Sains Malaysiana 41(6)(2012): 697–700

Common Microorganisms Causing Onychomycosis in Tropical Climate

(Mikroorganisma Penyebab Utama Onikomikosis di Iklim Tropika)

M. Leelavathi*

Jabatan Perubatan Keluarga, Fakulti Perubatan, Universiti Kebangsaan Malaysia

Jalan Yaacob Latif, Bandar Tun Razak

56000 Cheras Kuala Lumpur, Malaysia

M.N. Tzar

Jabatan Mikrobiologi dan Imunologi Perubatan, Fakulti Perubatan, Universiti Kebangsaan Malaysia

Jalan Yaacob Latif, Bandar Tun Razak,  56000 Cheras Kuala Lumpur, Malaysia

J. Adawiah

Unit Dermatologi, Fakulti Perubatan, Universiti Kebangsaan Malaysia, Jalan Yaacob Latif

Bandar Tun Razak, 56000 Cheras , Kuala Lumpur, Malaysia

Received: 18 October 2011 / Accepted: 22 December 2011

ABSTRACT

Onychomycosis is the infection of nail apparatus by dermatophytes, yeasts or non-dermatophyte moulds and is responsible for 50% of all nail disorders. A five year retrospective study was conducted at Universiti Kebangsaan Malaysia to identify the common pathogens responsible for onychomycosis and to describe the epidemiology of the affected patients. A total of 278 abnormal nails were cultured, out of which 231 were positive for fungus. Females constituted 50.2% (n=116) while males 49.8% (n=115). The majority (51.9%, n=120) were between ages 50-69 years. The Malay ethnic group was most commonly affected (44.2%, n=102) followed by Chinese (33.8%, n=78), Indians (18.2%, n=42) and other ethnic groups (3.8%, n=9). The most common fungal element isolated was non-dermatophyte moulds (45.4%, n=105) followed by yeast (34.6%, n=80) and dermatophytes (1.3%, n=3). Aspergillus spp. was the commonest (59.8%,n=81) non-dermatophyte mould, while Candida spp. was the commonest yeast (74.3%, n=89) isolated. In this study, non-dermatophyte moulds are the most common microorganisms implicated to cause onychomysosis. Treatment for non-dermatophyte mould is challenging as the current available antifungal agents are more effective against dermatophytes and yeasts.

Keywords: Aspergillus; mould; onychomycosis

ABSTRAK

Onikomikosis adalah jangkitan kuku oleh kulat seperti dermatofit, yis atau kulat selain dermatofit. Ianya merangkumi 50% daripada semua penyakit kuku. Satu kajian retrospektif telah dijalankan di Universiti Kebangsaan Malaysia untuk mengenalpasti patogen penyebab utama onikomikosis dan mengkaji epidemiologi pesakit yang terlibat. Sejumlah 278 sampel kuku yang tidak normal telah dikultur dan 231 daripadanya didapati positif dengan kulat. Kaum wanita mewakili 50.2% (n=116) manakala lelaki mewakili 49.8% (n=115) pesakit yang dikenalpasti dengan onikomikosis. Kebanyakkan pesakit (51.9%, n=120) berumur di antara 50-69 tahun dan terdiri daripada kaum etnik Melayu (44.2%, n=102), Cina (33.8%, n=78), India (18.2%, n=42) dan kumpulan etnik yang lain (3.8%, n=9). Kulat yang paling kerap dikultur adalah kulat selain dermatofit (45.4%, n=105), yis (34.6%, n=80) dan dermatofit (1.3%, n=3). Aspergillus spp. merupakan kulat selain dermatofit yang paling kerap dikultur (59.8%,n=71), sementara Candida spp. pula merupakan yis yang paling kerap (74.3%, n=89) dikultur. Kajian ini menunjukkan bahawa kulat selain dermatofit adalah mikroorganisma penyebab utama onikomikosis. Rawatan untuk onikomikosis disebabkan oleh kulat selain dermatofit adalah sukar memandangkan rawatan yang sedia ada adalah lebih efektif terhadap jangkitan kulat dermatofit.

Kata kunci: Aspergillus; kulat; onikomikosis

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*Corresponding author; email: drleelaraj@yahoo.com