A Study of Prevalence of Dermatophytes in North Chennai and a Profile of Their Antifungal Susceptibility Pattern.

Suganthi, M (2010) A Study of Prevalence of Dermatophytes in North Chennai and a Profile of Their Antifungal Susceptibility Pattern. Masters thesis, Stanley Medical College, Chennai.

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Abstract

INTRODUCTION : The cutaneous infections of man includes a wide variety of diseases In which the integuments and its appendages the hair and the nail are Involved. Infection is generally restricted to the non lining cornified layer But a variety of changes occur in the host because of the presence of the Infectious agent and its metabolic products. Majority of the infections are Caused by a homogenous group of keratophilic fungus called the Dermatophytes. A single species might be involved in several clinical Types each with its distinct pathology. The fungi are the commonest Infective agent of man and no group of people or geographical areas are Without taenia or ringworm infection (taenia-latin for worm). Evolutionary Development towards an accommodating host parasite relationship can be Seen among the dermatophytes which is absent among other fungal agent of Human disease. This group of disease is collectively referred to as Dermatophytosis. Dermatophytes are a group of closely related group of organisms that Can use keratin as a nitrogen source. On the basis of clinical, Morphologic and microscopic charecterteristics three genera are recognized As Dermatophytes; Trichophyton, Microsporum and Epidermophyton. Depending on their natural habitat dermatophytes may be Anthropophilic (people loving), Zoophilic(animal loving) and Geophilic (soil loving). Dermatophytes includes several distinct clinical varieties, depending On the anatomical site and the etiological agent involved. The pathology Induced on the host initially is an eczemiform response followed by allergy And inflammatory manifestations. The type and severity of these reactions Are related to the immune status of the host as well as to the strain and Species of the organism causing the infection. AIMS AND OBJECTIVES : 1. To isolate the dermatophytes from clinical specimens like skin, nail and hair obtained from patients attending Dermatology OP. 2. To speciate the isolates of dematophytes. 3. To study the correlation of fungal isolates and the clinical manifestations. 4. To determine the commonest prevalent genus and species of dermatophytes in North Chennai. 5. To determine the antifungal susceptibility of the isolates by different methods. 6. To compare the results obtained by different methods. 7. To determine the MIC values of different drugs for the isolates. CONCLUSION : 1. 170 clincally diagnosed cases of dematophytosis were subjected to mycological study. 2. Male : Female sex ratio was 54%: 46%. 3. Maximum isolates of dermatophytes were from the age group of above20 years (70%) The post pubertal changes in harmones may be attributable to this finding. 4. Maximum number of Tinea capitis cases was found in the age group of >10 years. As universally reported Tinea capitis is a infection of children. 5. Culture positivity was 35.2%. Tinea unguium cases showed more positivity than other lesions(28%) 6. Trichophyton spp were the predominant isolates (93.9%) followed by Microsporum spp (5%) and Epidermophyton (3.3%). 7. Trichophyton rubrum was the most predominant isolate from skin(35.7%) and nail (28.5%).Adults males were found to be more susceptible to T.rubrum infection than children. 8. In Tinea corporis, Trichophyton rubrum was the most commonest isolate (46.6%). 9. In cases of Tinea cruris, Trichophton verrucosum and Epidermophyton floccosm were isolated in maximum numbers (33.3% each). 10. In Tinea capitis, Trichophyton violeceum was isolated maximally (44.4%). 11. In Tinea mannum , Trichophyon mentagrophytes was the main isolate (50%). 12. In Tinea pedis , Trichophyton tonsurans was the maximum isolated species(66.6%). 13. In Tinea barbae , 50% of isolates were Trichophyton mentagrophytes and 50% were Trichophyton verrucosum. 14. In tinea unguium , Trichophyton rubrum was the main isolate (28.5%) followed by Trichophyton mentagrophytes (23.8%) and Trichophyton verrucosum (19%). 15. Fluconazole showed a higher MIC value when compared to other drugs by both methods. 16. Terbinifine was found to be the most effective antifungal drug as evaluated by the agar dilution method and microbroth dilution method. 17. A marked reduction in the MIC range was noted when antifungal susceptibility testing was done by microbroth dilution method. 18. Terbinifine was the most effective of all the drugs tested. In recent years several studies on In vitro susceptibility of dermatophytes to anti fungal drugs have been done and the results have shown considerable variation. This variability is probably due to important methodological differences among the laboratories. Our study demonstrated that several antifungal agents are very active against dermatophytes, although these results are species dependent. This can allow clinician to adopt different therapeutic options with high probability to successful results.

Item Type: Thesis (Masters)
Uncontrolled Keywords: Dermatophytes ; Prevalence ; North Chennai ; Antifungal ; Susceptibility Pattern.
Subjects: MEDICAL > Microbiology
Depositing User: Subramani R
Date Deposited: 26 Jul 2017 03:56
Last Modified: 26 Jul 2017 03:56
URI: http://repository-tnmgrmu.ac.in/id/eprint/1697

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