The epidemiology and etiology of onychomycosis in 2 laboratory centers affiliated to Tehran university of medical sciences during 2019-2020
-
Taraneh Razavyoon
,
Seyed Jamal Hashemi
,
Parvin Mansouri
,
Zahra Rafat
,
Ali Akbar Saboor-Yaraghi
,
Hasti Kamali Sarvestani
,
Zeinab Ghasemi
Abstract
Background and Objectives: Onychomycosis is caused by dermatophyte species, non- dermatophyte moulds (NDMs), and accounts for roughly 50% of all nail diseases. As the prevalence of onychomycosis is increasing, new epidemiologic documents may help with treatment and prevention. The present investigation aims to determine the epidemiological profile of onychomycosis in 2 mycology laboratories.
Materials and Methods: A cross-sectional study conducted during eight months (2019-2020) on 169 patients with positive nail mycology tests referred to two mycological laboratory centers affiliated with Tehran University of Medical Science. The nail clippings were examined by direct smear and culture. Also, molecular assays were performed if needed.
Results: 10% of nail lesions referred to Razi Hospital (RH), and 30% of nail lesions referred to TUMS mycology laboratory were positive. Middle age (40-60) suffer more from onychomycosis. Aspergillus flavus, Trichophyton mentagrophytes, and Candida albicans were the most common etiologic agents in each of the three main classes of fungi causing onychomycosis. Females were more infected. NDMs were the predominant etiologic agents, and toenails were the most common site of onychomycosis.
Conclusion: The pattern of etiologic agents and clinical signs of onychomycosis differs according to geographical region and age, so repeated epidemiological surveys of onychomycosis seem to be fundamental.
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6. Bramono K, Budimulja U. Epidemiology of Onychomycosis in Indonesia: data obtained from three individual studies. Nihon Ishinkin Gakkai Zasshi 2005; 46: 171-176.
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8. Moreno G, Arenas R. Other fungi causing onychomycosis. Clin Dermatol 2010; 28: 160-163.
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14. Khosravi AR, Mansouri P. Onychomycosis in Tehran, Iran: prevailing fungi and treatment with itraconazole. Mycopathologia 2001; 150: 9-13.
15. Nenoff P, Verma SB, Vasani R, Burmester A, Hipler UC, Wittig F, et al. The current Indian epidemic of superficial dermatophytosis due to Trichophyton mentagrophytes-a molecular study. Mycoses 2019; 62: 336-356.
16. Gupta AK, Jain HC, Lynde CW, MacDonald P, Cooper EA, Summerbell RC. Prevalence and epidemiology of onychomycosis in patients visiting physicians’ offices: a multicenter Canadian survey of 15,000 patients. J Am Acad Dermatol 2000; 43: 244-248.
17. Veer P, Patwardhan NS, Damle AS. Study of onychomycosis: prevailing fungi and pattern of infection. Indian J Med Microbiol 2007; 25: 53-56.
18. Garg A, Venkatesh V, Singh M, Pathak KP, Kaushal GP, Agrawal SK. Onychomycosis in central India: a clinicoetiologic correlation. Int J Dermatol 2004; 43: 498-502.
19. Godoy-Martinez P, Nunes FG, Tomimori-Yamashita J, Urrutia M, Zaror L, Silva V, et al. Onychomycosis in São Paulo, Brazil. Mycopathologia 2009; 168: 111-116.
20. Kukhar Y, Smagulova A, Daniyarova A, Baiduissenova A, Kiyan V. Candida parapsilosis as a causative agent of onychomycosis in patient with cirrhosis of the liver. J Fungi (Basel) 2020; 6: 313.
21. Sylla K, Tine RCK, Sow D, Lelo S, Dia M, Traoré S, et al. Epidemiological and mycological aspects of onychomycosis in Dakar (Senegal). J Fungi (Basel) 2019; 5: 35.
22. Bitew A, Wolde S. Prevalence, risk factors, and spectrum of fungi in patients with onychomycosis in Addis Ababa, Ethiopia: a prospective study. J Trop Med 2019; 2019: 3652634.
23. Afshar P, Khodavaisy S, Kalhori S, Ghasemi M, Razavyoon T. Onychomycosis in North-East of Iran. Iran J Microbiol 2014; 6: 98-103.
24. Chadeganipour M, Mohammadi R. Causative agents of onychomycosis: a 7-year study. J Clin Lab Anal 2016; 30: 1013-1020.
