Abstract
Dermatomycosis is an infection with fungi related to the skin: glabrous skin, hair and/or nails. Oral treatment of fungal infections in dermatology has become a preferred modality for the management of these very common conditions. Although there are increasing numbers of antifungals available for treatment of dermatophytes, some cases and relapses have been unresponsive to treatment. The determination of fungus in-vitro antifungal susceptibility has been reported to be important for the ability to eradicate dermatophytes. It is necessary to perform antifungal susceptibility testing of dermatophytes. E-test (AB Biodisk, Sweden) is a rapid, easy-to-perform in-vitro antifungal susceptibility test. The aim of this study was to investigate the susceptibility of the different species of dermatophyte strains isolated clinical specimens to five antifungal agents using the E-test method. A total of 66 specimens were collected from the nails, feet, inguinal region, trunk and hands. These strains tested MIC endpoints of E-test for amphotericin B, fluconazole, itraconazole, caspofungin, and ketoconazole were read after 72, and 96 hours incubation for each strain on RPMI 1640 agar. The dermatophytes tested included Trichophyton rubrum 43 (65.1%), Trichophyton mentagrophytes 7 (10.7%), Microsporum canis 5 (7.6%), Trichophyton tonsurans 5 (7.6%), Epidermophyton floccosum 4 (6.0%) and Trichophyton violaceum 2 (3.0%). The most active agent against all dermatophytes species was caspofungin with a minimal inhibitory concentration (MIC) range (μg/mL(-1)) (0.02-3, 0.032-4, 0.125-0.50, 0.032-2, 0.25-0.50, 0.125-0.50) and it raconazole with an MIC range (μg/mL(-1)) (0.038-1.5, 0.094-1.5, 1-32, 0.016-0.50, 0.25-0.50, 0.125-0.50). The least active agent was fluconazole with an MIC range (μg/mL(-1)) (0, 19-48, 2-256, 2-8, 256, 256, 8-24). E-test seems to be an alternative method to MIC-determination of antifungal drugs for dermatophytes species, since it is a less-laborious methodology and results could be obtained faster.
Highlights
Dermatophytes are a specialized group of fungi, which effect keratinous tissue of humans and other vertebrates, causing superficial infections
The most active agent against all dermatophytes species was caspofungin with a minimal inhibitory concentration (MIC) range (0.02-3, 0.0324, 0.125-0.50, 0.032-2, 0.25-0.50, 0.125-0.50) and it raconazole with an MIC range (0.038-1.5, 0.094-1.5, 1-32, 0.016-0.50, 0.25-0.50, 0.125-0.50)
The least active agent was fluconazole with an MIC range (0, 19-48, 2-256, 2-8, 256, 256, 8-24)
Summary
Dermatophytes are a specialized group of fungi, which effect keratinous tissue of humans and other vertebrates, causing superficial infections. The organisms belong to three genera, Trichophyton, Epidermophyton, and Microsporum Infections caused by these fungi are among the most prevalent cutaneous infections globally and the recent increase in the number of patients with immunocompromised states, such as AIDS, diabetes mellitus, cancer and organ transplantation has given these infections more prominence [1,2,3,4,5,6]. A reference method is not yet available, various techniques have been used to test dermatophytes, including broth macro- and micro dilution methods, agar dilution and disc diffusion. These methods are time-consuming and labour-intensive, and are not practical for the clinical laboratory. Simple alternative approaches are needed [1, 3, 4, 6,7,8]
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