Antifungal Susceptibility of Dermatophyte Isolates from Patients with Chronic and Recurrent Dermatophytosis

Background: The widespread occurrence of chronic and recurrent dermatophytosis has significantly affected the quality of life for patients in India and beyond. Identifying the causative dermatophytes and understanding their antifungal susceptibility can aid clinicians in tailoring effective antifung...

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Main Authors: Nikhitha Amin, Manjunath M. Shenoy, Vidya Pai
Format: Article
Language:English
Published: Wolters Kluwer Medknow Publications 2025-01-01
Series:Indian Dermatology Online Journal
Subjects:
Online Access:https://journals.lww.com/10.4103/idoj.idoj_192_24
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author Nikhitha Amin
Manjunath M. Shenoy
Vidya Pai
author_facet Nikhitha Amin
Manjunath M. Shenoy
Vidya Pai
author_sort Nikhitha Amin
collection DOAJ
description Background: The widespread occurrence of chronic and recurrent dermatophytosis has significantly affected the quality of life for patients in India and beyond. Identifying the causative dermatophytes and understanding their antifungal susceptibility can aid clinicians in tailoring effective antifungal therapies. Materials and Methods: Patients with chronic and recurrent dermatophytosis were enrolled, and conventional fungal cultures were conducted on skin scrapings. Identified isolates underwent antifungal susceptibility testing using the Clinical and Laboratory Standards Institute broth microdilution method (CLSI M38-A2) for common systemic antifungals, determining the minimum inhibitory concentration (MIC) range and calculating MIC 50 and MIC 90. Results: Sixty samples were tested. Tinea corporis was the most common presentation (66.6%). Trichophyton mentagrophyte species complex was the prevalent species (45, 75%), followed by Trichophyton rubrum (7, 11.7%). In Trichophyton mentagrophytes species complex, MIC range was 8-64 μg/mL for fluconazole, 0.06-0.25 μg/mL for terbinafine, and 0.125-0.5 μg/mL for griseofulvin. For Trichophyton rubrum, the MIC range was 8-64 μg/mL for fluconazole, 0.06-0.25 μg/mL for terbinafine, and 0.125-0.5 μg/mL for griseofulvin. For all species, itraconazole MIC was ≤0.125 μg/mL. Hence, itraconazole and terbinafine had the best MIC range against tested isolates in our study. Limitations: Absence of genotyping of isolate and not compared the results with studies where sequence-based identification to species level was done. Conclusion: In vitro, resistance to itraconazole for any of the four isolated agents was not seen. Terbinafine resistance appears to be an uncommon occurrence in South India. In vitro susceptibility tests shall be regularly done to design the epidemiological cutoff values.
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spelling doaj-art-1d9880ddfdce44ba81a55b5c516005672025-01-08T15:35:10ZengWolters Kluwer Medknow PublicationsIndian Dermatology Online Journal2229-51782249-56732025-01-0116111011510.4103/idoj.idoj_192_24Antifungal Susceptibility of Dermatophyte Isolates from Patients with Chronic and Recurrent DermatophytosisNikhitha AminManjunath M. ShenoyVidya PaiBackground: The widespread occurrence of chronic and recurrent dermatophytosis has significantly affected the quality of life for patients in India and beyond. Identifying the causative dermatophytes and understanding their antifungal susceptibility can aid clinicians in tailoring effective antifungal therapies. Materials and Methods: Patients with chronic and recurrent dermatophytosis were enrolled, and conventional fungal cultures were conducted on skin scrapings. Identified isolates underwent antifungal susceptibility testing using the Clinical and Laboratory Standards Institute broth microdilution method (CLSI M38-A2) for common systemic antifungals, determining the minimum inhibitory concentration (MIC) range and calculating MIC 50 and MIC 90. Results: Sixty samples were tested. Tinea corporis was the most common presentation (66.6%). Trichophyton mentagrophyte species complex was the prevalent species (45, 75%), followed by Trichophyton rubrum (7, 11.7%). In Trichophyton mentagrophytes species complex, MIC range was 8-64 μg/mL for fluconazole, 0.06-0.25 μg/mL for terbinafine, and 0.125-0.5 μg/mL for griseofulvin. For Trichophyton rubrum, the MIC range was 8-64 μg/mL for fluconazole, 0.06-0.25 μg/mL for terbinafine, and 0.125-0.5 μg/mL for griseofulvin. For all species, itraconazole MIC was ≤0.125 μg/mL. Hence, itraconazole and terbinafine had the best MIC range against tested isolates in our study. Limitations: Absence of genotyping of isolate and not compared the results with studies where sequence-based identification to species level was done. Conclusion: In vitro, resistance to itraconazole for any of the four isolated agents was not seen. Terbinafine resistance appears to be an uncommon occurrence in South India. In vitro susceptibility tests shall be regularly done to design the epidemiological cutoff values.https://journals.lww.com/10.4103/idoj.idoj_192_24antifungal agentsantifungal resistanceazoledermatophytesterbinafine
spellingShingle Nikhitha Amin
Manjunath M. Shenoy
Vidya Pai
Antifungal Susceptibility of Dermatophyte Isolates from Patients with Chronic and Recurrent Dermatophytosis
Indian Dermatology Online Journal
antifungal agents
antifungal resistance
azole
dermatophytes
terbinafine
title Antifungal Susceptibility of Dermatophyte Isolates from Patients with Chronic and Recurrent Dermatophytosis
title_full Antifungal Susceptibility of Dermatophyte Isolates from Patients with Chronic and Recurrent Dermatophytosis
title_fullStr Antifungal Susceptibility of Dermatophyte Isolates from Patients with Chronic and Recurrent Dermatophytosis
title_full_unstemmed Antifungal Susceptibility of Dermatophyte Isolates from Patients with Chronic and Recurrent Dermatophytosis
title_short Antifungal Susceptibility of Dermatophyte Isolates from Patients with Chronic and Recurrent Dermatophytosis
title_sort antifungal susceptibility of dermatophyte isolates from patients with chronic and recurrent dermatophytosis
topic antifungal agents
antifungal resistance
azole
dermatophytes
terbinafine
url https://journals.lww.com/10.4103/idoj.idoj_192_24
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AT vidyapai antifungalsusceptibilityofdermatophyteisolatesfrompatientswithchronicandrecurrentdermatophytosis