Trichophyton Tonsurans Research Articles

Appraisal of selected ethnomedicinal plants as alternative therapies against onychomycosis: Evaluation of synergy and time-kill kinetics.

Introduction: This study aims at the biological profiling of Allium sativum, Zingiber officinale, Nigella sativa, Curcuma longa, Mentha piperita, Withania somnifera, Azadirachta indica, and Lawsonia inermis as alternatives against onychomycosis to combat the treatment challenges. Methods: An extract library of aqueous (DW), ethyl acetate (EA), and methanol (M) extracts was subjected to phytochemical and antioxidant colorimetric assays to gauge the ameliorating role of extracts against oxidative stress. RP-HPLC quantified therapeutically significant polyphenols. Antifungal potential (disc diffusion and broth dilution) against filamentous (dermatophytes and non-dermatophytes) and non-filamentous fungi (yeasts; Candida albicans), synergistic interactions (checkerboard method) with terbinafine and amphotericin-B against resistant clinical isolates of dermatophytes (Trichophyton rubrum and Trichophyton tonsurans) and non-dermatophytes (Aspergillus spp., Fusarium dimerum, and Rhizopus arrhizus), time-kill kinetics, and protein estimation (Bradford method) were performed to evaluate the potential of extracts against onychomycosis. Results: The highest total phenolic and flavonoid content along with noteworthy antioxidant capacity, reducing power, and a substantial radical scavenging activity was recorded for the extracts of Z. officinale. Significant polyphenolics quantified by RP-HPLC included rutin (35.71 ± 0.23µg/mgE), gallic acid (50.17 ± 0.22µg/mgE), catechin (93.04 ± 0.43µg/mgE), syringic acid (55.63 ± 0.35µg/mgE), emodin (246.32 ± 0.44µg/mgE), luteolin (78.43 ± 0.18µg/mgE), myricetin (29.44 ± 0.13µg/mgE), and quercetin (97.45 ± 0.22µg/mgE). Extracts presented prominent antifungal activity against dermatophytes and non-dermatophytes (MIC-31.25μg/ml). The checkerboard method showed synergism with 4- and 8-fold reductions in the MICs of A. sativum, Z. officinale, M. piperita, L. inermis, and C. longa extracts and doses of amphotericin-B (Amp-B) and terbinafine (against non-dermatophytes and dermatophytes, respectively). Furthermore, the synergistic therapy showed a time-dependent decrease in fungal growth even after 9 and 12h of treatment. The inhibition of fungal proteins was also observed to be higher with the treatment of synergistic combinations than with the extracts alone, along with the cell membrane damage caused by terbinafine and amp-B, thus making the resistant fungi incapable of subsisting. Conclusion: The extracts of A. sativum, Z. officinale, M. piperita, L. inermis, and C. longa have proven to be promising alternatives to combat oxidative stress, resistance, and other treatment challenges of onychomycosis.

Clonal Outbreak of Trichophyton tonsurans Causing Tinea Capitis Among a Wrestling Team in Beijing, China.

Trichophyton tonsurans mostly causes tinea capitis and tinea corporis and often associates with outbreaks among combat sports athletes. Here, we report an outbreak of tinea capitis caused by T. tonsurans among five juvenile athletes in a wrestling team in Beijing, China. Scrapings from the lesions of the five patients were performed by direct microscopic examination and fungal culture. The fungal pathogens were all identified as T. tonsurans by morphology and sequencing of the internal transcribed spacer (ITS) regions. Multilocus genotyping analysis was performed by sequencing of 13 gene loci. The sequences of these markers were identical among the five isolates, revealing a single genotype. Antifungal susceptibilities of terbinafine, itraconazole, fluconazole, ketoconazole, and amphotericin B against T. tonsurans was determined by broth microdilution method according to the Clinical and Laboratory Standards Institute M38-A3 document and these isolates were all susceptible to the common antifungal drugs treating tinea capitis.

Antimycotic potential of protein preparation and fixed oil obtained from Moringa oleifera seeds against Trichophyton tonsurans

