Das Sudeshna, Rawat Deepti, Kaur Ravinder, Mendiratta Vibhu, Singh Pradeep K
From the Department of Microbiology, Lady Hardinge Medical College and Associated Hospitals, New Delhi, India.
Department of Dermatology, Lady Hardinge Medical College and Associated Hospitals, New Delhi, India.
Indian J Dermatol. 2025 May-Jun;70(3):117-124. doi: 10.4103/ijd.ijd_647_23. Epub 2025 May 8.
The currently reported prevalence of dermatophytosis (superficial mycoses) in India ranges from 6.09%-61.5%. Due to the rising cases of treatment failure, chronic recalcitrant disease, and frequent relapses, standardization of antifungal susceptibility testing of dermatophytes has become important.
To determine the susceptibility profile of different isolates of dermatophytes to eight antifungal drugs by broth microdilution method.
In total, 236 consecutive patients who were clinically suspected of suffering from dermatophytosis were included in this cross-sectional descriptive study. Nails, hair clippings, and skin scrapings were tested by the KOH mount and cultured on Sabouraud's agar medium (incubated at 25°C and 37°C) and dermatophyte test media. The dermatophytes isolated were identified based on the morphology of the colony growth as observed in the lacto phenol cotton blue (LPCB) mount, temperature tolerance, urease production, and hair perforation test. Antifungal susceptibility test was performed for dermatophytes against eight antifungal agents (terbinafine, griseofulvin, itraconazole, fluconazole, voriconazole, ketoconazole, luliconazole, and posaconazole) using the Clinical and Laboratory Standards Institute broth microdilution method (M38-3 edition).
was the most common dermatophyte species isolated in the study. Triazoles were found to have low minimum inhibitory concentration (MIC), except fluconazole, which showed very high MIC values with 55.2% isolates showing resistance (MIC ≥ 32 μg/mL). Luliconazole had the lowest MIC90 (0.003 μg/mL). There was a wide variation in the MIC values for terbinafine (0.06-16 μg/mL) and griseofulvin (0.125-8 μg/mL) with 13.1% and 52.6% of isolates showing resistance (MIC ≥ 4 μg/mL) to terbinafine and griseofulvin respectively.
The present study showcases the MIC values of eight anti-fungal drugs used for the treatment of different species of dermatophytes. It was observed that the commonly used antifungals such as fluconazole, griseofulvin, and terbinafine showed high MIC values compared to newer drugs such as luliconazole, posaconazole and voriconazole. More studies based on species distribution and antifungal susceptibility testing (AFST) should be performed to understand the changing epidemiology of dermatophytosis.
目前报道的印度皮肤癣菌病（浅表真菌病）患病率在6.09%至61.5%之间。由于治疗失败、慢性顽固性疾病和频繁复发的病例不断增加，皮肤癣菌抗真菌药敏试验的标准化变得至关重要。
通过肉汤微量稀释法确定不同皮肤癣菌分离株对八种抗真菌药物的药敏谱。
本横断面描述性研究共纳入236例临床疑似患有皮肤癣菌病的连续患者。指甲、毛发剪片和皮肤刮屑经氢氧化钾涂片检查，并在沙氏琼脂培养基（在25°C和37°C下培养）和皮肤癣菌试验培养基上培养。根据在乳酚棉蓝（LPCB）涂片中观察到的菌落生长形态、温度耐受性、尿素酶产生和毛发穿孔试验，对分离出的皮肤癣菌进行鉴定。使用临床和实验室标准协会肉汤微量稀释法（M38-3版）对皮肤癣菌进行八种抗真菌药物（特比萘芬、灰黄霉素、伊曲康唑、氟康唑、伏立康唑、酮康唑、卢立康唑和泊沙康唑）的药敏试验。
是本研究中分离出的最常见皮肤癣菌种类。发现三唑类药物的最低抑菌浓度（MIC）较低，除氟康唑外，氟康唑显示出非常高的MIC值，55.2%的分离株表现出耐药性（MIC≥32μg/mL）。卢立康唑的MIC90最低（0.003μg/mL）。特比萘芬（0.06 - 16μg/mL）和灰黄霉素（0.125 - 8μg/mL）的MIC值差异很大，分别有13.1%和52.6%的分离株对特比萘芬和灰黄霉素表现出耐药性（MIC≥4μg/mL）。
本研究展示了用于治疗不同种类皮肤癣菌的八种抗真菌药物的MIC值。观察到，与卢立康唑、泊沙康唑和伏立康唑等新药相比，常用抗真菌药如氟康唑、灰黄霉素和特比萘芬显示出较高的MIC值。应开展更多基于菌种分布和抗真菌药敏试验（AFST）的研究，以了解皮肤癣菌病不断变化的流行病学情况。
