Summary

Dermatophytes infections have been considered to be a major public health problem in many parts of the world. The aim of this study is to determine the causative agents of dermatophytoses and their antifungal susceptibilities in Al-yarmook teaching Hospital. A total of 85 patients suspected to have dermatophytic lesions (tinea corporis and tinea cruris) were examined over a period of ninth months. Samples collected were submitted to direct microscopical examination using KOH mount smear and lactophenol cotton blue stain, cultured primarily on Sabouraud dextrose agar and dermatophyte test medium. From the fifty cases of tinea corporis 37(74%) were positive by both direct KOH mount smear and by culture, 9(81%) were negative in direct KOH mount smear but positive in culture and the remaining 4(8%) gave a positive direct KOH mount smear but negative in culture. From the thirty five cases of tinea cruris 20(57.1%) were positive by both direct KOH mount smear and by culture, 7(20%) were negative in direct KOH mount smear but positive in culture and the remaining 8(22.9%) gave a positive direct KOH mount smear but negative in culture. Species identification revealed that Trichophyton mentagrophytes was the most frequent dermatophyte isolated 35(41%), followed by Trichophyton rubrum 18(21%), Epidermophyton floccosum 11(12.9%), Microsporum canis 6(7%), Trichophyton violaceum 1(1.17%), Trichophyton verrucosum 1(1.17%), and Microsporum ferrugineum 1(1.17%). Females were more infected in both, tinea corporis 37(74%) and tinea cruris 22(62.9%), were affected by dermatophytes (almost double in number) than male tinea corporis 13(26%) and tinea cruris 13(37.1%).

According to residence there was a significant difference in the incidence of dermatophytosis amongst peoples from urban or rural areas. The relationship between dermatophytes infections with the localities of the eighty five patients was quite clear that higher percentage of infection recorded in urban areas, tinea corporis 32(64%), and in tinea cruris 22(62.9%). Epsilometer test seems to be a reliable methodology for susceptibilitytesting of dermatophytes. Specific test conditions for the epsilometer test are required to correctly assay the susceptibility of dermatophytes to antifungal drugs. The species of dermatophytes showed similar patterns of susceptibility to each antifungal agent tested with exception of Trichophyton rubrum which showed low suscebtibility deserved to be mentioned. Voriconazole was the most and Fluconazole was the less-active drug from azole derivative drugs, amphotericin B has showed the highest Minimum inhibitory concentration values of all the antifungal agents tested. Minimum inhibitory concentration values for tinea corporis and tinea cruris with MeanSD of inhibition zone for; Voriconazole were (0.026, 0.046), itraconazole (0.005, 0.027), Fluconazole (0.0001, 0.438), and amphotericin B (0.170, 0.215) (p <0.05).