• This study evaluated the antifungal potential of protein fraction (PF) and fixed oil (FO) obtained from Moringa oleifera seeds. • PF contained lectins and FO had oleic, palmitic, and elaidic acids as major compounds. • PF and FO were fungistatic agents on T. tonsurans but were not fungicidal. • Synergistic effect was detected for PF+itraconazole and FO+itraconazole. • PF and FO cause apoptosis and necrosis of fungal cells. Species of the genus Trichophyton are etiological agents of dermatophytoses. The appearance of fungi resistant to drugs used to treat these diseases has prompted the search for natural compounds with anti- Trichophyton action. This study sought to determine the antifungal potential of protein fraction (PF) and fixed oil (FO) obtained from Moringa oleifera seeds against T. tonsurans . The synergistic potential of the two preparations and their synergy with commercial antifungal drugs were also evaluated. The possible mechanisms of action were assessed using the sorbitol protection assay and flow cytometry using probes to ascertain cell death, lysosomal integrity, and mitochondrial membrane potential. PF contained 72.24 mg/mL of proteins and lectins (specific hemagglutinating activity of 113.24). Further, FO had oleic (66%), palmitic (9.25%), and elaidic (9.06%) acids as major compounds. PF and FO were identified as fungistatic agents (minimum inhibitory concentration of 1024 μg/mL) but were not fungicidal. An additive effect was found for the PF+FO and PF+ketoconazole combinations, while a synergistic effect was detected for PF+itraconazole and FO+itraconazole. By evaluating T. tonsurans growth in the presence of sorbitol, this osmoprotectant was found to prevent the fungistatic action of FO, indicating that the oil acts on cell wall biosynthesis pathways. The number of cells in apoptosis and necrosis increased when the fungi were treated with PF and FO. Further, mitochondrial hyperpolarization increased in cells exposed to the oil. Of note, there were no changes in lysosomal integrity. In conclusion, PF and FO from M. oleifera seeds were identified as fungistatic agents against T. tonsurans, and are thus promising for combating dermatophytosis caused by this fungus.

Tinea capitis caused by Trichophyton tonsurans among adults: Clinical characteristics and treatment response.

Trichophyton tonsurans tinea capitis has become a growing epidemiological concern. Yet, its clinical manifestations and treatment response, specifically among adults, have only been described among small sample size studies. To assess clinical manifestations and treatment outcome of T. tonsurans tinea capitis among adults. A retrospective cohort study was carried out among 111 adults with T. tonsurans tinea capitis. Diagnosis was confirmed by fungal culture or polymerase chain reaction. Examinees' demographics, disease characteristics and treatment response were measured. The risk factors for the treatment failure were evaluated. The mean age was 20.1 years (±3.1), with men (98.2%) outnumbering women. The follow-up lasted 12.2 months (±5.6). The majority of T. tonsurans tinea capitis was seen in the occipital area (87.6%). In 78.9% of the cases, the scalp manifestation was non-inflammatory (scaly plaques and papules:76.1% and seborrhoea-like: 2.8%). 21.1% of cases presented with inflammatory tinea capitis (21.1%; Kerion: 10.1% and pustular: 11%). Concomitant involvement of other than scalp areas was common: tinea corporis was seen in 38.7% of the cases; tinea faciei and barbae in 24.3%; nape and anterior neck in 76.6% and 2.7% of the cases, respectively. An adequate treatment course with oral terbinafine resulted in 83.2% clinical cure rate. Treatment failure was significantly associated with concomitant tinea corporis (odds ratio 3.9; 95% confidence interval 1.3-12.1, p-Value< .02). The most common clinical presentation of T. tonsurans tinea capitis included occipital scaly plaques and papules with concomitant non-scalp lesions. Oral terbinafine was found to be highly effective. Concomitant tinea corporis increased the risk for treatment failure.

Loop-mediated isothermal amplification-microfluidic chip for the detection of Trichophyton infection

Trichophyton is the most pathogenic type of fungal skin infection. It often invades and grows in a keratin-rich matrix, and lesions include human skin, hair, and fingernails (toenails). We designed LAMP primers for Trichophyton and developed a LAMP-Microfluidic chip detection system for Trichophyton. This system detects six common species of Trichophyton in the genus Trichophyton, including Trichophyton rubrum, Trichophyton mentagrophyte, Trichophyton violaceum, Trichophyton tonsurans, Trichophyton verrucosum, and Trichophyton schoenleinii. The specificity reached 100%, and the sensitivity could reach about 1 × 102 copies/μl. The entire detection process can be completed within 60 min and does not cross-react with other dermatophytes. The established LAMP-Microfluidic chip detection system has the advantages of simple operation, high specificity, and high sensitivity, and has the potential for clinical application.

Concept of tinea capitis

Tinea capitis is a superficial and dermatophytes infection primarily located in the hair follicles and surrounding stratum corneum. The infection is widely disseminated among prepubertal children, difficult to treat due to poor efficacy of available antifungal agents and mimic ailments related to the infection. This study reviewed the current and predominant attributes of tinea capitis including diagnostic measures and therapies against the infection. A Google search was conducted using the key term “Tinea capitis”. The search strategy includes literature reviews, clinical trials, meta-analyses, observational studies and randomized controlled trials. The result showed that Trichophyton tonsurans and Microsporum canis causes the higher number of tinea capitis cases with ectothrix and endothrix as a clinical manifestation. Terbinafine therapy had the highest cure rate in a short period of time against the infection. Non-commercial kits had the highest specificity and sensitivity than real time PCR commercial kits. The mimic ailments related to infection include trichotillomania, alopecia areata, seborrheic dermatitis, atopic dermatitis, psoriasis and bacterial scalp abscess. Allylamines and imidazole are commonly used antifungal agents against infection. Effective antifungal agents, new methods of diagnosis should be employed such as PCR targeting the 28S rDNA gene for the identification and characterization of etiological agents of tinea capitis, and practice good habits of personal and environmental hygiene should be encouraged through health education and promotion activities.

