Volume 12, Issue 2 (6-2024)                   JoMMID 2024, 12(2): 159-170 | Back to browse issues page

XML Print

Download citation:
BibTeX | RIS | EndNote | Medlars | ProCite | Reference Manager | RefWorks
Send citation to:
Farhana A, Mansoor T, Naqash U. Epidemiological Investigation of Superficial Fungal Infections and Associated Factors in a Tertiary Care Hospital of Kashmir. JoMMID 2024; 12 (2) :159-170
URL: http://jommid.pasteur.ac.ir/article-1-653-en.html
Epidemiological Investigation of Superficial Fungal Infections and Associated Factors in a Tertiary Care Hospital of Kashmir
Anjum Farhana , Tabeen Mansoor * , Unairah Naqash
Department of Microbiology, Government Medical College, Srinagar, Jammu and Kashmir, India
Abstract:   (238 Views)
Introduction: Superficial mycoses are a significant public health concern worldwide, especially in regions like India, due to their high disease burden and impact on quality of life. This study aimed to investigate the epidemiology of superficial fungal infections in a tertiary care hospital in Kashmir, examining their prevalence, etiological agents, anatomical involvement, and associated risk factors. Methods: A hospital-based cross-sectional study was conducted at the Government Medical College, Srinagar, Kashmir, from April 2019 to October 2020. A total of 672 patients with suspected superficial fungal infections were enrolled and analyzed using direct microscopy and culture techniques. Statistical analyses were performed using SPSS version 25.0 and R version 4.0.2, employing descriptive statistics and chi-square/Fisher's exact tests for categorical associations. Results: Among 672 patients (mean age 42 ± 15 years, 52.08% male), dermatophytosis was the most common superficial fungal infection (44.64%), followed by candidiasis (29.76%) and pityriasis versicolor (14.88%). Pityriasis versicolor was more frequent in patients younger than 20 years old, while dermatophytosis and candidiasis were prevalent in those aged 20-59 years old. Non-dermatophyte fungi, including Candida species and non-dermatophyte molds, were more common in nail and skin samples. Candida albicans and Trichophyton mentagrophytes were the primary causative agents. Significant risk factors included diabetes, immunosuppression, antibiotic/corticosteroid use, the sharing of personal items, occupational exposure, excessive sweating, and tight clothing (P < 0.05). Conclusion: This study underscores the substantial burden of superficial fungal infections, particularly dermatophytosis and non-dermatophyte mycoses in a tertiary care setting in Kashmir. Our findings emphasize the need for accurate identification of causative agents and associated risk factors to inform tailored antifungal therapy and preventive strategies.
Keywords: Superficial fungal infections, Dermatomycoses, Candidiasis, Epidemiology, Risk Factors, Kashmir
Full-Text [PDF 1034 kb]   (51 Downloads)    
Type of Study: Original article | Subject: Other
Received: 2024/03/19 | Accepted: 2024/09/20 | Published: 2024/09/18
References
1. Medical Microbiology by Samuel Baron.4th edition, Chapter 4. Galveston (TX): University of Texas Medical Branch at Galveston; 1996.ISBN-10: 0-9631172-1-1.
2. Chanyachailert P, Leeyaphan C, Bunyaratavej S. Cutaneous Fungal Infections Caused by Dermatophytes and Non-Dermatophytes: An Updated Comprehensive Review of Epidemiology, Clinical Presentations, and Diagnostic Testing. J Fungi (Basel). 2023; 9 (6): 669. [DOI:10.3390/jof9060669]
3. Ameen M. Epidemiology of superficial fungal infections. Clin Dermatol. 2010; 28 (2): 197-201. [DOI:10.1016/j.clindermatol.2009.12.005]
4. Havlickova B, Czaika VA, Friedrich M. Epidemiological trends in skin mycoses worldwide. Mycoses. 2008; 51 Suppl 4:2-15. [DOI:10.1111/j.1439-0507.2008.01606.x]
5. Achterman RR, White TC. Dermatophyte virulence factors: identifying and analyzing genes that may contribute to chronic or acute skin infections. Int J Microbiol. 2012; 358305. [DOI:10.1155/2012/358305]
6. Naglot A, Shrimali DD, Nath BK, Gogoi HK, Veer V, Chander J, et al. Recent trends of dermatophytosis in northeast India (Assam) and interpretation with published studies. Int J Curr Microbiol App Sci. 2015; 4 (11): 111-20.
7. Rajagopalan M, Inamadar A, Mittal A, Miskeen AK, Srinivas CR, Sardana K, et al. Expert Consensus on The Management of Dermatophytosis in India (ECTODERM India). BMC Dermatol. 2018 ; 18 (1) : 6. [DOI:10.1186/s12895-018-0073-1]
8. Brigida S, Muthiah N. Pediatric Sedation: Prevalence of Tinea Corporis and Tinea Cruris in Outpatient Department of Dermatology Unit of a Tertiary Care Hospital. J Pharmacol Clin Res. 2017; 3 (1): 555602 [DOI:10.19080/JPCR.2017.03.555602]
