title: Identification of fungi species in the onychomycosis of institutionalized elderly.
abstract: BACKGROUND
  Superficial fungal infections are caused by dermatophytes, yeasts or filamentous fungi. They are correlated to the etiologic agent, the level of integrity of the host immune response, the site of the lesion and also the injured tissue.
  
  
  OBJECTIVE
  The purpose of this study is to isolate and to identify onychomycosis agents in institutionalized elderly (60 years old +).
  
  
  METHODS
  The identification of the fungi relied upon the combined results of mycological examination, culture isolation and micro cultures observation under light microscopy from nail and interdigital scales, which were collected from 35 elderly with a clinical suspicion of onychomycosis and a control group (9 elderly with healthy interdigital space and nails). Both groups were institutionalized in two nursing homes in Sao Bernardo do Campo, SP, Brazil.
  
  
  RESULTS
  The nail scrapings showed 51.40% positivity. Of these, dermatophytes were found in 44.40% isolates, 27.78% identified as Trichophyton rubrum and 5.56% each as Trichophyton tonsurans, Trichophyton mentagrophytes and Microsporum gypseum. The second more conspicuous group showed 38.89% yeasts: 16.67% Candida guilliermondii, 11.11% Candida parapsilosis, 5.56% Candida glabrata, and 5.56% Trichosporon asahii. A third group displayed 16.70% filamentous fungi, like Fusarium sp, Aspergillus sp and Neoscytalidium sp (5.56% each). The interdigital scrapings presented a positivity rate of 14.29%. The agents were coincident with the fungi that caused the onychomycosis. In the control group, Candida guilliermondii was found at interdigital space in one person.
  
  
  CONCLUSIONS
  Employing a combination of those identification methods, we found no difference between the etiology of the institutionalized elderly onychomycosis from that reported in the literature for the general population.
authors.affiliation: University of São Paulo, Medical School, São Paulo, Brazil. cidiav@ig.com.br
authors.forename: Cidia
authors.initials: C
authors.lastname: Vasconcellos
authors.forename: Carolina Queiroz Moreira
authors.initials: CQ
authors.lastname: Pereira
authors.forename: Marta Cristina
authors.initials: MC
authors.lastname: Souza
authors.forename: Andrea
authors.initials: A
authors.lastname: Pelegrini
authors.forename: Roseli Santos
authors.initials: RS
authors.lastname: Freitas
authors.forename: Juliana Possato
authors.initials: JP
authors.lastname: Takahashi
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001938:Brazil / Q000453:epidemiology; D005260:Female; D005533:Foot Dermatoses / Q000453:epidemiology / Q000382:microbiology*; D006707:Homes for the Aged / Q000706:statistics & numerical data; D006801:Humans; D007326:Institutionalization; D008297:Male; D008875:Middle Aged; D003904:Mitosporic Fungi / Q000302:isolation & purification*; D014009:Onychomycosis / Q000453:epidemiology / Q000382:microbiology*; D012737:Sex Factors