Antifungal Susceptibility of Dermatophytes Isolated From Cutaneous Fungal Infections: The Vietnamese Experience

Chau Van Tro; Khuong Ho Thi Ngoc; Thuong Nguyen Van; Khang Tran Hau; Marco Gandolfi; Francesca Satolli; Claudio Feliciani; Michael Tirant; Aleksandra Vojvodic; Torello Lotti

doi:10.3889/oamjms.2019.062

Authors

Chau Van Tro Department of Dermatology, Pham Ngoc Thach University of Medicine, Vietnam
Khuong Ho Thi Ngoc Hospital of Dermato-Venereology of HCMC, Ho Chi Minh City, Vietnam
Thuong Nguyen Van National hospital of Dermatology and Venereology, Hanoi, Vietnam
Khang Tran Hau National hospital of Dermatology and Venereology, Hanoi, Vietnam
Marco Gandolfi Unit of Dermatology, University of Parma, Parma, Italy
Francesca Satolli Unit of Dermatology, University of Parma, Parma, Italy
Claudio Feliciani Unit of Dermatology, University of Parma, Parma, Italy
Michael Tirant University of Rome G. Marconi, Rome, Italy; Psoriasis Eczema Clinic, Melbourne, Australia
Aleksandra Vojvodic Department of Dermatology and Venereology, Military Medical Academy of Belgrade, Belgrade, Serbia
Torello Lotti University of Rome G. Marconi, Rome, Italy

DOI:

https://doi.org/10.3889/oamjms.2019.062

Keywords:

Cutaneous dermatophytosis, Dermatophytes, Antifungal resistance

Abstract

AIM: Evaluate the resistance of dermatophytes to systemic antifungal drugs in the Vietnamese population.

METHODS: We enrolled 101 patients with cutaneous dermatophytosis at the Dermato-Venereology hospital in HCMC from August 2016 to March 2017. All the specimens were subjected to direct examination (10% KOH mount) and culture on Sabouraud dextrose agar. In vitro antifungal sensitivity testing was done on species isolated from a culture with broth microdilution method.

RESULTS: Direct microscopy was positive for dermatophytes in all patients. However this pathogen was found in fungal cultures in only 61.38% of patients. The main causative agent isolated was Trichophyton spp. (90.3%), followed by Microsporum spp. (8%) and Epidermophyton spp. (1.7%). Trichophyton spp. Has shown resistance to fluconazole, griseofulvin, ketoconazole, and itraconazole in 92.9%, 46.4%, 5.4% and 1.8% of strains, respectively. All Microsporum spp. Strains were found resistant to fluconazole and griseofulvin while resistance to ketoconazole was demonstrated in only 20% of strains and none of them was resistant to itraconazole. Epidermophyton spp strains were all resistant to fluconazole, griseofulvin, ketoconazole while none of them was resistant to itraconazole.

CONCLUSION: Based upon our results, Itraconazole shows the greatest probability of efficacy in the treatment of cutaneous dermatophytosis in Vietnamese patients.

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