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 adultscontribute around 50% of wholly nail illnesses. Nail mycoses give until 2-9% global and itsoccurrence is regularly growing mainly in poor state. Even though Onychomycosis is minorillness, it affects patient psychology and also it is expensive disease by means of absenteeism fromjob due to seeking medication and also it has job discomfort. Regardless of recent advanced in thedevelopment of anti-fungal drugs and therapy Onychomycosis is still difficult to treat conventionaltreatments 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 spectrumof fungal etiologic agent’s associate with the nail mycosis among patients attending at Rankdermatologic clinic from February-July 2019 G.C Addis Ababa, Ethiopia.
Material and methods: The present study was a single institutional cross-sectional study wasconducted among a total of 200 patients visiting dermatology clinic from Feb 2019 to July 2019at Rank dermatology clinic in Addis Ababa. Nail scrapings that was collected from studyparticipants following standard procedure. A small amount nail scraps specimen was put on a slidethen added droplet of 20% KOH and stay for a minimum of 5 minutes, then detection wasperformed by direct microscope for the positive or negative of fungal pathogen. The rest of nailscraped of every specimen was inoculated on culture media. At same time culture processed forevery positive or negative result of detection. Every nail scraps specimen was inoculated on twopetredishe Mycosel agar and Sabouraud’s dextrose agar prepare with antimicrobial antibiotics butnot 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 fordermatophytes were sub-cultured onto potato dextrose agar to generate pure isolate. Molds werefound by investigative macroscopic and microscopic analysis. Microscopic detection of Moldswas done by small amount from growth culture putting to new slide and added lactophenol cottonblue reagent then cover by a cover slip and examined by microscope. Yeast investigation of C.albicans by performed by germ tube production. Datawas evaluated by performing excel and SPSSversion 20 software.
Results: Out of 200 nail scrap samples processed, 161(80.5%) yielded significant Onychomycosisof which 106(65.8) obtained from female patients and 55(34.2%) were from male patients. Theages of research participant were from 2 to 72 year. From 200 study participant, 61(30.5%) fungalelement was detected by direct microscopy whereas 161(80.5%) nail scraps specimen was isolatedby 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 pathogenin 26 (16.1%) patient and then dermatophytes were identified in 22(13.7%) next by yeasts thatcontributed 14(8.7%) of the isolates. Aspergillus fumigatus was the predominate fungal pathogenidentified from non-dermatophytes and from dermatophyte, T.mentagrophyte was the leadingfungal 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 andyeasts fungi also representing the reason for Onychomycosis are diverse. Clinical diagnosis, directmicroscopy and culture isolate are essential for appropriate analysis. These highlight the need fornationwide study on the spectrum.
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Keywords
Dermatophytes , non-dermatophytes,Onychomycosis