Onychomycosis: Sampling, diagnosing as efficiant part of hospital pharmacology

Abstract

Introduction Onychomycosis is a fungal infection of one or more nails. Causes of onychomycosis are dermatophytes, yeasts and non-dermatophyte molds, but the most common cause is Trichophytonrubrum (T. Rubrum) from the group of dermatophyte fungi. The aims Using sampling determination of the most common clinical type of onychomycosis, lokalization and involvement of the nail plate, and monitoring the efficacy of methods/tests in the diagnosis of nail onychomycosis. Material and methods This paper is a part of academic IV phase study. The study included 30 patients with onychomycosis. Each sample was seeded on Sabouraud Dextrose Agar (SDA) and Diluted SDA (D-SDA) at 28°C and 37°C, as well as the Dermatophyte Test Medium (DTM) at 28°C. Identification of isolated fungi to the level of genus/species has been based on macroscopic and microscopic characteristics by KOH and Blancophor fluorescent dye. PCR were performed to detect T. Rubrum-specific and pan-dermatophyte multiplex PCR product. Informed consent was obtained from all patients. Results The most common clinical form was subungual lateral distal onychomycosis (DLSO)of the hands and feet pollex fingernails, while the size of the involvement of the nail plate was 1/2 - 1/3 in the majority of patients. Cultivation gave a positive result in 50% of cases and the most commonly isolated microorganism was the T. Rubrum. For negative cultures (50%) the PCR was carried out which demonstrated high sensitivity and T. Rubrum remained the most frequently detected. Conclusions Using the methods of cultivation and PCR, onychomycosis was confirmed in 28 (93.3%) patients. Cultivation gave a negative result in 50% of cases, while the PCR was positive in 86.6%. Our research shows the highest incidence of T. Rubrum (60%). In continuation of this study will be analyzed the choice and effectiveness of therapy.

Keywords

• dermatophytes
• nail
• cultivation
• PCR
• T. Rubrum