P107 Spectrum of Dermatophyte infections and drug susceptibility pattern of Dermatophytes in patients visiting to tertiary care hospital in Chhattisgarh state of India

Poster session 1, September 21, 2022, 12:30 PM - 1:30 PMObjectives1. To isolate and identify various species of Dermatophytes from clinical specimens 2. To perform and analyze the antifungal susceptibility testing of isolated Dermatophytes for commonly used antifungal agents; terbinafine and itraconazole.MethodsA prospective study was conducted from December 2019 to October 2021. Clinical specimens (skin, hair, and nail) from suspected cases of dermatophytosis were received and processed in the department of microbiology. All the samples were subjected to microscopic examination and culture by standard techniques. Their clinico-demographic profile was obtained. Specimen were processed for KOH and fungal culture. Dermatophytes were identified by studying macroscopic and microscopic characteristics of the isolates. The conidium-forming dermatophyte isolates were processed for antifungal susceptibility testing for terbinafine and itraconazole by Microbroth dilution testing following the CLSI M-38A2 guidelines.ResultsTotal 248 patients with male predominance (68%) were noted in the above-mentioned study period. Predominance of study population belonged to rural area. Maximum numbers of cases were from the age group 21-30 years. Majority of patients belong to poor socioeconomic status. Out of 248 samples, 178 (72%) had a positive KOH mount amongst which 72% had positive culture results. Amongst 2 4881% were skin scraping, 17% were nail, and 1.6% hair samples were processed. Out of culture-positive samples 52% were Dermatophytes. The most clinical form of dermatophytosis was combination of both Tinea cruris and T. carporis (31%) followed by T. cruris (22%), and T. corporis (17%) for which skin scraping was processed. The most common isolate was Trichophyton tonsurans (73%) followed by T. mentagrophytes (10%), and T. verrucosum. Onychomycosis was diagnosed in 17% patients of which 59% were positive by KOH 49% were culture positive.11.5% isolates from nails were dermatophytes.Antifungal susceptibility testing was done by Microbroth dilution method and analyzed the range. The MIC range of major isolates, i.e., T. tonsurans showed MIC ranges against terbinafine <0.03-4 μg/ml and itraconazole 0.03-2 μg/ml. Trichophyton mentagrophyte for terbinafine <0.12-4 μg/ml and for itraconazole 0.12-2 μg/ml. Four isolates of T. tonsurans had higher MIC values for terbinafine and two isolates had higher MIC for itraconazole. One isolate of T. mentagrophytes had higher MIC values of itraconazole, and one another isolate had higher MIC for terbinafine.ConclusionThis study highlights the change in pattern of causative agents of dermatophytosis. The present study showed the predominance of T. tonsurans. More extensive studies are needed to evaluate the cut-off range of antifungal susceptibility testing of dermatophytes with clinical follow-up to see the response of respective antifungals and to guide the therapy.

P285 Predominance of Trichophyton tonsurans causing tinea capitis: a 12-years retrospective study in north of Iran

Poster session 2, September 22, 2022, 12:30 PM - 1:30 PMBackground: Tinea capitis is a common and endemic fungal infection of the scalp that Trichophyton spp. and Microsporum spp. usually cause. This study aimed to investigate tinea capitis and its etiologic agents for 12 years in northern Iran.Material Methods: The study is a retrospective analysis involving 11 095 patients referred to the Reference Laboratory of Medical Mycology at Sari, Iran, from July 2009 to April 2022. The skin scraping and hair samples were assessed based on direct microscopy and culture, and causative agents were identified based on macroscopic, and microscopic morphology.ResultsTinea capitis was confirmed in 209 patients: 157 (75.1%) male and 52 (24.9%) female out of 921 suspected patients with a scalp lesion. The prevalence of tinea capitis in patients who refer to the Reference Laboratory of Medical Mycology varied from 6.1 to 37.5%. In both sexes, a higher rate of tinea capitis was observed in patients younger than 20 years of age. Trichophyton tonsurans (146/209; 69.9%) was the most etiological agent, followed by T. mentagrophytes (13/209; 6.2), T. violaseum (9/209; 4.3), Microsporum canis (3/209; 1.4%), T. verrucosum (2/209; 1%), and T. rubrum (1/209; 0.5%). On direct microscopy examination, endothrix hair invasion in 77.0% cases, ectothrix in 2.3%, septate hyphae in 10.5%, and ecto-endothrix in one case were observed.ConclusionIn recent decades, the prevalence of tinea capitis caused by anthropophilic fungi has remained high, particularly in younger children. Therefore, it is essential to focus on public and personal health education in this age group to prevent and control the disease.