25. Gregoriou S, Mpali N, Vrioni G, Hatzidimitriou E, Chryssou SE, Rigopoulos D. Epidemiology of Onychomycosis in an Academic Nail Unit in South Greece during a three-year period. Skin Appendage Disord 2020; 6: 102-107.
26. Sakkas H, Kittas C, Kapnisi G, Priavali E, Kallinteri A, Bassukas ID, et al. Onychomycosis in Northwestern Greece over a 7-year period. Pathogens 2020; 9: 851.
27. Motamedi M, Ghasemi Z, Shidfar MR, Hosseinpour L, Khodadadi H, Zomorodian K, et al. Growing incidence of non-dermatophyte onychomycosis in Tehran, Iran. Jundishapur J Microbiol 2016; 9(8): e40543.
28. Assadamongkol R, Lertwattanarak R, Wannachalee T, Bunyaratavej S, Leeyaphan C, Matthapan L. Prevalence, risk factors, and type of organism in fungal foot infection and toenail onychomycosis in Thai diabetic patients. J Med Assoc Thai 2016; 99: 659-664.
29. Quaade AS, Simonsen AB, Halling AS, Thyssen JP, Johansen JD. Prevalence, incidence, and severity of hand eczema in the general population - A systematic review and meta-analysis. Contact Dermatitis 2021; 84: 361-374.
2. Halvaee S, Daie-Ghazvini R, Hashemi SJ, Khodavaisy S, Rahimi-Foroushani A, Bakhshi H, et al. A mycological and molecular epidemiologic study on onychomycosis and determination in vitro susceptibilities of isolated fungal strains to conventional and new antifungals. Front Cell Infect Microbiol 2021; 11: 693522.
3. Fatahinia M, Jafarpour S, Rafiei A, Taghipour S, Makimura K, Rezaei-Matehkolaei A. Mycological aspects of onychomycosis in Khuzestan Province, Iran: A shift from dermatophytes towards yeasts. Curr Med Mycol 2017; 3: 26-31.
4. Rafat Z, Hashemi SJ, Saboor-Yaraghi AA, Pouragha B, Taheriniya A, Moosavi A, et al. A systematic review and meta-analysis on the epidemiology, casual agents and demographic characteristics of onychomycosis in Iran. J Mycol Med 2019; 29: 265-272.
5. Neupane S, Pokhrel DB, Pokhrel BM. Onychomycosis: A clinico-epidemiological study. Nepal Med Coll J 2009; 11: 92-95.
6. Bramono K, Budimulja U. Epidemiology of Onychomycosis in Indonesia: data obtained from three individual studies. Nihon Ishinkin Gakkai Zasshi 2005; 46: 171-176.
7. Hilmioğlu-Polat S, Metin DY, Inci R, Dereli T, Kılınc I, Tümbay E. Non-dermatophytic Molds as agents of onychomycosis in Izmir, Turkey – a prospective study. Mycopathologia 2005; 160: 125-128.
8. Moreno G, Arenas R. Other fungi causing onychomycosis. Clin Dermatol 2010; 28: 160-163.
9. Gianni C, Cerri A, Crosti C. Non-dermatophytic onychomycosis. An understimated entity? A study of 51 cases. Mycoses 2000; 43: 29-33.
10. Nouripour-Sisakht S, Mirhendi H, Shidfar MR, Ahmadi B, Rezaei-Matehkolaei A, Geramishoar M, et al. Aspergillus species as emerging causative agents of onychomycosis. J Mycol Med 2015; 25: 101-107.
11. Agarwalla A, Agrawal S, Khanal B. Onychomycosis in eastern Nepal. Nepal Med Coll J 2006; 8: 215-219.
12. Raghavendra KR, Yadav D, Kumar A, Sharma M, Bhuria J, Chand AE. The nondermatophyte molds: Emerging as leading cause of onychomycosis in south-east Rajasthan. Indian Dermatol Online J 2015; 6: 92-97.
13. Hedayati MT, Mayahi S, Denning DW. A study on Aspergillus species in houses of asthmatic patients from Sari City, Iran and a brief review of the health effects of exposure to indoor Aspergillus. Environ Monit Assess 2010; 168: 481-487.
14. Khosravi AR, Mansouri P. Onychomycosis in Tehran, Iran: prevailing fungi and treatment with itraconazole. Mycopathologia 2001; 150: 9-13.
