Antifungal Susceptibility Pattern of Non - Dermatophytic Fungi Causing Onychomycosis

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...

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Main Authors: Apurva Kaushal, Pratik Gahalaut, R K Goyal, Neni Agarwal, Nitin Mishra, Madhur Kant Rastogi
Format: Article
Language:English
Published: Society of Dermatologists, Venereologists and Leprologists of Nepal (SODVELON) 2020-10-01
Series:Nepal Journal of Dermatology, Venereology & Leprology
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Online Access:https://nepjol.info/index.php/NJDVL/article/view/27120
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author Apurva Kaushal
Pratik Gahalaut
R K Goyal
Neni Agarwal
Nitin Mishra
Madhur Kant Rastogi
author_facet Apurva Kaushal
Pratik Gahalaut
R K Goyal
Neni Agarwal
Nitin Mishra
Madhur Kant Rastogi
author_sort Apurva Kaushal
collection DOAJ
description 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.
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publishDate 2020-10-01
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spelling doaj-art-2eec1a54252d4777a656a3d80f40d0522025-08-24T10:06:12ZengSociety of Dermatologists, Venereologists and Leprologists of Nepal (SODVELON)Nepal Journal of Dermatology, Venereology & Leprology2091-02312091-167X2020-10-01181Antifungal Susceptibility Pattern of Non - Dermatophytic Fungi Causing OnychomycosisApurva Kaushal0Pratik Gahalaut1R K Goyal2Neni Agarwal3Nitin Mishra4Madhur Kant Rastogi5FAIZABAD, Uttar PradeshShri Ram Murti Smarak Institute of Medical Sciences, BareillyShri Ram Murti Smarak Institute of Medical Sciences, BareillyShri Ram Murti Smarak Institute of Medical Sciences, BareillyShri Ram Murti Smarak Institute of Medical Sciences, BareillyShri Ram Murti Smarak Institute of Medical Sciences, Bareilly 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. https://nepjol.info/index.php/NJDVL/article/view/27120Antifungal AgentsFluconazoleItraconazoleOnychomycosisTerbinafine
spellingShingle Apurva Kaushal
Pratik Gahalaut
R K Goyal
Neni Agarwal
Nitin Mishra
Madhur Kant Rastogi
Antifungal Susceptibility Pattern of Non - Dermatophytic Fungi Causing Onychomycosis
Nepal Journal of Dermatology, Venereology & Leprology
Antifungal Agents
Fluconazole
Itraconazole
Onychomycosis
Terbinafine
title Antifungal Susceptibility Pattern of Non - Dermatophytic Fungi Causing Onychomycosis
title_full Antifungal Susceptibility Pattern of Non - Dermatophytic Fungi Causing Onychomycosis
title_fullStr Antifungal Susceptibility Pattern of Non - Dermatophytic Fungi Causing Onychomycosis
title_full_unstemmed Antifungal Susceptibility Pattern of Non - Dermatophytic Fungi Causing Onychomycosis
title_short Antifungal Susceptibility Pattern of Non - Dermatophytic Fungi Causing Onychomycosis
title_sort antifungal susceptibility pattern of non dermatophytic fungi causing onychomycosis
topic Antifungal Agents
Fluconazole
Itraconazole
Onychomycosis
Terbinafine
url https://nepjol.info/index.php/NJDVL/article/view/27120
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