| Abstract [eng] |
Prevalence of Pathogens Causing Dermatophytosis and Application of Laboratory Diagnostic Methods The aim of the Thesis: To perform a retrospective analysis of dermatophytosis, review and compare its laboratory diagnostic methods used in everyday practice. Objectives: To perform retrospective analysis of dermatophytosis cases examined in Vilnius university hospital Santaros clinics (VUH SC) Microbiology laboratory (ML) in 2014 – 2018 period; To compare laboratory diagnostic methods of dermatophytosis used in VUH SC ML in 2014-2018 period; To compare two antifungal susceptibility testing methods – disk diffusion method and minimal inhibitory concentration method - in 50 fungal samples. To identify 30 fungal cultures using MALDI-TOF methods and compare two different identification protocols. Methods: A retrospective analysis of five-year period was performed at VUH SK CLM. There were 3165 clinical samples tested for dermatophytosis and susceptibility to antifungals. Susceptibility to antifungals was evaluated according to manufacturer’s recommendations (MAST diagnostics, Germany). Fungal species were identified by MALDI-TOF method, morphological and microscopic characteristics. Results. Female patients were more frequently affected than male patients. Female infections mostly were caused by yeasts and male infections – by dermatophytes. Yeasts were the most common type of isolated fungi, but the most frequent causative agent was T. rubrum, which was more common in male cases. The lesions of toe nails, skin and scalp mainly were caused by dermatophytes and lesions of hand nails and nails of both limbs by yeasts. Lessions of toenails and nails of both limbs were more common in age group above 65 years, lessions of hand nails – in 21-49, lessions of scalp and skin – in below 12 years age groups. The most susceptible to nystatin was C. albicans, the most resistant – C. parapsilosi. The most susceptible to fluconazole was C. parapsilosis, the most resistant – C. glabrata. The most susceptible to itraconazole and ketoconazole was C. parapsilosis, the most resistant – C. albicans. The evaluation of DDM and MIC methods shows that susceptibility to itraconazole and fluconazole should be determined using MIC method. Results of evaluation of two MALDI-TOF protocols have not shown no statistical significant results. |
