title: [Fusarium as a cause of onychomycosis resistant to common antifungal therapy].
abstract: BACKGROUND
  Fusarium species are common soil saprophytes and plant pathogens. Members of the genus have been frequently reported as etiologic agents of opportunistic infections in humans and animals. We report six cases of confirmed or suspected onychomycosis caused by members of the genus Fusarium (F. solani and F. oxysporum species complexes).
  
  
  METHODS
  The isolates were identified by rDNA ITS sequencing analysis. The EMBL accession numbers for the ITS are HE974453-HE974458. A disk diffusion method was used for in vitro susceptibility testing. Comparison of disks (ITEST) and Neo-Sensitabs tablets (Rosco) on a different media at two different temperatures (25 °C and 35 °C) was made.
  
  
  RESULTS
  Six strains of Fusarium spp. (4 strains of F. solani and 2 strains of F. oxysporum) were isolated from patients with confirmed or suspected onychomycosis. Natamycin (pimaricin) was the only antifungal effective in vitro in all isolates tested. Variable susceptibility of the isolates was detected in amphotericin B, econazole and terbinafine. The remaining antifungals tested were not effective. The results varied depending on the culture medium and temperature for nystatin and econazole disks and amphotericin B and terbinafin tablets.
  
  
  CONCLUSIONS
  It is important to adhere to recommended methods when testing in vitro susceptibility to antifungals in moulds. An incubation temperature of 35 °C is important for obtaining valid results in amphotericin B tablets (and probably also terbinafine ones). Determination of multidrug-resistant Fusarium spp. in onychomycosis make the choice of therapy difficult. Good clinical effect was recorded with nail plate ablation and subsequent local econazole therapy.
authors: Department of Parasitology, Public Health Institute in Ustí nad Labem, Czech Republic. pavlina.lyskova@zuusti.cz
authors: Pavlína
authors: P
authors: Lysková
authors: Vít
authors: V
authors: Hubka
authors: Kateřina
authors: K
authors: Fajkošová
authors: Helena
authors: H
authors: Macková
authors: Magdalena
authors: M
authors: Skořepová
authors: Blanka
authors: B
authors: Srámková
authors: Miroslav
authors: M
authors: Kolařík
mesh_terms: D000328:Adult; D000935:Antifungal Agents / Q000627:therapeutic use*; D025141:Drug Resistance, Fungal; D005260:Female; D060585:Fusariosis / Q000188:drug therapy*; D006801:Humans; D008297:Male; D008826:Microbial Sensitivity Tests; D014009:Onychomycosis / Q000188:drug therapy* / Q000382:microbiology
chemical_list: D000935:Antifungal Agents