Clinical and Microbiological Spectrum of Dermatophytosis From a Tertiary Care Institute

Introduction There is an increasing incidence of recalcitrant dermatophytosis in India due to the irrational use of antifungals, inappropriate treatment, and in vitro resistance of the organism. The study aims to determine the clinic-mycological profile, antifungal susceptibility, and outcome of patients with dermatophytosis in our institute. Methods This was a retrospective observational study from January 2019 to December 2019. Detailed clinical data of all the enrolled patients were collected. Identification of the dermatophytes was performed by colony morphology and microscopy. Further, the preserved isolates were sent to the Post Graduate Institute of Medical Education & Research (PGIMER), Chandigarh for confirmation of identification and antifungal susceptibility testing. Results Of the 155 clinical suspected cases, growth of dermatophytes was observed in 55 (35.4%) of the cases. Tinea corporis (39/55, 70.9%) was the predominant clinical type. The duration of infection was less than six months in 22/55 (40%) of cases. Most patients were in the age group of 20-30 years. Diabetes mellitus was the predominant comorbid condition in 7/55 (12.7%) patients. Previous therapy with topical and systemic antifungals was given in 32/55 (58.8%) of the patients. Trichophyton mentagrophytes complex (69%) was the predominant species complex isolated followed by Microsporum gypseum (10.9%). All Trichophyton isolates showed minimum inhibitory concentration (MIC) >1 µg/ml for fluconazole and griseofulvin. Two isolates showed mutation in the squalene epoxidase (SE) gene. In the present study, the patients were treated with both oral and topical antifungals. Conclusion T. mentagrophytes complex was the predominant species isolated and Tinea corporis was the commonest clinical presentation. Resistance to terbinafine, griseofulvin, and fluconazole has been noted.