Volume 3, Issue 4 ( December 2017)                   Curr Med Mycol 2017, 3(4): 26-31 | Back to browse issues page

XML Print

Download citation:
BibTeX | RIS | EndNote | Medlars | ProCite | Reference Manager | RefWorks
Send citation to:

fatahinia M, Jafarpour S, Rafiei A, Taghipour S, Makimura K, Rezaei-Matehkolaei A. Mycological Aspects of Onychomycosis in Khuzestan Province, Iran, a New Scenario as Shift from Dermatophytes towards Yeasts. Curr Med Mycol. 2017; 3 (4) :26-31
URL: http://cmm.mazums.ac.ir/article-1-179-en.html
Abstract:   (1125 Views)
Background and Purpose: Onychomycosis is fungal infection of the nails with an overall increasing incidence, worldwide. The epidemiological aspects of onychomycosis in Khuzestan, Iran have not been established. This study was aimed to evaluate the clinical and mycological status of fungal nail infection in Khuzestan Province, Iran.
Material and Methods: The study population included 433 patients (143 males vs. 290 females). Nail samples were undergone to primary direct microscopy and culture. The isolated yeasts and dermatophytes were then subjected to additional molecular identification by r-DNA ITS-RFLP. Identification of some non-dermatophytes molds (NDMs) and unknown yeasts were accomplished by ITS and beta tubulin sequencing.
Results: Onychomycosis was confirmed in 154 patients (35.6%; 58 males vs. 96 females) whose age ranged from 2-85 years with highest prevalence in the age group of 41-50 years old. Infection was more occurred due to yeasts (59.7%) with Candida albicans as the most frequent (29.35%) species, followed by C. parapsilosis (13.8%) and C. tropicalis (4.5%). Dermatophytes were isolated in 38.35% of the cases; the most commonly isolates were found to be Trichophyton interdigitale (21.1%), Epidermophyton floccosum (10.5%), T. rubrum (5.25%) and Microsporum canis (1.5%). NDMs were isolated only in 4.5% with Aspergillus spp., as the commonest agents. Dermatophytes and NDMs more frequently seen in toenails whereas, yeasts mostly infected fingernails and fingernail onychomycosis has remarkably more occurred in females than males (P < 0.05).
Conclusion: The study highlighted that the agents of infection in the population with onychomycosis from Khuzestan have shifted from dermatophytes to the yeasts.

Full-Text [PDF 465 kb]   (338 Downloads)    
Type of Study: Original Articles | Subject: Medical Mycology
Received: 2018/01/21 | Accepted: 2018/03/10 | Published: 2018/03/17

