Studies on Fungal Skin Diseases Caused by Dermatophytes in Karachi Region.

Abstract

Microsporum, Trichophyton and Epidermophyton are organisms termed as dermatophytes, which are responsible to cause dermatophytosis. They are the pathogenic associates of the keratinophilic (digesting keratin) fungi. Generally, they grow only in keratinized tissues such as hair, nails and the outer layer of skin, to invade them; the fungus frequently halts spreading where it comes in contact to living cells or areas of inflammation. Dematophytosis the most frequent human infectious diseases have become a stern medical and social problem and encountered all over the world. The rate of work, on dermatophyte infections, is limited as compared to the extensive work being done in the field of bacteriology, virology and mycology. In Karachi region, so far no extensive work has been carried out on the spread of different skin ailments caused by fungi and their influence on human health. During the sampling period, various fungi were collected and isolated from the affected specimens (skin, hairs, foot and nails) from different hospitals of Karachi and identified as Trichophyton rubrum, T. violaceum, T. verrucosum, T. mentagrophytes, T. tonsurans, T. interdigitale, Epidermophyton floccosum, Microsporum gypseum and M. canis. In the present studies five common epidemics were selected these were Tinea corporis (glabrous skin), Tinea capitis (scalp and hairs), Tinea pedis (foot), Tinea cruris (groin area) and Tinea unguium (nails) and found infected by different pathogenic dermatophyte fungi. This work was based on questionnaires. Epidemics showed different pattern of severity in different districts. In spite of this the severity described their viable effectiveness by the significant grouping in epidemics for five different areas such as East, West, South, Central and miscellaneous with decreasing order, respectively. In general, in all five areas Tinea corporis and Tinea capitis were significantly high in their distribution, while the occurrence of Tinea pedis, Tinea cruris and Tinea unguium had lesser incidence. Moreover, associations of these epidemics were determined by cluster analysis. Age and gender were the main categories considered in relation to the different epidemics investigated in the five selected districts of Karachi. For the determination of significant differences in age and gender, a factorial analysis of variance was employed on the data. The findings showed highly significant differences among age groups and sex at four out of five districts while sex did not show any difference in West as well as in the combined Studies on the fungal skin diseases caused by dermatophytes in Karachi region 2 data. At all five districts, male patients had considerably suspected by fungal infection especially Tinea corporis, Tinea cruris and Tinea pedis in contrast to females. Based on general correlation, its observed that dermatophytic fungal infections are more common infection in adult as compared to pediatric population. It was also noticed that the intensity of these infections is more frequent which is low socio economically class and live in unhygienic conditions. On the basis of frequency of isolated dermatophyte mean values of Trichophyton rubrum, T. violaceum T. verrucosum, T. mentagrophytes, T. tonsurans, T. interdigitale, Epidermophyton floccosum and Microsporum gypseum were highly distributed fungal species in four selected epidemics recorded from Karachi, while M. canis was only recorded from Tinea capitis whereas T. rubrum and T. violaceum were the dominant fungal species. The effects of antagonistic fungi on the growth of six pathogenic dermatophyte fungi were carried out. Among these isolates, Trichoderma harzanium and Aspergillus niger showed most promising results as exciting antagonists which inhibiting the growth of the pathogenic dermatophyte fungi by 72.9 and 61.2% individually. Concerning other, the least antagonist was Penicillium commune, inhibited the growth of the pathogens by 45.5%. The consequences of ANOVA demonstrated that all the isolates in the study significantly inhibited all the six fungal species including T. rubrum, T. tonsurans, T. verrucosum, T. mentagrophytes, T. violaceum and E. floccosum to varying degree. Each of the six species demonstrated as interacted with various infectious pathogens. All the tested bacterial strains in the study showed varying degree of antagonistic effect against all pathogenic dermatophytic fungi viz., T. rubrum, T. tonsurans, T. verrucosum, T. mentagrophytes, T. violaceum and E. floccosum. In this probationary, against all tested fungi Pseudomonas aeruginosa revealed highest antifungal activity by 67.5%. The least antagonists were P. fluorescence and Bacillus subtilis which inhibited the growth of the pathogen by 58.3 and 51.4%, respectively. Moreover, the results obtained from this study revealed that there was a momentous difference among the bacterial antagonistic activities against each and every fungus. Studies on the fungal skin diseases caused by dermatophytes in Karachi region 3 In antifungal test, the extracts of seven selected plants were tested against six fungi viz., T. rubrum, T. violaceum T. verrucosum, T. mentagrophytes, T. tonsurans and E. floccosum. Maximum inhibition activities were recorded in T. rubrum against all extracts of selected plants. However, some plant extracts did show less inhibitory activity against other five pathogenic dermatophytic fungi viz., T. violaceum T. verrucosum, T. mentagrophytes, T. tonsurans and E. floccosum. It was determined that Caesalpinia bonducella extract showed most promising antifungal activity against different dermatophytes by 71%. Moderate activity was recorded contrary to different dermatophytes by using Allium sativum, Cymbopogan citratus, Ocimum sanctum, Aloe barbadensis and Allium cepa by 68 to 58%. Minimum activity was recorded for Punica granatum i.e. 52%. For evaluating the efficacy of the frequently used antifungal drugs such as Terbinafine, Itraconazole, Clotrimazole, Ketaconazole, Griseofulvin and Fluconazole, was compared with the selected fungi, bacteria and extract of plants which inhibited significantly the growth of pathogenic dermatophyte fungi. It is concluded that six fungi T. rubrum, T. tonsurans, T. verrucosum, T. mentagrophytes, T. violaceum and E. floccosum were tested against the selected six antifungal drugs. All the selected drugs strongly suppressed the mycelial growth of T. rubrum. However, some antifungal drugs showed moderate and poor inhibitory activity against other pathogenic dermatophyte fungi. Regarding the data, present study revealed that Terbinafine by 81% was the most effective antifungal drug followed by Itraconazole, Clotrimazole, Ketaconazole and Griseofulvin by 69%, 63%, 52% and 42%, respectively which exhibited good activity against dermatophyte fungi and Fluconazole showed poorest activity by 19%. For the investigations regarding to correlate the data, comparison has been done between the consequences of antifungal drugs, antagonistic fungi, bacterial strains and medicinal plant extracts it was found that the plant extracts had extreme antidermatophytic effects by 62.1% as compared to the tested fungi, bacterial strains and antifungal drugs by 60, 59 and 54.3%, respectively. It is concluded that measures for anticipation should be done by the conservation of resistance not only to dermatophytic but other infections by personal Studies on the fungal skin diseases caused by dermatophytes in Karachi region 4 care and hygiene as well as try for improving sanitary conditions for public health. Much detailed in vitro or in vivo clinical analysis should be essential to explicate the particular antifungal mechanism shown by tested fungi, bacterial strains and medicinal plant extracts for establishing cheaper, affordable and acceptable products for future use.