Dermatophytosis is a major health problem all over the world including Pakistan. This is the first report of detection of dermatophytes and their antifungal drug resistance in the Northern and Western parts of Pakistan. A total of 154 samples were collected from different hospitals of Khyber Pakhtunkhwa, and out of them 136 samples were found positive. Tinea corporis (35%) was the most predominant type of infection followed by Tinea capitis (22%). The fungi identified in Tinea corporis infection types were identified as Trichophyton rubrum, Trichophyton mentagrophytes, Epidermophyton floccosum. The fungi identified in Tinea capitis included Trichophyton violaceum, T. mentagrophytes, Microsporum ferrugineum. The gender wise distribution showed both males (52%) and females (48%) were infected with the fungi. More cases belonged to the rural parts of the country. Age wise distribution showed that the infection was more prevalent in the children and the prevalence decreased with the increase in age. The positive samples were checked against two antifungal agents: fluconazole and nystatin. Among 136 positive samples, none of the isolates showed resistance to nystatin while 7% of the samples showed resistance to fluconazole. The resistant isolates were then identified by amplifying the 18S rRNA gene, using universal primers (ITS1, ITS4). Among the 9 resistant isolates, 5 isolates were identified as Trichophyton spp., 3 as Microsporum spp. and 1 as Epidermophyton spp.
White TC. , Findley K , Dawson TL , Scheynius A , Boekhout T , Cuomo CA , Saunders CW . Fungi on the skin: dermatophytes and Malassezia. Cold Spring Harbor Perspect Med 2014; 4(8): a019802.
Oliveira LDQD . Influence of the essential oils of Cinnamomum cassia and Cymbopogon flexuosus on susceptibility and virulence factors in yeasts of the Cryptococcus neoformans complex; 2017.
Gnat S , Łagowski D , Nowakiewicz A . Major challenges and perspectives in the diagnostics and treatment of dermatophyte infections. J Appl Microbiol 2020; 129(2): 212–232.
Martinez-Rossi NM , Bitencourt TA , Peres NT , Lang EA , Gomes EV , Quaresemin NR , Rossi A . Dermatophyte resistance to antifungal drugs: mechanisms and prospectus. Front Microbiol 2018; 9: 1108.
Teklebirhan G , Bitew A . Prevalence of dermatophytic infection and the spectrum of dermatophytes in patients attending a tertiary hospital in Addis Ababa, Ethiopia. Int J Microbiol 2015.
Kim SH , Cho SH , Youn SK , Park JS , Choi JT , Bak YS , Kim YK . Epidemiological characterization of skin fungal infections between the years 2006 and 2010 in Korea. Osong Public Health Res Perspect 2015; 6(6): 341–345.
Achterman RR , White TC . Dermatophyte virulence factors: identifying and analyzing genes that may contribute to chronic or acute skin infections. Int J Microbiol 2012.
Bassiri-Jahromi S . Epidemiological trends in zoophilic and geophilic fungi in Iran. Clin Exp Dermatol Clin Dermatol 2013; 38(1): 13–19.
Lockhart SR , Guarner J . Emerging and reemerging fungal infections. Semin Diagn Pathol 2019; 36(3): 177–181.
Attal RO , Deotale V , Yadav A . Tinea capitis among primary school children: a clinic mycological study in a rural hospital in central India. Int J Curr Res Rev 2017; 9(23): 25.
Husain MA , Alam MN , Joarder Y , Ferdous M . Correlation between clinical and mycological diagnosis of onychomycosis. J Pak Assoc Dermatol 2018; 27(3): 220–225.
Ahsan U , Zaman T , Rashid T , Jahangir M . Cutaneous manifestations in 1000 Pakistani newborns. J Pak Assoc Dermatol 2010; 20(4): 199–205.
Haroon TS , Qureshi AS , Alvi KH , Khan HZ , Lakhani S , Sherali A . A study of skin disease in Chitral. J Pak Med Assoc 1987; 37: 247–250.
