Incidence and prevalence of dermatophytosis in and around Chennai, Tamilnadu, India

Background: Dermatophytes are group of fungi that infect keratinized tissues of human and animals. The group consist of three different genera namely, Trichophyton, Microsporum, Epidermophyton and several species within each genera. Among Trichophyton, Trichophyton rubrum is predominant, followed by various strains of Trichophyton mentagrophytes, which include both anthropophiles and zoophiles. Prevalence of dermatophytes varies with location and environmental condition. The infection is common worldwide with higher prevalence in tropical countries like India. Molecular diagnosis renders accurate identification of clinical dermatophyte isolates to species level. The main objective of this study was to determine the prevalence of dermatophytoses, isolate and identify the dermatophyte from samples of clinically suspected cases attending tertiary care centre using conventional and molecular methods.Methods: A total of 210 patients showing lesions typical of dermatophytes infection from outpatient Department of dermatology were sent to mycology unit, Department of Microbiology for the period of April 2011-March 2014 were studied. Diagnosis was confirmed by conventional and polymerase chain reaction - restriction fragment length polymorphism (PCR-RFLP) technique.Results: Out of 210 samples received, tinea corporis was the predominant clinical site which was followed by tinea cruris. A total of 143 dermatophytes were isolated from the clinical samples. T. rubrum was the predominant etiological agent with 70/143 isolates and T. mentagrophytes was the second most common with 64/143 isolates. Amplification of internal transcribed spacers (ITS) was successful in all the clinical isolates by PCR and produced species specific banding pattern in RFLP using restriction enzyme Mva I.Conclusions: Among dermatophytoses, T. rubrum was the predominant etiological agent present in the whole of Chennai District and T. mentagrophytes takes the second place

Evaluation of antifungal susceptibility testing in Candida isolates by Candifast and disk-diffusion method

With the increase in invasive fungal infections due to Candida species and resistance to antifungal therapy, in vitro antifungal susceptibility testing is becoming an important part of clinical microbiology laboratories. Along with broth microdilution and disk diffusion method, various commercial methods are being increasingly used for antifungal susceptibility testing, especially in the developed world. In our study, we compared the antifungal susceptibility patterns of 39 isolates of Candida to three antifungal drugs (fluconazole, amphotericin B, ketoconazole) by Candifast and disk diffusion method. The following resistance pattern was found by Candifast: Fluconazole (30.8%), ketoconazole (12.8%), amphotericin B (0%). The results obtained by disk diffusion method were in complete agreement with Candifast results

Postoperative fungal endophthalmitis due to Basidiobolus ranarum: Report of a rare case

Postoperative fungal endophthalmitis is a significant cause of visual loss due to the rapid progress and severe inflammation. Management is dictated by the precise identification of fungus subspecies, choice of antifungal agent, and associated systemic features. We report a rare case caused by Basidiobolusranarum, never known to have caused endophthalmitis or any form of ocular infection or inflammation. A 59-year-old, Asian, immunocompetent, agriculturist presented with endophthalmitis on the 3 rd postoperative day. Smear and culture from the aqueous and vitreous samples detected a species of fungus called Basidiobolusranarum. Fungal endophthalmitis should be suspected even in patients who present in the early postoperative period and rare species considered even in immunocompetent individuals. Early detection and aggressive treatment is necessary for preventing morbidity or mortality due to these infections

Malassezia-Can it be ignored?

Genus Malassezia comprises of 14 species of "yeast like fungi," 13 of which are lipophilic and 1 is nonlipophilic. They are known commensals and in predisposed individuals they commonly cause a spectrum of chronic recurrent infections. They rarely also cause serious illnesses like catheter-related blood stream infections, CAPD associated peritonitis etc., Though these fungi have been known to man for over 150 years, their fastidious nature and cumbersome culture and speciation techniques have restricted research. Since the last taxonomic revision, seven new species have been added to this genus. Their ability to evade the host immune system and virulence has increased the spectrum of the diseases caused by them. These agents have been implicated as causal agents in common diseases like atopic dermatitis recently. Though culture-based research is difficult, the new molecular analysis techniques and facilities have increased research in this field such that we can devote more attention to this genus to study in detail, their characteristics and their growing implications implications in the clinical scenario

Evaluation of 3-(4,5-dimethylthiazol- 2-yl)-2,5-diphenyl tetrazolium bromide method for assessing biofilm formation in vitro by Trichosporon spp.

BACKGROUND: Invasive infections due to Trichosporon spp. have increased recently and are frequently associated with indwelling medical devices. Such infections which are associated with biofilm formation do not respond to the routinely used antifungal agents and are often persistent, associated with high mortality rate. Various methods have been described by researchers to evaluate and quantify the biofilm formation. AIM: This study was conducted to compare two methods of biofilm production by Trichosporon sp, i.e., test tube method with crystal violet (CV) staining and 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyl tetrazolium bromide (MTT) assay. MATERIALS AND METHODS: Seventy-two clinical isolates of Trichosporon spp. collected from various sources were considered for the study. The identity of all the isolates was genotypically confirmed by Trichosporon-specific polymerase chain reaction (PCR). The isolates were further speciated phenotypically using biochemical profile and growth characteristics which identified the isolates as Trichosporon asahii (64/72), Trichosporon asteroides (5/72), Trichosporon cutaneum (2/72), and Trichosporon mucoides (1/72). Biofilm production was then evaluated and compared by test tube-CV method and MTT assay. RESULTS: All the Trichosporon isolates produced biofilm by MTT assay, whereas only 42 (53.6%) of the isolates were detected to be biofilm producers by CV method. Furthermore, MTT assay could differentiate better between weak and moderate biofilm producers as compared to CV method. CONCLUSION: Hence, MTT assay is a reliable method for quantification of biofilm produced by Trichosporon spp. using 96-well microtiter plate

Curvularia lunata, a rare fungal peritonitis in continuous ambulatory peritoneal dialysis (CAPD); a rare case report

Peritonitis is an inflammation of the peritoneum that occurs in patients with end-stage renal disease (ESRD) treated by peritoneal dialysis. Fungal peritonitis is a dreaded complication of peritoneal dialysis. Curvularia lunata is known to cause extra renal disease like endocarditis, secondary allergic bronchopulmonary aspergillosis and endophthalmitis. This case report presents a case of continuous ambulatory peritoneal dialysis peritonitis with this disease and its management. This case is of a 45-year-old man, presented with ESRD, secondary to diabetic nephropathy. After 3 months of hemodialysis the patient was put on continuous ambulatory peritoneal dialysis (CAPD). Local Examination at catheter site showed skin excoriation and purulent discharge. Further peritoneal dialysis (PD) fluid analysis showed neutrophilic leukocytosis and diagnosis of Curvularia lunata PD peritonitis