title: Prevalence and antifungal susceptibility patterns of dermatophytes isolated from patients with neoplastic diseases: a case control study.
abstract: Patients with neoplasia who are severely immunocompromised have a higher risk of fungal infections. There are limited data in the literature regarding the frequency of dermatophyte infections and efficacy of antifungals in patients with malignancies. Objective was assessment of the incidence of dermatophyte infections and antifungal susceptibility, determination of dermatophyte species isolated from patients with neoplastic diseases. 138 patients diagnosed with various malignancies and 160 immunocompetent patients who were referred to the Department of Dermatology in Brasov, Romania, for suspicion of dermatophyte infections were included in the study. Nail clippings or skin scrapings were examined by direct microscopy and cultures in Sabouraud agar medium. Susceptibility tests for antifungals were conducted in vitro using a method of broth microdilution. Infections with dermatophytes were identified in 30.4% of patients with neoplastic diseases and in 29.37% in the control group. There was a significantly higher frequency of dermatophyte infections in patients with hematologic malignancies (52%) compared to those with solid cancers (25.66%) (P=0.01). The clinical aspects of dermatophyte infections in patients with neoplastic diseases were not different from those of patients without cancer; though in some cases the infections were more extensive. There were no statistically significant differences between mean values of minimum inhibitory concentration of antifungals compared with controls. Terbinafine had the highest antidermatophyte activity for all tested dermatophyte species isolated from patients with neoplastic diseases. There were no differences in frequency of dermatophyte infections and antifungal susceptibility to dermatophytes between patients with neoplastic diseases and immunocompetent patients.
authors.affiliation: Marius Irimie Irimie, MD, 40, Zizinului Street, Brasov, Romania; marius_irimie2002@yahoo.com.
authors.forename: Marius
authors.initials: M
authors.lastname: Irimie
authors.forename: Alexandru
authors.initials: A
authors.lastname: Oanta
authors.forename: Claudia Alexandrina
authors.initials: CA
authors.lastname: Irimie
authors.forename: Dan Ioan
authors.initials: DI
authors.lastname: Minea
mesh_terms: D000328:Adult; D000368:Aged; D000935:Antifungal Agents / Q000494:pharmacology / Q000627:therapeutic use*; D003883:Arthrodermataceae / Q000187:drug effects* / Q000302:isolation & purification; D016022:Case-Control Studies; D003881:Dermatomycoses / Q000188:drug therapy / Q000453:epidemiology* / Q000382:microbiology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D016867:Immunocompromised Host / Q000276:immunology; D008297:Male; D008826:Microbial Sensitivity Tests / Q000706:statistics & numerical data; D008875:Middle Aged; D009369:Neoplasms / Q000175:diagnosis / Q000453:epidemiology / Q000382:microbiology*; D009894:Opportunistic Infections / Q000175:diagnosis / Q000453:epidemiology / Q000276:immunology*; D015995:Prevalence; D012016:Reference Values; D018570:Risk Assessment
chemical_list: D000935:Antifungal Agents