A Study on the Prevalence of Dermatophytosis and Rapid Identification of Dermatophytes in a Tertiary Care Hospital.

Hemalatha, K (2006) A Study on the Prevalence of Dermatophytosis and Rapid Identification of Dermatophytes in a Tertiary Care Hospital. Masters thesis, Madras Medical College, Chennai.

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Abstract

INTRODUCTION : Fungal infections are very common in man. Dermatophytosis are the most common types of cutaneous fungal infection seen in man affecting skin, hair, and nail in both developed and developing countries due to advent of immunosuppressive drugs and diseases84. Hot and humid climate in the tropical and subtropical countries like India makes dermatophytosis or ringworm as very common superficial fungal infection. The dermatophytes are keratinophilic fungus, which causes dermatophytosis by virtue of their unique ability to degrade keratin and thus colonize and invade the skin and its appendages. The infections caused by dermatophytes are clinically classified on the basis of the location of the lesion on the body. The name ‘ringworm’ was based on the worm like appearance of lesion with irregular inflammatory border with some clearing of central area of the lesion. The infection are named according to the body site after the Latin word Tinea. Antifungal susceptibility testing is receiving increased attention with the advent of newer antifungal drugs53. Antifungal resistance is important whenever the treatment failure occurs, and need to establish the sensitivity of the causal organism. In such cases antifungal drugs are ideally given on the basis of in vitro sensitivity of the isolates68. Choosing the best therapy for each patient has become very important now a days and the day is not so far off when clinicians would expect susceptibility testing for guiding the selection of appropriate drugs. AIM OF THE STUDY : To isolate and identify the Dermatophyte species from clinically diagnosed cases of dermatophytosis patients attending the out patient clinic of the Department of Dermatology, Government General Hospital. Chennai. To evaluate the incidence of dermatophytosis in the immediate environment and to characterize the dermatophytes isolates from different categeries of patients. To compare the sensitivity and specificity of Calcofluor white Staining with 10% KOH wet mount in direct microscopic examination. To study the effectiveness and rapid identification using Dermatophyte Identification Medium (DIM) with Sabouraud’s Dextrose Medium with antibiotics and cycloheximide in isolation of dermatophytes. To perform Antifungal susceptibility testing to find out Minimum Inhibitory Concentration for chronic dermatophyte isolates by Agar Dilution Method using Yeast Nitrogen Dextrose Agar with Fluconzole and Griseofulvin. MATERIALS AND METHODS : This study was a discriptive study, where one hundred and five patients, who attended the out patient clinic of the Department of Dermatology, Government General Hospital, Chennai, and clinically diagnosed as dermatophytosis during one year period between August 2004 to August 2005 were the study group. Complete details about data of the patient and history were recorded as shown in the proforma given in the appendix. No: 9. These included the age, sex of the patient, duration of the lesion i.e duration less than one year taken as acute and more than one year of lesion were taken as chronic, H/O recurrence, type of the lesion, whether scaly or papular, site of lesion, , any contact with pet animal, house hold contacts and about the details regarding immunosuppressive illness or therapy and treatment taken earlier. CONCLUSION : Dermatophtes isolated included predominately Trichophyton species, of which T.rubrum was the commonest in both acute and chronic dermatophytosis. T.mentagrophytes, T.rubrum, T.tonsurans, T.simii, T.verrucosum, M.gypseum were other isolates from chronic illness. Source of infection of T.simii, T.verrucosum was from patient’s pet animal. Source of infection to be monitored especially in zoophilic isolates. T.violaceum was isolated from T.capitis and E.floccosum from T.corporis. Calcofluor white is ideal for microscopic examination for detection of fungi in clinical sample even though it is cost effective, accurate diagnosis can be obtained without false positive results and it does not require experienced person for interpretation. Dermatophyte Identification Medium is an inexpensive rapid means of presumptively identifying dermatophyte from clinical samples. It is useful in laboratories which has no access to mycological consultation and in large public screening. It is particularly useful in rapidly identifying the dermatophytes, so the antifungal drugs can be started earlier in order to prevent its complication. Majority of the dermatophyte isolate had MIC within normal range. Periodic evaluation of Antifungal Susceptiblity Testing is necessary especially in immune suppressive illness and in chronic dermatophytosis to find out antifungal resistance.

Item Type: Thesis (Masters)
Uncontrolled Keywords: Dermatophytosis ; Rapid Identification ; Dermatophytes ; Tertiary Care Hospital.
Subjects: MEDICAL > Microbiology
Depositing User: Subramani R
Date Deposited: 11 Aug 2017 02:17
Last Modified: 11 Aug 2017 02:17
URI: http://repository-tnmgrmu.ac.in/id/eprint/1317

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