Significativo aumento de onicomicosis por hongos filamentosos no dermatofitos en red de salud privada en Santiago de Chile entre los períodos 2008-2009 y 2016-2017 / Significant increase in onychomycosis due to Filamentous Fungi Non Dermatophytes in Network of Private Health in Santiago de Chile among the periods 2008-2009 and 2016-2017

INTRODUCCION: La onicomicosis corresponde a una patología prevalente causada por hongos dermatofitos, levaduras y en menor proporción, hongos filamentosos no dermatofitos (HFND). Se ha reportado un aumento a nivel mundial en la incidencia de onicomicosis por HFND1 , sin embargo, en Chile no hay registros de ello. OBJETIVO: Comparar la epidemiología local de onicomicosis por HFND en una red privada de Santiago de Chile entre dos períodos de tiempo. Material y métodos: Se realizó un estudio transversal de análisis de los registros de laboratorio de la Red de Salud UC-Christus entre los períodos 2008- 2009 y 2016-2017. RESULTADOS: Se obtuvieron un total de 9.579 muestras en ambos períodos, 4.985 entre 2008-2009 y 4.594 entre 2016-2017, con 3.442 (36%) cultivos positivos para hongos, 1.831 (36,7%) en el primer período y 1.611 (35%) en el segundo. Del total 40 muestras (1,2%) fueron de HFND, destacando que la prevalencia aumentó significativamente entre ambos períodos: 8 (0,4%) y 32 (2,0%) cultivos, respectivamente (p<0,0001). Del total, las especies de HFND más prevalentes fueron: 23 Fusarium sp (57,5%), 8 Scopulariopsis sp (20%) y 7 Acremonium sp (17,5%). En pacientes con cultivo positivo para HFND, se buscaron asociaciones probables en los antecedentes a través de la ficha clínica, sin encontrar resultados significativos. CONCLUCION: Los HFND son la tercera causa de onicomicosis y su prevalencia fue 1,2%. Las especies más frecuentes fueron Fusarium sp, Scopulariopsis sp, Acremonium sp. La prevalencia de HFND aumentó significativamente en un período de 6 años.

INTRODUCTION: Onychomycosis is a frequent nail disease caused mainly by dermatophytes, in less proportion yeast and last non-dermatophyte molds (NDM). NDM onychomycosis is an increasing problem worldwide, though in Chile there is no epidemiological registry about it. OBJETIVE: The aim of the study was to determine the local epidemiology of NDM onychomycosis. MATERIAL Y METHODS: We did a transversal cohort study in the Red de Salud UC-Christus between 2008-2009 and 2016-2017. RESULTS: Of the 9,579 clinically suspected cases of onychomycosis, 4,985 in 2008-2009 and 4,594 in 2016-2017, 3,448 (36%) cultures were positive in total, 1,831 (36.7%) in the first period and 1,611 (35%) in the second. Only 40 cultures (1.2%) were NDM in total, but the prevalence significantly increased between both periods with 8 (0.45%) and 32 (2.0%) cultures, respectively (p y (p<0.0001). Among the total of NDM, the most prevalent species were: 23 Fusarium sp (57.5%), 8 Scopulariopsis sp (20%) and 7 Acremonium sp (17.5%). We searched for possible associations of patients with NDM onychomycosis and morbid history, but found no significant result. COMCLUSION: NDM are the third cause of onychomycosis and its prevalence of 1.2% was predominantly from toe nails. The most frequent species were Fusarium sp, Scopulariopsis sp. and Acremonium sp. The prevalence of NDM increased significantly in a period of 6 years.

Changing Trend of Superficial Mycoses with Increasing Nondermatophyte Mold Infection: A Clinicomycological Study at a Tertiary Referral Center in Assam.

BACKGROUND: Superficial mycosis is the commonest infections affecting human globally. Though they do not cause mortality, their clinical significance lies in their morbidity, recurrence, and cosmetic disfigurement, thus creating a major public health problem. The infections are more prevalent in the tropical regions. The etiological agents are also seen to vary with time and geographical location. AIM: This study was carried out to find out the trend of superficial mycosis in Assam, along with a clinicomycological correlation. MATERIALS AND METHODS: A total of 130 clinically diagnosed cases of superficial mycoses attending the outpatient department (OPD) of a tertiary hospital in Assam for a period of 1 year were taken up for the study. After taking the informed consent and a proper history, the clinical materials like skin scrapings, nail clippings, and infected hair were sent for mycological examination. RESULTS: The infection was found to be more prevalent among males than females (M:F, 3:2) and among the farmers and laborers (24.61%). Tinea corporis was the commonest clinical type (21.5%). Among the fungal isolates, dermatophytes were the most frequent isolates (43.54%), out of which Trichophyton rubrum was commonest. nondermatophyte moulds like Fusarium, Aspergillus, Scopulariopsis, Trichosporon, and Penicillium spp. were isolated. CONCLUSION: The epidemiology of fungal infection and the causative fungi is seen to vary geographically and with time. This study reflects the changing trend of fungal infection in the north eastern region with a high rate of isolation of nondermatophyte moulds as the causative agent.

The nondermatophyte molds: Emerging as leading cause of onychomycosis in south-east Rajasthan.

