological pattern of dermatophytic infections in patients with clinically suspected dermatophytosis attending the Dermatology Outpatient Clinic and characterization of antifungal susceptibility pattern for various dermatophytes species isolated from these patients. Methodology: A total of 62 dermatophytosis specimens   (skin scrapings, nail, hair) were collected from 85 patients clinically suspected to have dermatophytosis. All the specimens were subjected to direct examination (10% KOH mount) and culture on Mycobiotic agar media   then identification by macroscopic and microscopic characters. In vitro antifungal sensitivity testing to (fluconazole, ketoconazole, itraconazole, terbinafine and voriconazole) was done on species isolated from a culture with E. test method. Results: Dermatophytosis had a higher incidence in men (n=42, 68%) and more common in age group from (6-20 years) (40%). Tinea corporis was the most common clinical type 23 (37%), followed by tinea capitis 20 (32%). Sixty two isolated dermatophytes species were distributed as follows: T. mentagrophytes 20 (32%), T. rubrum 16 (26%), T.violaceum 14 (23%), T.schoenlinii 7 (11%), M.canis 5 (8%). Voriconazole and terbinafine were the most active antifungal agents, while fluconazole showed the least antifungal activity. Conclusion: highest incidence of cases falling in the 6–20 years old age group with male predominance. Tinea corporis was the most common clinical type followed by tinea capitis, tinea pedis, tinea ungums and tinea cruris. T.mentagrophytes was the most prevalent species isolated   followed by T.rubrum, T. violaceum,T. Schoenlinii, and M.canis. Voriconazole showed notably low MIC values and was the most active azole against all dermatophytes isolates, followed by terbinafine, itraconazole ketoconazole. While fluconazole showed the least antifungal activity with high MICs values

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