A Study on Prevalence of Superficial Mycoses and its Anti-Fungal susceptibility pattern in Diabetic patients in a Tertiary Care Hospital.

Ponnammal, P (2013) A Study on Prevalence of Superficial Mycoses and its Anti-Fungal susceptibility pattern in Diabetic patients in a Tertiary Care Hospital. Masters thesis, Madras Medical College, Chennai.

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Abstract

INTRODUCTION : Diabetes mellitus is a chronic metabolic dysregulation of glucose. It is A world-wide problem of increasing importance. It affects approximately 285 Million people and likely to rise to 438 million by 2030. In Asia, where two thirds of the world’s diabetic patients live , the type 2 diabetes accounts for 90% of the cases. Population based analysis states that the prevalence of Diabetes in India was 31.7 million in 2000 and will rise to 79.4 million in 2030. Cutaneous infection accounts for 20-50% of the skin manifestation Among the diabetic patients due to poor glycaemic control. More often These cutaneous signs heightens the suspicion of a physician regarding the Diagnosis of the disease. The fungal infection is the commonest cutaneous infection in diabetic Patients. Moreover the prevalence of superficial mycoses namely Onychomycosis and tinea pedis is 75% in diabetic patients especially in type 2. The relative occurrence of the etiological agents of these superficial Mycotic infections varies among countries. Hence this study was conducted to know the prevalence and the causative agents in our region. Diabetes is often associated with various serious complications, in particular diabetic foot ulcers .This causes considerable morbidity, disability and also the leading cause for foot amputations and hospitalization. AIMS AND OBJECTIVES : To study the prevalence of superficial mycoses in Diabetes Mellitus. To isolate and identify the causative organisms of superficial mycoses . To evaluate the minimum inhibitory concentration (MIC) and the antifungal susceptibility pattern of the isolates. MATERIALS AND METHODS : The study was conducted after obtaining approval from the institutional ethical committee of Madras Medical college, RGGGH, Chennai. Permission to conduct this study was received from the Institute of Diabetology and Institute of Dermatology .Informed consent was obtained from the patients before their enrollment in the study. All diabetic patients attending diabetology and dermatology OPD and those admitted with fungal infections of skin,hair and nail. Sample size-150. Inclusion criteria - All diabetic patients (type I and II) presenting with clinical features suggestive of superficial mycoses. Exclusion criteria - Patients on immunosuppressive drugs, Patients on Systemic antibiotic therapy, Patients on oral contraceptive pills, Patients on long term steroids, Autoimmune disorders. CONCLUSION : Diabetes is increasing worldwide and the mortality due to diabetic foot syndrome is also on the rise.Superficial mycoses accounts the common cutaneous manifestation and especially onychomycosis which can act as a chronic reservoir. Due to associated complications like neurovasculopathy, obesity and hyperglycaemia, the tissues are further damaged before the patient can recognise the lesion. The chronicity and tissue disruption can lead to secondary bacterial infection. Clinical suspicion, early laboratory examination to confirm diagnosis and appropriate treatment is very crucial in this group of patients. Diabetic patients are susceptible to superficial mycoses irrespective of their age, gender, type of DM and blood sugar level as proved with statistical analysis. Thus their immunosuppressive state is the main risk factor. Though early complete course of treatment gives mycological cure, resistant strains are also occurring which can act as a chronic reservoir of infection.Hence routine antifungal susceptibility testing especially in these group of patients for whom mycological cure can save a limb has to be done routinely for timely interventions.

Item Type: Thesis (Masters)
Uncontrolled Keywords: Prevalence ; Superficial Mycoses ; Antifungal Susceptibility Pattern ; Diabetic Patients ; Tertiary Care Hospital.
Subjects: MEDICAL > Microbiology
Depositing User: Subramani R
Date Deposited: 02 Aug 2017 01:54
Last Modified: 02 Aug 2017 01:54
URI: http://repository-tnmgrmu.ac.in/id/eprint/1735

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