Characterization of Dermatophytes and Non-dermatophytes Isolated from Patient with Onychomycosis, Attending at Rank Dermatology Clinic, Addis Ababa, Ethiopia.
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Date
2021-03
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Addis Abeba University
Abstract
Background: Onychomycosis a chronic nail infection caused by dermatophyte, yeast, and non-
dermatophyte molds, is one of the most usual forms of people disease, Onychomycosis in adults
contribute around 50% of wholly nail illnesses. Nail mycoses give until 2-9% global and its
occurrence is regularly growing mainly in poor state. Even though Onychomycosis is minor
illness, it affects patient psychology and also it is expensive disease by means of absenteeism from
job due to seeking medication and also it has job discomfort. Regardless of recent advanced in the
development of anti-fungal drugs and therap
y Onychomycosis is still difficult to treat conventional
treatments often fail and it has been suggested that many reasons such as age, peripheral vascular
disease, nail growth, poor drug penetration into the nail lesions and fungal growth patterns
adversely affect clinical result.
Objective: This research was designed to assess the prevalence of Onychomycosis and spectrum
of fungal etiologic agent’s associate with the nail mycosis among patients attending at Rank
dermatologic clinic from February-July 2019 G.C Addis Ababa, Ethiopia.
Material and methods: The present study was a single institutional cross-sectional study was
conducted among a total of 200 patients visiting dermatology clinic from Feb 2019 to July 2019
at Rank dermatology clinic in Addis Ababa. Nail scrapings that was collected from study
participants following standard procedure. A small amount nail scraps specimen was put on a slide
then added droplet of 20% KOH and stay for a minimum of 5 minutes, then detection was
performed by direct microscope for the positive or negative of fungal pathogen. The rest of nail
scraped of ev
ery specimen was inoculated on culture media. At same time culture processed for
every positive or negative result of detection. Every nail scraps specimen was inoculated on two
petredishe Mycosel agar and Sabouraud’s dextrose agar prepare with antimicrobial antibiotics but
not added cycloheximide. All culture media performed based on the manufacture’s guide and
inoculated media stay at room temperature (25-30 C 0) aerobically and put the inoculated plate by
inverted part up to six weeks. The processed media which incubate in the incubator were checked
3 times per week for the presence or absence of any growth. Culture growth supposed for
dermatophytes were sub-cultured onto potato dextrose agar to generate pure isolate. Molds were
found by investigative macroscopic and microscopic analysis. Microscopic detection of Molds
was done by small amount from growth culture putting to new slide and added lactophenol cotton
blue reagent then cover by a cover slip and examined by microscope. Yeast investigation of C.
albicans by performed by germ tube production. Data
was evaluated by performing excel and SPSS
version 20 software.
Results: Out of 200 nail scrap samples processed, 161(80.5%) yielded significant Onychomycosis
of which 106(65.8) obtained from female patients and 55(34.2%) were from male patients. The
ages of research participant were from 2 to 72 year. From 200 study participant, 61(30.5%) fungal
element was detected by direct microscopy whereas 161(80.5%) nail scraps specimen was isolated
by culture and Six specimens become negative for culture whereas positive by KOH detection.
Non dermatophyte were the main pathogen that contribute 99(61.5
%) after that mixed pathogen
in 26 (16.1%) patient and then dermatophytes were identified in 22(13.7%) next by yeasts that
contributed 14(8.7%) of the isolates. Aspergillus fumigatus was the predominate fungal pathogen
identified from non-dermatophytes and from dermatophyte, T.mentagrophyte was the leading
fungal pathogen and also Candida albican was the chief fungi identify from yeast.
Conclusion: The prevalence Onychomycosis was high, that was 161/200 (80.5%). However non-
dermatophytes were the most common causative agents for Onychomycosis, dermatophyte and
yeasts fungi also representing the reason for Onychomycosis are diverse. Clinical diagnosis, direct
microscopy and culture isolate are essential for appropriate analysis. These highlight the need for
nationwide study on the spectrum.
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Keywords
Dermatophytes , non-dermatophytes,Onychomycosis