Thebo NK , Abro H , Soomro AQ , Anwer J , Suhail M . Isolation and identification of dermatophytes from Sindh, Pakistan. Pak J Bot 2006; 38(2): 493.
Mirza SH , Gardezi AH , Khan Y , Wiqar MA . Subcutaneous facial mycosis in a child due to Madurella mycetomatis. J Pak Med Assoc 2007; 57(9): 466.
Abbas SQ , Maan A , Iqbal J , Niaz M , Waqas M , Ahmed H , Liaqat A . A report of Paecilomyces variotii on human from Pakistan. Pak J Bot 2009; 41(1): 467–472.
Yasmeen N , Khan MR . Spectrum of common childhood skin diseases: a single center experience. J Pak Med Assoc 2005; 55(1): 60–63.
Namboodiri MT , Pakshirajan K . Sustainable and green approach of chitosan production from Penicillium citrinum biomass using industrial wastewater as a cheap substrate. J Environ Manage 2019; 240: 431–440.
Bitew A . Dermatophytosis: prevalence of dermatophytes and non-dermatophyte fungi from patients attending Arsho advanced medical laboratory. Addis Ababa, Ethiopia: Dermatol Res Pract; 2018.
Suárez-Villota EY , Carmignotto AP , Brandão MV , Percequillo AR , Silva MJDJ . Systematics of the genus Oecomys (Sigmodontinae: Oryzomyini): molecular phylogenetic, cytogenetic and morphological approaches reveal cryptic species. Zool J Linn Soc 2018; 184(1): 182–210.
Feghali N , Albertin W , Tabet E , Rizk Z , Bianco A , Zara G , Budroni M . Genetic and phenotypic characterization of a Saccharomyces cerevisiae population of ‘Merwah’ white wine. Microorganisms 2019; 7(11): 492.
Hasan TSS , Aleem S , Tabassum L . Clinical evaluation of efficacy of Majoon Ushba and Marham Gulabi in Qooba. Indian J Traditional Knowledge 2011; 10: 702–705.
Zhan P , Liu W . The changing face of dermatophytic infections worldwide. Mycopathologia 2017; 182(1–2): 77–86.
Chen M , Xu Y , Hong N , Yang Y , Lei W , Du L , Liao W . Epidemiology of fungal infections in China. Front Med-Prc 2018; 12(1): 58–75.
Mashedi OM . Characterization and antifungal drug profile of Dermatophytes from clinical sources in Nairobi. Doctoral dissertation, Kenya: University of Nairobi; 2010.
Balakumar S , Rajan S , Thirunalasundari T , Jeeva S . Epidemiology of dermatophytosis in and around Tiruchirapalli, Tamilnadu, India. Asian Pac J Trop Dis 2012; 2(4): 286–289.
Naseri A , Fata A , Najafzadeh MJ , Shokri H . Surveillance of dermatophytosis in northeast of Iran (Mashhad) and review of published studies. Mycopathologia 2013; 176(3–4): 247–253.
Pontes ZBVDS , Oliveira ACD , Guerra FQS , Pontes LRDA , Santos JPD . Distribution of dermatophytes from soils of urban and rural areas of cities of Paraiba State, Brazil. Rev Do Inst Med Trop SP 2013; 55(6): 377–383.
Akcaglar S , Ener B , Toker SC , Ediz B , Tunali S , Tore O . A comparative study of dermatophyte infections in Bursa, Turkey. Med Mycol 2011; 49(6): 602–607.
Agarwal RK , Gupta S , Mittal G , Khan F , Roy S , Agarwal A . Antifungal susceptibility testing of dermatophytes by agar-based disk diffusion method. Int J Curr Microbiol Appl Sci 2015; 4(3): 430–436.
Khatri PK , Kachhawa D , Maurya V , Meena S , Bora A , Rathore L , Khullar S . Antifungal resistance pattern among dermatophytes in Western Rajasthan. Int J Curr Microbiol Appl Sci 2017; 6: 499–509.
Habeb KA , Maikhan HK , Rachid SK . Molecular identification of dermatophytes among clinical isolates. Asian J Nat Appl Sci 2016; 5(2): 1–11.