P076 The promising antimycotic activities of a novel cyclic antifungal lipopeptide against Human Dermatophyte Isolates

Poster session 1, September 21, 2022, 12:30 PM - 1:30 PMObjectivesTo determine the minimum inhibitory concentrations (MICs) of a novel antifungal lipopeptide against clinical isolates of dermatophytes of human origin.MethodsTo perform antifungal susceptibility testing (AFST) by CLSI microbroth dilution method, a reversed-phase high-performance liquid chromatography (RP-HPLC) purified lipopeptide of 1071.4 Da from a wild-type soil isolate Bacillus subtilis was used and compared with the standard allylamine terbinafine MICs. Briefly, 1200 ml of cell-free culture supernatant was extracted using a solvent mixture and silica gel (230-400 mesh size)-based adsorption chromatography. The semi-preparative RP-HPLC system consisted of an Agilent quaternary pump and a variable wavelength detector equipped with a Phenomenex Luna C18 column (10 mm × 250 mm, 5 μm). The solvent system for RP- HPLC was (A) water with 0.1% trifluoroacetic acid (TFA) and (B) acetonitrile containing 0.1% TFA. The gradient of solvent B used for purification was as follows: 0%-54% for 0-20 min at the flow rate of 1 ml/min, 54%-60% from 20-48 min at 0.5 ml/min, 60%-100% from 48-58 min at 0.5 ml/min, 100%-0% from 58-65 min at 1 ml/min and monitored at 210 nm.ResultsSuperficial skin infections are caused by dermatophytes including Trichophyton spp. Nowadays, resistance to terbinafine in Trichophyton spp. isolates with higher MICs have been documented in India. We report here the antifungal prowess of a novel small antifungal lipopeptide against 20 clinical isolates of Trichophyton spp. of human origins (from human skin scrapings and nails) with the clinical diagnosis of tinea corporis/cruris and tinea unguium. The representative photographs of T. tonsurans, T. rubrum, and T. mentagrophytes complex are provided below. A total of 6 isolates of T. mentagrophytes and T. rubrum carry point mutations at F397L of squalene epoxidase (SQLE) protein. The in vitro antifungal efficacies determined by AFST revealed that the lipopeptide showed less or equivalent MICs (100% inhibition) in the case of five dermatophytes. The lipopeptide drug has exhibited improved MICs against two T. mentagrophytes complex and two T. rubrum isolates with amino acid substitution F397L in SQLE protein. Trichophyton mentagrophytes complex and T. rubrum with F397L mutations were inhibited at MICs 4-32 μg/mL of terbinafine. In comparison, the lipopeptide showed 4-16 μg/ml (100% inhibition). In the case of all four Trichophyton tonsurans, the MICs ranged between 2-4 μg/ml for the lipopeptide.ConclusionsThe broad-spectrum lipopeptide showed promising antifungal activity against dermatophytes and may be considered for nano-emulsion formulation and tested for topical application in a mice model.

P309 Clonal outbreak of Trichophyton tonsurans causing tinea capitis among wrestlers in Beijing, China

Poster session 2, September 22, 2022, 12:30 PM - 1:30 PMObjectives Trichophyton tonsurans, an anthropophilic dermatophyte, mostly causes tinea capitis and tinea corporis and is often associated with outbreaks among athletes involved in combat sports, such as wrestlers and judo athletes. Here, we report an outbreak of tinea capitis caused by Trichophyton tonsurans among five juvenile athletes aged ten to fourteen in a wrestling team in Beijing, China.MethodsA total of 5 wrestlers aged 10-14 years presented with alopecia, erythema, scales, and pustule on the scalp (Fig. 1a). Scrapings from the lesions were performed by direct microscopic examination using 10% potassium hydroxide (KOH) with calcofluor white and fungal culture. The fungal pathogens were identified by morphology and sequencing of the internal transcribed spacer (ITS) regions. Multilocus genotyping analysis was performed by sequencing of the five gene loci including the ITS and non-transcribed spacer (NTS) of the ribosomal RNA (rRNA) locus, alkalineprotease-1 (ALP1), metalloprotease-5 (MEP5), carboxypeptidases Y (CarbY), which show intraspecies diversity and can be applied to epidemiological investigations and determining the route of infection transmission. Antifungal susceptibility of terbinafine (TBF), itraconazole (ITC), fluconazole (FLC), ketoconazole (KTC), and amphotericin B (AMB) against the causative fungal isolates was determined by broth microdilution method according to the Clinical and Laboratory Standards Institute (CLSI) M38-A3 document.ResultsThe five patients were diagnosed with tinea capitis because of the scalp lesions, spores, and hyphae observed by direct microscopic examination (Fig. 1b), and positive fungal culture. The causative isolates were all identified as T. tonsurans by macroscopic and microscopic characteristics (Fig. 2) and sequencing of ITS regions. The sequences of ITS, NTS, ALP1, MEP5, and CarbY were identical among the five isolates, revealing a single genotype. The abovementioned sequences have been deposited to Genbank. The minimum inhibitory concentrations (MICs) of TBF, ITC, FLC, KTC, and AMB against five T. tonsurans isolates were 0.015 μg/ml, 0.015 μg/ml, 8 μg/ml, 0.06 μg/ml, and 0.5 μg/ml, respectively.ConclusionWe report an outbreak of tinea capitis caused by T. tonsurans among wrestlers in Beijing, China. Multilocus genotyping analysis revealed that all isolates consisted of a single genotype, suggesting the outbreak may be caused by a single strain of T. tonsurans. The isolates were all susceptible to the common antifungal drugs treating tinea capitis.