9. Verma S, Madhu R. The Great Indian Epidemic of Superficial Dermatophytosis: An Appraisal. Indian J Dermatol. 2017; 62 (3): 227-36. [DOI:10.4103/ijd.IJD_206_17]
10. HiMedia Laboratories. Sabouraud Dextrose Agar M063: Product Information [Internet]. Mumbai: HiMedia Laboratories; 2023 [cited 2024 Jun 20]. Available from: https://himedialabs.com/HML/pdfs/literature/ml063.pdf
11. Leboffe MJ, Pierce BE. A Photographic Atlas for the Microbiology Laboratory. 4th ed. Morton Publishing Company; 2011.
12. de Hoog GS, Guarro J, Gené J, Figueras MJ. Atlas of Clinical Fungi [Internet]. 4th ed. Utrecht: Centraalbureau voor Schimmelcultures; 2019 [cited 2024 Jun 20]. Available from: http://www.clinicalfungi.org
13. Larone DH. Medically Important Fungi: A Guide to Identification. 6th ed. Washington, D.C.: ASM Press; 2018.
14. Koneman EW, Allen SD, Janda WM, Schreckenberger PC, Winn WC Jr. Color Atlas and Textbook of Diagnostic Microbiology. 6th ed. Philadelphia: Lippincott Williams & Wilkins; 2006.
15. Clinical and Laboratory Standards Institute. Reference Method for Broth Dilution Antifungal Susceptibility Testing of Filamentous Fungi; Approved Standard--Third Edition. CLSI document M38-A2. Wayne, PA: Clinical and Laboratory Standards Institute; 2008.
16. Sood P, Bindra S. Modified Kuppuswamy socioeconomic scale: 2022 update of India. Int J Community Med Public Health. 2022; 9 (10): 3841-4. [DOI:10.18203/2394-6040.ijcmph20222581]
17. Bhagra S, Ganju SA, Kanga A, Sharma NL, Guleria RC. Mycological pattern of dermatophytosis in and around shimla hills. Indian J Dermatol. 2014; 59 (3): 268-70. [DOI:10.4103/0019-5154.131392]
18. Veer P, Patwardhan NS, Damle AS. Study of onychomycosis: prevailing fungi and pattern of infection. Indian J Med Microbiol. 2007; 25 (1): 53-6. [DOI:10.1016/S0255-0857(21)02235-0]
19. Lilly KK, Shukla D, Brumble LM, Babski DM, Dietrich L, Porady R, et al. Identifying dermatophyte fungal infections: A comparison of practice patterns and diagnostic aids. J Am Acad Dermatol. 2020; 83 (1): 214-22.
20. Weitzman I, Summerbell RC. The dermatophytes. Clin Microbiol Rev. 1995; 8 (2): 240-59. [DOI:10.1128/CMR.8.2.240]
21. Gräser Y, Monod M, Bouchara JP, Demierre M, Stanzanic P, Gaillemord T, et al. Identification of dermatophytes by phenotypic and molecular methods. Mycopathologia. 1999; 145 (1): 49-56.
22. Eing BR, Ouyang J, Nogrady K, Moser SA. Molecular-based identification of dermatophytes. Curr Fungal Infect Rep. 2013; 7 (3): 241-51.
23. Brillowska-Dabrowska A, Nielsen SS, Nielsen HV, Arendrup MC. Optimized 5-hour multiplex PCR test for the detection of tinea unguium: Performance on dermatological specimens from a completed multicentre collection. Med Mycol. 2010; 48 (2): 348-56. [DOI:10.3109/13693780903531579]
24. Gupta AK, Stec N, Summerbell RC, Shear NH, Piguet V, Tosti A, Piraccini BM. Onychomycosis: a review. J Eur Acad Dermatol Venereol. 2020; 34 (9): 1972-1990. [DOI:10.1111/jdv.16394]
25. Hazarika D, Jahan N, Sharma A. Changing Trend of Superficial Mycoses with Increasing Nondermatophyte Mold Infection: A Clinicomycological Study at a Tertiary Referral Center in Assam. Indian J Dermatol. 2019; 64 (4): 261-5. [DOI:10.4103/ijd.IJD_579_18]
26. Thakur R, Kalsi AS. Outbreaks And Epidemics Of Superficial Dermatophytosis Due To Trichophyton mentagrophytes Complex And Microsporum canis: Global And Indian Scenario. Clin Cosmet Investig Dermatol. 2019; 12: 887-893. [DOI:10.2147/CCID.S220849]
27. Hill RC, Caplan AS, Elewski B, Gold JAW, Lockhart SR, Smith DJ, et al. Expert Panel Review of Skin and Hair Dermatophytoses in an Era of Antifungal Resistance. Am J Clin Dermatol. 2024; 25 (3): 359-89. [DOI:10.1007/s40257-024-00848-1]
28. Sardana K, Gupta A, Mathachan SR. Immunopathogenesis of Dermatophytoses and Factors Leading to Recalcitrant Infections. Indian Dermatol Online J. 2021; 12 (3): 389-99. [DOI:10.4103/idoj.IDOJ_503_20]
29. Moskaluk AE, VandeWoude S. Current Topics in Dermatophyte Classification and Clinical Diagnosis. Pathogens. 2022; 11 (9): 957. [DOI:10.3390/pathogens11090957]
30. Ameen M. Epidemiology of superficial fungal infections. Clin Dermatol. 2010; 28 (2): 197-201. [DOI:10.1016/j.clindermatol.2009.12.005]
Add your comments about this article : Your username or Email:
CAPTCHA
Send email to the article author

Rights and permissions
Creative Commons License This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.

Creative Commons License
This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.