15. Nenoff P, Verma SB, Vasani R, Burmester A, Hipler UC, Wittig F, et al. The current Indian epidemic of superficial dermatophytosis due to Trichophyton mentagrophytes-a molecular study. Mycoses 2019; 62: 336-356.
16. Gupta AK, Jain HC, Lynde CW, MacDonald P, Cooper EA, Summerbell RC. Prevalence and epidemiology of onychomycosis in patients visiting physicians’ offices: a multicenter Canadian survey of 15,000 patients. J Am Acad Dermatol 2000; 43: 244-248.
17. Veer P, Patwardhan NS, Damle AS. Study of onychomycosis: prevailing fungi and pattern of infection. Indian J Med Microbiol 2007; 25: 53-56.
18. Garg A, Venkatesh V, Singh M, Pathak KP, Kaushal GP, Agrawal SK. Onychomycosis in central India: a clinicoetiologic correlation. Int J Dermatol 2004; 43: 498-502.
19. Godoy-Martinez P, Nunes FG, Tomimori-Yamashita J, Urrutia M, Zaror L, Silva V, et al. Onychomycosis in São Paulo, Brazil. Mycopathologia 2009; 168: 111-116.
20. Kukhar Y, Smagulova A, Daniyarova A, Baiduissenova A, Kiyan V. Candida parapsilosis as a causative agent of onychomycosis in patient with cirrhosis of the liver. J Fungi (Basel) 2020; 6: 313.
21. Sylla K, Tine RCK, Sow D, Lelo S, Dia M, Traoré S, et al. Epidemiological and mycological aspects of onychomycosis in Dakar (Senegal). J Fungi (Basel) 2019; 5: 35.
22. Bitew A, Wolde S. Prevalence, risk factors, and spectrum of fungi in patients with onychomycosis in Addis Ababa, Ethiopia: a prospective study. J Trop Med 2019; 2019: 3652634.
23. Afshar P, Khodavaisy S, Kalhori S, Ghasemi M, Razavyoon T. Onychomycosis in North-East of Iran. Iran J Microbiol 2014; 6: 98-103.
24. Chadeganipour M, Mohammadi R. Causative agents of onychomycosis: a 7-year study. J Clin Lab Anal 2016; 30: 1013-1020.
25. Gregoriou S, Mpali N, Vrioni G, Hatzidimitriou E, Chryssou SE, Rigopoulos D. Epidemiology of Onychomycosis in an Academic Nail Unit in South Greece during a three-year period. Skin Appendage Disord 2020; 6: 102-107.
26. Sakkas H, Kittas C, Kapnisi G, Priavali E, Kallinteri A, Bassukas ID, et al. Onychomycosis in Northwestern Greece over a 7-year period. Pathogens 2020; 9: 851.
27. Motamedi M, Ghasemi Z, Shidfar MR, Hosseinpour L, Khodadadi H, Zomorodian K, et al. Growing incidence of non-dermatophyte onychomycosis in Tehran, Iran. Jundishapur J Microbiol 2016; 9(8): e40543.
28. Assadamongkol R, Lertwattanarak R, Wannachalee T, Bunyaratavej S, Leeyaphan C, Matthapan L. Prevalence, risk factors, and type of organism in fungal foot infection and toenail onychomycosis in Thai diabetic patients. J Med Assoc Thai 2016; 99: 659-664.
29. Quaade AS, Simonsen AB, Halling AS, Thyssen JP, Johansen JD. Prevalence, incidence, and severity of hand eczema in the general population - A systematic review and meta-analysis. Contact Dermatitis 2021; 84: 361-374.
| Files | ||
| Issue | Vol 14 No 2 (2022) | |
| Section | Original Article(s) | |
| DOI | https://doi.org/10.18502/ijm.v14i2.9196 | |
| Keywords | ||
| Onychomycosis; Epidemiology; Dermatophyte; Saprophyte; Yeast | ||
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This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License. |
How to Cite
1.
Razavyoon T, Hashemi SJ, Mansouri P, Rafat Z, Saboor-Yaraghi AA, Kamali Sarvestani H, Ghasemi Z. The epidemiology and etiology of onychomycosis in 2 laboratory centers affiliated to Tehran university of medical sciences during 2019-2020. Iran J Microbiol. 2022;14(2):268-275.