The association of physical development density, prevalence and types of microbes in colonized façade finishes in Enugu metropolis, Nigeria

PurposeThis research examines the association of physical development density, prevalence and types of microbes in colonized façade finishes of buildings in Enugu metropolis, Nigeria.Design/methodology/approachSurvey and experimental research designs were adopted. A total of 383 buildings were investigated with samples collected from those with colonized façade finishes. The microbes were identified using the standard procedure for genomic sequencing with descriptive statistics, and the chi-square test used to analyse the data.FindingsThe results revealed a 64% prevalence of microbial colonization and a significant association between this and physical development density with 71.0% of the colonized buildings located in high-density neighbourhoods of the metropolis. The sequencing also showed 24 different microbes with Trichophyton tonsurans, Trichophyton mentagrophytes and Trichoderma harzianum species being the most common in the colonized façade finishes.Practical implicationsThe research informs building professionals and owners of the specific microbes involved in the colonization of façade finishes of buildings in high-density urban areas. It also provides a clue about the nature of damages and defects associated with microbial colonization of building façades and the type of biocide additives required for the production of microbial-resistant façade finishes in the hot-humid tropical environment of Nigeria and beyond.Originality/valueThe study has shown that there is a significant relationship between the intensity of urban land use and microbial colonization of façade finishes of buildings. It also identified some new or less known microbes responsible for the biodeterioration of façade finishes and the effects this has on the buildings and public health in the hot-humid tropics of Enugu, Southeast Nigeria.

Epidemiology of Dermatophytosis in Tehran, Iran: A Ten-year Retrospective Study

Background: Dermatophytosis still remains a major public health concern worldwide, particularly in developing countries. This study was undertaken to determine the etiological and epidemiological factors of dermatophyte infections in Tehran, Iran. Methods: A total of 1530 patients clinically suspected of cutaneous fungal infections were examined in two hospitals over a period of 10 years (2010–2020). Samples were analyzed using direct microscopic examination and culture. Data regarding age, gender, and clinical manifestations were also recorded. Results: Out of 1530 cases examined, dermatophytes were detected in 493 (32.2%) patients. Of these patients, 288 (58.4%) were males and 205 (41.6%) were females. The most affected age group was the 25–44 years old (31.6%). Tinea corporis (n=134) was the most prevalent type of ringworm, followed by tinea cruris (n=131), tinea pedis (n=90), tinea manuum (n=65), tinea unguium (n=29), tinea faciei (n=20), tinea capitis (n=18), and tinea barbae (n=2). Both tinea cruris (P&lt;0.001) and tinea pedis (P=0.002) had a significant association with male gender. As for etiological agents, Trichophyton mentagrophytes (29.0%) was the most frequent isolate, followed by Trichophyton tonsurans (25.8%), Trichophyton rubrum (25.3%), Epidermophyton floccosum (6.9%), Trichophyton verrucosum (4.9%), Microsporum audouinii (4.5%), Microsporum canis (2.0%), and Trichophyton violaceum (1.6%). Conclusion: Dermatophytes are still the prevailing causes of fungal infection of the skin, hair, and nails in Iran. Further studies with larger samples sizes and inclusion of diverse locations would yield more accurate results.

Prevalence of Dermatophytosis Infection Among Patients Attending National Obstetric Fistula Centre Babbar-Ruga Hospital, Katsina State