BACKGROUND: Onychomycosis is a fungal disease of the nail apparatus caused by both dermatophytic and nondermatophytic strains. Treatment involves long duration antifungal therapy. However, long treatment duration without identifying the causative species may lead to resistance. Confirmation of diagnosis and speciation by culture before administering antifungal therapy is ideal. AIMS: To study the clinical and epidemiological aspects of onychomycosis in Hadoti region (south-east Rajasthan) and identify various mycological strains and predisposing factors causing onychomycosis. MATERIALS AND METHODS: A prospective study of clinically diagnosed cases of onychomycosis attending the outpatient Department of Dermatology in our institute conducted from June 2012 to May 2013. The clippings were subjected to potassium hydroxide (KOH) examination and culture in the appropriate medium. RESULTS: A total of 150 cases were enrolled in our study. There were 110 males (73.33%) and 40 females (26.66%) and male to female ratio was 2.75:1. The total dystrophic onychomycosis was the most common presentation seen in the majority of cases (46%) followed by distal lateral subungual onychomycosis in 52 cases (34.6%), mixed onychomycosis in 16 cases (10.66%), superficial white onychomycosis in 11 cases (7.33%), and proximal subungual onychomycosis in 2 cases. None had the endonyx variant. Direct microscopic examination of the nail clipping mounted with 40% KOH demonstrated fungal elements in 83 (55.33%) cases. Rate of isolation of organisms by culture was 64%. Nondermatophytes were isolated in 53 (35.33%), dermatophytes in 28 (18.66%), and yeasts in 15 (10%) of cases. The most commonly isolated species was Aspergillus in 45 (30%) cases. Aspergillus flavus was more commonly isolated compared to Aspergillus niger. CONCLUSION: The nondermatophyte molds appear to be more common causative agents of onychomycosis compared to usual dermatophyte species in south-east Rajasthan. Our study re-emphasizes the importance of culture for diagnosis of onychomycosis in every suspected case prior to therapy.

Isolation Rates of Fungi from Dogs and Horses in Shelters and Soil near Them / 대한의진균학회지

BACKGROUND: Soil is one of the main habitat of fungi and important infection source of dermatophytosis. Objective: This study was performed to assess influence of dogs and horses to distribution of keratinophilic fungi (KPF) in soil. METHODS: We visited 3 dog shelters and 3 horse riding grounds in Daegu and Kyeongbuk province from September to November 2012 and examined isolation rates of fungi from 88 soil samples, 16 dogs and 16 horses. By the distance away from the animal shelters, soil samples were divided into 3 groups consist of near, 10 m and 100 m. Hair and scales from skin of the dogs and the horses were collected by Mackenzie's brush technique. RESULTS: Of the 88 soil samples examined, 35 (39.7%) yielded KPF and were all dermatophytes including Microsporum(M.) gypseum (34.1%) and Trichphyton(T.) ajelloi (5.6%). Isolation rates of KPF from the soil were observed in 79.3% of near, 40% of 10 m, and 0% of 100 m from animal shelters. Of the 16 samples from dogs, 6 (37.5%) yielded positive dermatophyte cultures and they were identified as M. canis 31.2% (5/16) and T. eboreum 6.2% (1/16). Of the 16 samples from horses, 1 (6.2%) yielded positive dermatophyte culture and it was T. eboreum. CONCLUSION: In this study, isolation rates of KPF especially M. gypseum and T. ajelloi were higher in the soil closer to the animal shelters. Soil nearby the dogs and the horses, the environment rich in keratinous material, is conducive for the growth of dermatophytes. But M. gypseum and T. ajelloi that rich in the soil were not isolated from skin of the dogs and the horses. Their pathogenicity might be low. We consider that if not human have immune deficiency or skin injury, they do not cause infection.

Isolation Rates and Carrier State of Dermatophytes, Nondermatophyte Molds, Malassezia Species, and Candida Species in Indoor Dogs and Cats in Daegu / 대한의진균학회지

BACKGROUND: Fungal agents are commonly transmitted from dogs and cats to humans. OBJECTIVE: To identify the mycoflora of and association of skin diseases in dogs and cats fed as pets indoors. METHODS: A total of 435 animals (355 dogs and 80 cats) with or without skin lesions were included in the study; these animals lived indoors and had been examined in a veterinary hospital between August 2010 and May 2011. Their hair and scales were obtained using Mackenzie's brush technique, and a mycologic study was performed. RESULTS: Of the 435 animals examined, 3.2% had dermatophytes (DM), including 1.5% of the dogs with dermatoses (D-dogs), 0.6% of the dogs with normal skin (N-dogs), 43.8% of the cats with dermatoses (D-cats), and 6.3% of the cats with normal skin (N-cats). All the DMs isolated were identified as Microsporum canis. Nondermatophyte molds were isolated from 24.1% of the animals examined, including 19.3% of the D-dogs, 29.7% of the N-dogs, 18.8% of the D-cats, and 26.6% of the N-cats. Of the 435 samples examined, 49.5% yielded Malassezia pachydermatis (Mz. pachydermatis), including those from 58.4% of the D-dogs, 53.8% of the N-dogs, 31.3% of the D-cats, and 17.2% of the N-cats. The prevalence of Mz. pachydermatis infection in dogs aged 6 years and more was higher than that in the other dogs. CONCLUSION: In this study, the prevalence of DM in dogs and cats was lower than that reported in previous studies. DMs were found in a significantly higher percentage of D-cats (43.8%) than D-dogs (1.5%) (p < .001) and of N-cats (6.3%) than N-dogs (0.6%) (p=0.022). The prevalence of nondermatophyte molds did not significantly differ between dogs and cats with dermatoses or normal skin.