Abstract

Objective: Dermatomycosis is an infection with fungi related to the skin: glabrous skin, hair and/or nails. Oral treatment of fungal infections in dermatology has become a preferred modality for the management of these very common conditions. Although there are increasing numbers of antifungals available for treatment of dermatophytes, some cases and relapses have been unresponsive to treatment. The determination of fungus in-vitro antifungal susceptibility has been reported to be important for the ability to eradicate dermatophytes. It is necessary to perform antifungal susceptibility testing of dermatophytes. E-test (AB Biodisk, Sweden) is a rapid, easy-to-perform in-vitro antifungal susceptibility test. The aim of this study was to investigate the susceptibility of the different species of dermatophyte strains isolated clinical specimens to five antifungal agents using the E-test method. 

Materials and Methods: A total of 66 specimens were collected from the nails, feet, inguinal region, trunk and hands. These strains tested MIC endpoints of E-test for amphotericin B, fluconazole, itraconazole, caspofungin, and ketoconazole were read after 72, and 96 hours incubation for each strain on RPMI 1640 agar. 

Results: The dermatophytes tested included Trichophyton rubrum 43 (65.1%), Trichophyton mentagrophytes 7 (10.7%), Microsporum canis 5 (7.6%), Trichophyton tonsurans 5 (7.6%), Epidermophyton floccosum 4 (6.0%) and Trichophyton violaceum 2 (3.0%). The most active agent against all dermatophytes species was caspofungin with a minimal inhibitory concentration (MIC) range (μg/mL-1) (0.02-3, 0.032- 4, 0.125-0.50, 0.032-2, 0.25-0.50, 0.125-0.50) and it raconazole with an MIC range (μg/mL-1) (0.038-1.5, 0.094-1.5, 1-32, 0.016-0.50, 0.25-0.50, 0.125-0.50). The least active agent was fluconazole with an MIC range (μg/mL-1) (0, 19-48, 2-256, 2-8, 256, 256, 8-24).

Conclusion: E-test seems to be an alternative method to MIC-determination of antifungal drugs for dermatophytes species, since it is a less-laborious methodology and results could be obtained faster.