This study aimed to determine the prevalence of dermatophytosis infections among patients attending National obstetrics fistula center Babbar-ruga hospital, Katsina state. A total number of 100 patients were diagnosed, (40/100) were males and 60% (60/100) were females, giving a gender ratio of 3:2 (males: females), 40% of the participants were of the age range 10-29 years and 60% of age from 14-21 years respectively. Out of 60 cases, a total of 53 dermatophytes were isolated belonging to the genera Trichophyton and Microsporum. The most frequently isolated dermatophytes were Trichophyton mentagrophyte (26.41% 14/53), followed by Microsporum audouinii (22.64% 12/53), Trichophyton rubrum (15.09% 8/53), Trichophyton schoenleinii (7.547% 4/53), Microsporum gypseum (5.660% 3/53) and the least were Microsporum canis (9.433% 5/53) and Trichophyton tonsurans (9.433% 5/53), Trichophyton verrucosum (3.77% 2/53). Although 38 cases (63.33%) had single infections with dermatophytes, mixed infections with 2-4 dermatophytes of the genera Microsporum and Trichophyton were observed in 15 cases (36.67%). 67% (10/15) of the mixed infections were with Microsporum and Trichophyton species, 20% (3/15) were with Microsporum species alone, and 13.3 %( 2/15) were with Trichophyton species alone. This study indicates an outstanding prevalence of dermatophytosis infection among patients who shared combs and scarves and who owned pets; this suggests a thriving animal-human transmission route of dermatophytes and the potentiality of the fomites. The research proposes intensive health promotion and education interventions to promote hygiene practices among patients.

Molecular Typing of Dermatophytes Isolated from Pupils and Staff Members of Some Selected Schools in Anambra State, Nigeria

Dermatophytes are the fungal pathogens of human and animals infecting the keratinized tissues of the body namely skin, hair and nails. They include species of Trichophyton, Microsporum and Epidermophyton. This study was aimed at molecular typing of dermatophytes isolated from school pupils and staff members of some selected Schools in Anambra East and Ayamelum L.G.As of Anambra State in Nigeria. One thousand (1000) samples (scalp/hair, nail, feet, glabrous skin and groin/perianal) were collected from pupils and staff members of both gender and age bracket of (1 to 10, 11 to 20, 21 to 30 etc ) years that showed visible signs of skin infection located in these two Local Government Areas. Standard procedures were employed in processing of test samples and inoculation on dermatophyte test medium. The plates were incubated at room temperature (25 – 270C) for 7 – 10days for observation of fungal growth. Colonial, morphology, and molecular studies and sequencing were used for identification. Sensitivity was performed using sterilized discs (6mm) prepared from whatman No. 1 filter paper, impregnanted with different concentrations (25mg, 50mg, 100mg and 200mg) of terbinafine, itraconazole, ketoconazole, fluconazole and griseofulvin dissolved in 2% dimethylsuphuroxide (DMSO). Molecular studies were used as confirmatory tests on dermatophytic isolates using Sanger sequencing method. The results show that the dermatophytic isolates includes: Trichophyton tonsurans, Microsporum audounii, Trichophyton rubrum, Microsporum canis, Trichophyton violaceum, Trichophyton verrucosum, Trichophyton mentagrophytes, and Epidermorphyton flocossum. Results also revealed the nucleotide sequences of the dermatophytes and genetic relationships between isolated dermatophytes from different pupils and schools. PCR-RFLP was used as gold standard for the diagnosis and Confirmation of Source of infection of dermatophytes and can aid in initiating prompt and appropriate antifungal therapy. Phylogenetic tree was drawn to show the relationships between the isolates.

Tinea Gladiatorum: Epidemiology, Clinical Aspects, and Management

Tinea gladiatorum (TG) is a fungal skin infection that occurs among wrestlers and other contact sport athletes with a varied prevalence rate. The most common causative factor responsible as well for local outbreaks of the infection is an anthropophilic dermatophyte species—Trichophyton tonsurans (T. tonsurans). The purpose of this study was to gather current data about TG, including epidemiology, possible diagnosing methods, clinical features, treatment approaches, and potential prevention techniques. We also performed a systematic review of studies describing TG incidence. The prevalence of the disease varied from 2.4% up to 100%. That wide range of variability forces medical practitioners to update knowledge about TG and points to the fact that it still may be a diagnostic and therapeutic challenge. Spreading awareness among athletes and trainers is one of the most important preventive steps.

High Trichophyton violaceum-Induced Tinea Capitis with Isolation of Many Non-Dermatophyte Molds in Scalp Scrapings in Patients Referred to a Dermatology Clinic in Addis Ababa, Ethiopia.

ObjectiveThis work aimed to determine the magnitude of tinea capitis, the diversity and species composition of fungi, and the predominant dermatophytes implicated in causing tinea capitis.MethodsA prospective, cross-sectional study was conducted at a dermatology clinic. Scalp scrapings were collected and cultured, and dermatophyte and non-dermatophyte molds were identified.ResultsOf 364 scalp scrapings, fungi were recovered from 301 (82.7%) clinical samples. About 60.7% of the samples were collected from women, while 39.3% were collected from male study subjects. The association between the magnitude of scalp ringworm and gender was not statistically significant (P = 0.105). Two hundred eighty study subjects were less than 15 years of age, of which 254 were culture positive. The association of tinea capitis and the age of patients was statistically significant (P = 0). Three hundred forty-nine fungal isolates were isolated, of which 54.2% were dermatophytes, while 45.8% were non-dermatophyte molds. The occurrence of dermatophytes in their decreasing order was T. violaceum (138; 73%), Trichophyton mentagrophytes (18; 9.5%), Trichophyton tonsurans (16; 8.5%), Trichophyton verrucosum (8; 4.5%), Microsporum audouinii (7; 3.7%), Trichophyton schoenleinii (1; 0.5%), and Trichophyton soudanense (1; 0.5%).ConclusionA high prevalence rate of T. violaceum-induced tinea capitis was reported. The magnitude of scalp ringworm in adults was remarkably high. Therefore, conducting a nationwide epidemiological survey on tinea capitis regardless of age is suggested. The isolation of many non-dermatophyte molds in the current study may shade questions about the perception that tinea capitis is caused by dermatophytes only. Therefore, studies on their potential pathogenic role on skin and skin-related (nail and the scalp) infections appear to be an active field of research.

