Clinico-mycological profile of recurrent dermatophytosis with drug sensitivity in a tertiary care center in Southern Odisha

Abstract

Background: Recurrent dermatophytosis is a pressing problem worldwide due to inadequate treatment, drug resistance, and indiscriminate use of topical steroids. This scenario increases the need for the study of risk factors and antifungal susceptibility testing. There is a paucity of information on this subject. Objective: We aimed to find the clinico-mycological pattern of recurrent dermatophytic infections, the factors responsible for recurrence and determine the sensitivity pattern of isolates against four antifungals (fluconazole, itraconazole, terbinafine, and amphotericin B). Materials and Methods: Patients with recurrent dermatophytosis attending the outpatient Department of Our Tertiary Care Institute were enrolled in this study. A detailed history was taken; clinical examination was done; samples were collected for mycological examinations, and in-vitro antifungal sensitivity testing was done by broth microdilution method as per Clinical and Laboratory Standard Institute M38-A guidelines. Results: One hundred and twenty-eight patients were included in the study with a male:female ratio of 1.38:1. The most commonly affected age group was 31–40 years. Tinea corporis with tinea cruris was the most common type of clinical presentation. Potassium hydroxide mount was positive in 53 samples and culture was positive in 59 samples. Trichophyton rubrum was the predominant species isolated, followed by Trichophyton mentagrophytes. On in-vitro antifungal susceptibility testing, itraconazole and amphotericin B had the lowest minimum inhibitory concentrations (MIC), followed by terbinafine. Fluconazole had the highest MIC among the drugs tested. Conclusion: Topical corticosteroid abuse, lack of personal hygiene, and habit of sharing clothes were seen in many patients with recalcitrant dermatophytosis. T. rubrum was the most common isolated species. Antifungal susceptibility testing revealed itraconazole and amphotericin B to have the lowest MIC value and fluconazole to have the highest MIC value.