1. Weitzman I, Summerbell RC. The dermatophytes. Clinical microbiology reviews. 1995;8(2):240-59.
2. Westerberg DP, Voyack MJ. Onychomycosis: Current trends in diagnosis and treatment. 2013;88(11):762-770.
3. Singal A, Khanna D. Onychomycosis: Diagnosis and management. Indian Journal of Dermatology, Venereology, and Leprology. 2011;77(6):659-72 [DOI:10.4103/0378-6323.86475]
4. Ghannoum M, Isham N. Fungal nail infections (onychomycosis): a never-ending story? PLoS Pathog. 2014; 10(6):e1004105. [DOI:10.1371/journal.ppat.1004105]
5. Suryawanshi RS, Wanjare SW, Koticha AH, Mehta PR. Onychomycosis: dermatophytes to yeasts: an experience in and around Mumbai, Maharashtra, India. International Journal of Research in Medical Sciences. 2017;5(5):1959-63. [DOI:10.18203/2320-6012.ijrms20171825]
6. Nouripour-Sisakht S, Mirhendi H, Shidfar MR, et al. Aspergillus species as emerging causative agents of onychomycosis. Journal de Mycologie Médicale. 2015;25(2):101-7. [DOI:10.1016/j.mycmed.2014.12.001]
7. Welsh O, Vera-Cabrera L, Welsh E. Onychomycosis. Clinics in dermatology. 2010;28(2):151-9. [DOI:10.1016/j.clindermatol.2009.12.006]
8. Belyayeva E, Gregoriou S, Chalikias J, . The impact of nail disorders on quality of life. Eur J Dermatol. 2013;23(3):366-371.
9. Aghamirian MR, Ghiasian SA. Onychomycosis in Iran: epidemiology, causative agents and clinical features. Nippon Ishinkin Gakkai Zasshi. 2010;51(1):23-9. [DOI:10.3314/jjmm.51.23]
10. Chadeganipour M, Nilipour S, Ahmadi G. Study of onychomycosis in Isfahan, Iran. Mycoses. 2010;53(2):153-7. [DOI:10.1111/j.1439-0507.2008.01679.x]
11. Chadeganipour M, Mohammadi R. Causative Agents of Onychomycosis: A 7‐Year Study. Journal of clinical laboratory analysis. 2016;30(6):1013-20. [DOI:10.1002/jcla.21973]
12. Hashemi SJ, Gerami M, Zibafar E, Daei M, Moazeni M, Nasrollahi A. Onychomycosis in Tehran: mycological study of 504 patients. Mycoses. 2010;53(3):251-5. [DOI:10.1111/j.1439-0507.2009.01703.x]
13. Mikaeili A, Karimi I. The incidence of onychomycosis infection among patients referred to hospitals in Kermanshah province, Western Iran.Iran J Public Health. 2013;42(3):320-25.
14. Afshar P, Khodavaisy S, Kalhori S, Ghasemi M, Razavyoon T. Onychomycosis in north-East of iran. Iran J Microbiol. 2014;6(2):98-103.
15. Rezaei-Matehkolaei A, Rafiei A, Makimura K, Gräser Y, Gharghani M, Sadeghi-Nejad B. Epidemiological aspects of dermatophytosis in Khuzestan, southwestern Iran, an update. Mycopathologia. 2016;181(7-8):547-53. [DOI:10.1007/s11046-016-9990-x]
16. White TJ, Bruns T, Lee SJ, Taylor JL. Amplification and direct sequencing of fungal ribosomal RNA genes for phylogenetics. PCR protocols: a guide to methods and applications. 1990;18(1):315-22.
17. Rezaei-Matehkolaei A, Makimura K, Shidfar MR, et al. Use of single-enzyme PCR-restriction digestion barcode targeting the internal transcribed spacers (ITS rDNA) to identify dermatophyte species. Iranian journal of public health. 2012;41(3):82-94.
18. Mohammadi R, Mirhendi H, Rezaei-Matehkolaei A, et al. Molecular identification and distribution profile of Candida species isolated from Iranian patients. Medical mycology. 2013;51(6):657-63. [DOI:10.3109/13693786.2013.770603]
19. Glass NL, Donaldson GC. Development of primer sets designed for use with the PCR to amplify conserved genes from filamentous ascomycetes. Appl Environ Microbiol. 1995;61:1323-30.
20. Chi CC, Wang SH, Chou MC. The causative pathogens of onychomycosis in southern Taiwan. Mycoses. 2005;48(6):413-20. [DOI:10.1111/j.1439-0507.2005.01152.x]
21. Godoy-Martinez P, Nunes FG, et al. Onychomycosis in São Paulo, Brazil. Mycopathologia. 2009;168(3):111-6. [DOI:10.1007/s11046-009-9209-5]
22. Dubljanin E, Džamić A, Vujčić I, et al. Epidemiology of onychomycosis in Serbia: a laboratory‐based survey and risk factor identification. Mycoses. 2017;60(1):25-32. [DOI:10.1111/myc.12537]
23. Shahzad M, Alzolibani AA, Al Robaee AA, Saif GA, Babikir IH, Abdel-Magied EM, Elsayed AE. Onychomycosis in qassim region of saudi arabia: a clinicoaetiologic correlation. Journal of clinical and diagnostic research 2014;8(8):YC01-4. [DOI:10.7860/JCDR/2014/8277.4757]
24. Svejgaard EL, Nilsson J. Onychomycosis in Denmark: prevalence of fungal nail infection in general practice. Mycoses. 2004;47(3‐4):131-5. [DOI:10.1111/j.1439-0507.2004.00968.x]
25. El Sayed F, Ammoury A, Haybe RF, Dhaybi R. Onychomycosis in Lebanon: a mycological survey of 772 patients. Mycoses. 2006;49(3):216-9. [DOI:10.1111/j.1439-0507.2006.01224.x]
26. Pakshir K, Zomorodian K, Zakaei A, Motamedi M, Ghiasi MR, Karamitalab M. Molecular identification and in-vitro antifungal susceptibility testing of Candida species isolated from patients with onychomycosis. Current Medical Mycology. 2015;1(4):26-32. [DOI:10.18869/acadpub.cmm.1.4.26]
27. Sanguinetti M, Posteraro B, Lass‐Flörl C. Antifungal drug resistance among Candida species: mechanisms and clinical impact. Mycoses. 2015;58(S2):2-13. [DOI:10.1111/myc.12330]
28. Arendrup MC. Update on antifungal resistance in Aspergillus and Candida. Clinical microbiology and infection. 2014;20(s6):42-8. [DOI:10.1111/1469-0691.12513]
29. Abastabar M, Rezaei-Matehkolaei A, Shidfar MR, et al. A molecular epidemiological survey of clinically important dermatophytes in Iran based on specific RFLP profiles of beta-tubulin gene. Iranian journal of public health. 2013;42(9):1049-57.
30. Motamedi M, Ghasemi Z, Shidfar MR, Hosseinpour L, Khodadadi H, Zomorodian K, Mirhendi H. Growing incidence of non-dermatophyte onychomycosis in Tehran, Iran. Jundishapur journal of microbiology. 2016;9(8):e40543. [DOI:10.5812/jjm.40543]
31. Raghavendra KR, Yadav D, Kumar A, Sharma M, Bhuria J, Chand AE. The nondermatophyte molds: Emerging as leading cause of onychomycosis in south-east Rajasthan. Indian dermatology online journal. 2015;6(2):92-7. [DOI:10.4103/2229-5178.153010]

Add your comments about this article : Your username or Email:

Send email to the article author

© 2015 All Rights Reserved | Current Medical Mycology