Epidemiology of dermatomycoses and onychomycoses in Ireland (2001-2020): A single-institution review.

BackgroundFungal skin infections are recognised as one of the most common health disorders globally, and dermatophyte infections of the skin, hair and nails are the most common fungal infections. Dermatophytes can be classified as anthropophilic, zoophilic or geophilic species based on their primary habitat association, and this classification makes epidemiological analysis useful for the prevention and control of these infections. The Irish contribution to the epidemiology of these infections has been scant, with just two papers (both reporting paediatric tinea capitis only) published in the last 20 years, and none in the last seven.ObjectivesTo perform a comprehensive retrospective epidemiological analysis of all dermatological mycology tests performed in University Hospital Limerick over a 20‐year period.MethodsAll mycology laboratory test results were extracted from the Laboratory Information Management System (LIMS, iLab, DXC Technologies) from 2001 to 2020 inclusive for analysis. Specimen types were categorised according to the site of sampling. The data were analysed using Microsoft Excel.ResultsAbout 12,951 specimens of skin, hair and nails were studied. Median patient age was 42 years (IQR 26–57) with a slight female preponderance (57.2%). Two thirds of samples (67%, n = 8633) were nail, 32% were skin scrapings (n = 4118) and 200 hair samples (1.5%) were received. Zoophilic dermatophytes were more commonly present in females (38% F, 23% M, proportion of dermatophytes) and in those under 10 years of age or from 45 to 70 years (36% and 34% zoophiles, respectively, proportion of dermatophytes), although anthropophiles predominated every age and gender category. Anthropophiles had their highest prevalence in the 10–20 years age category (80% anthropophiles, proportion of dermatophytes), and yeast infections were more prevalent in older patients (29% of >60 year olds vs. 17% of <60 year olds, proportion of all fungal positives). Trichophyton rubrum was the most prevalent pathogen detected, accounting for 53% of all dermatophytes detected, 61% of those detected from nail samples and 34% from skin and hair samples. Trichophyton tonsurans was the most prevalent dermatophyte in tinea capitis, accounting for 37% of dermatophytes detected. Both of these organisms are anthropophilic, and this group showed consistently increased prevalence in proportion to all fungal isolates. The proportion of this dermatophyte class (anthropophiles) increased among both nail samples and skin/hair samples during the study period, from 55% of samples in the first 5 years of the study (2001–2005) to 88% (proportion of dermatophytes) in the final 5 years. Conversely, yeast detection decreased.ConclusionsThis study provides a detailed overview of the epidemiology of the fungal cultures of skin, nail and hair samples in the Mid‐West of Ireland over a 20‐year period. Monitoring this changing landscape is important in identifying likely sources of infections, to identifying potential outbreaks, and may help guide empiric treatment. To the best of our knowledge, this study provides the first detailed analysis from Ireland of fungal detections from skin, hair and nail samples, and is the first epidemiological fungal report of any kind in over 7 years.

ISOLATION AND MOLECULAR DIAGNOSIS OF TRICHODERMA SPP. AND EVALUATION OF ITS EFFECTIVENESS AGAINST DERMATOPHYTES

Dermatophyte infection of the human is difficult to eradicate with drug treatment. An alternative approach to treat dermatophytes might be the application of biological control agents against fungal diseases. Trichoderma spp, were isolated from the soil in Adana province of Turkey. 4 species were identified based on DNA-ITS and ITS4 sequence. T. viride, T. virens, T. harzianum and T. lixii. We tested Trichoderma species against Trichophyton tonsurans and Microsporum canis. All isolates of Trichoderma showed promising results in reducing the growth of pathogens under in vitro conditions, with different concentrations and dual culture assay. However, antagonistic assessment of isolates of Trichoderma against pathogens T.tonsurans and M.canis by concentrations assay (5,10 and 15 ml/L) showed variation in inhibition of pathogens. The colony diameter growth values ranging in all concentrations and isolates from 0.46 to 5.40 cm, The best antifungal concentration was (15 ml/L) with T. harzianum isolate in inhibition for T. tonsurans and M. canis, which reached 0.50 and 0.46 cm respectively. For dual culture assay showed that all isolates of Trichoderma reduced growth T.tonsurans and M.canis. Moreover, the highest inhibition with T. harzianum isolate Which colony diameter reached 1.34 and 1.50 cm, respectively.

