Abstract

Background: Superficial fungal infections are extremely common in the tropical and subtropical regions all over the world. Although numerous antifungal drugs are available for the treatment, the pattern of susceptibility to the drugs being used for dermatophytes varies with time and place.

Aims and Objectives: The objective of the study was to isolate, identify, and determine antifungal susceptibility pattern in dermatophytes isolated from patients attending dermatology OPD in a tertiary care hospital.

Materials and Methods: This study was conducted on 150 dermatophytes isolated from clinically diagnosed patients with dermatomycosis of skin and nail attending the Department of Dermatology Outpatient Clinic of JJM Medical College over a period of 1 year. These cases were referred to the Department of Microbiology for fungal isolation, culture and sensitivity testing.

Results: The most frequently affected age group was 21–30 years. The most common clinical manifestation was tinea corporis (52.56%) followed by tinea cruris (26%). The most common dermatophytes implicated were Trichophyton species in 88%. Irrespective of the species, about 96% of our isolates exhibited high minimum inhibitory concentration (MIC) (>1 μg/ml) to fluconazole. The MIC of luliconazole was < 0.004 μg/ml to all the dermatophytes isolates tested, compared to other antifungal agents that were ≥0.25 μg/ml. The MIC range was narrowest for luliconazole 0.002–0.128 μg/ml and the widest for fluconazole, itraconazole, and ketoconazole (0.125–64, 0.0321–16, and 0.0321–16, respectively).

Conclusion: Our study showed that luliconazole was the most active drug against all dermatophytes isolates, followed by itraconazole, ketoconazole, and fluconazole. The higher and wider range in MIC values for itraconazole, ketoconazole, and fluconazole found for some of our isolates raise the possibility of increasing resistance to these drugs.

Key words: Dermatophytes; Antifungal Resistance; Fluconazole; Luliconazole