Effect of Household Laundering, Heat Drying, and Freezing on the Survival of Dermatophyte Conidia.

Dermatomycoses are one of the most common dermatological infectious diseases. Dermatophytoses, such as tinea pedis (athlete’s foot) in adults and tinea capitis in children, are the most prevalent fungal diseases caused by dermatophytes. The transmission of anthropophilic dermatophytoses occurs almost exclusively through indirect contact with patient-contaminated belongings or environments and, subsequently, facilitates the spread of the infection to others. Hygienic measures were demonstrated to have an important role in removing or reducing the fungal burden. Herein, we evaluated the effectiveness of physical-based methods of laundering, heat drying, and freezing in the elimination of Trichophyton tonsurans, T. rubrum, and T. interdigitale conidia in diverse temperatures and time spectra. Based on our findings, laundering at 60 °C was effective for removing the dermatophyte conidia from contaminated linens. On the contrary, heat drying using domestic or laundromat machines; freezing at −20 °C for 24 h, 48 h, or one week; and direct heat exposure at 60 °C for 10, 30, or 90 min were unable to kill the dermatophytes. These results can be helpful for clinicians, staff of children’s communities, and hygiene practitioners for implementing control management strategies against dermatophytoses caused by mentioned dermatophyte species.

Inflammatory tinea capitis due to Microsporum canis transmitted from asymptomatic domestic cats

We report a case of Inflammatory tFiinea capitis due to Microsporum canis transmitted from asymptomatic domestic cats. Three of the patient’s Persian cats were revealed to be asymptomatically infected with M. canis and these isolates were confirmed to be same by using a microsatellite marker. We would like to emphasize that asymptomatic cats could be a source of infection of tinea capitis. Tinea capitis is a cutaneous fungal infection of the scalp that is common among children. It is mainly caused by Trichophyton tonsurans and Microsporum (M.) canis.1 M. canis is a dermatophyte fungus of which cats and dogs are natural hosts, which is easily transmitted to humans. A four-year-old girl with no immunodeficiency was referred to our hospital with a four-month history of erythematous lesions on her scalp. The lesions had gradually enlarged despite the use of antibiotics, oral, and topical corticosteroids. A physical examination revealed multiple erythematous lesions with hair loss, crusts, and pustules (Figure 1A). Potassium hydroxide examinations of the hair root and scales showed no fungal elements. A histological examination showed granulomatous inflammation (Figure 1B), histiocytes and a few multinucleated giant cells were present (Figure 1C). Periodic acid-Schiff and Grocott’s staining showed no fungal elements. Culturing of scalp scales obtained by tape stripping on Sabouraud Dextrose Agar at 25°C showed a cream color with a dense cottony surface (Figure 1D). The scraped specimen from the culture showed hyphae and spindle-shaped macroconidia (Figure 1E). The sequence of the internal transcribed spacer (ITS) region in the ribosomal RNA gene of the strain amplified with the ITS1 and ITS4 primer set2 was 100% homologous (698/698 bp) with that of the type strain M. canis CBS 217.69 (accession number MH859294.1) (data not shown). After 12 weeks of oral treatment with terbinafine (5 mg/kg/day), the hair regrew completely, although crusted erythema was observed (Figure 1F). Fungal cultures from domestic animals performed to estimate the route of infection resulted in the growth of colonies similar to patient isolates from three cats. The molecular biology of the strains was consistent with that isolated from the patient (data not shown). M. canis is classified into 20 genotypes by a combination of microsatellite markers. We attempted to classify this isolate using three primer sets, MS2, MS4, and MS7.3 Capillary electrophoresis did not result in a classification consistent with a previous report3; however, it showed that the peak positions of all isolates were consistent (Figure 1G), suggesting that the M. canis was transmitted from the domestic cats. We did not have a direct evidence that the case was kerion celsi caused by M. canis. However, M. canis grew on the tape stripping culture before treatment but not after treatment, suggesting that the M. canis on the scalp surface was probably pathogenic. Tinea capitis with inflammation mimicking scarring alopecia was reported and its clinical manifestation was similar to that of our case.4 We hypothesize that our patient had strong immunity to M. canis after the topical inoculation of the dermatophytes. There appear to be two routes of M. canis among cats via a pet shop for domesticated animals and via the outdoors in strays.5 Our patient’s Persian cats were purchased from a pet shop. However, the family had many cats and dogs, and they might have had contact with stray animals. A microsatellite marker analysis can be a useful method for tracing the route of transmission. None declared. Approval of the research protocol: No human participant was involved in this study. Informed Consent: The patient has provided informed consent for the publication of the images submitted with this article. Registry and the Registration No.: N/A. Animal Studies: N/A.