Onychomycosis: Which fungal species are involved? Experience of the Laboratory of Parasitology-Mycology of the Rabta Hospital of Tunis

• Published in: Journal de mycologie médicale Vol. 28; no. 4; pp. 651 - 654
• Main Authors: Youssef, A. Ben, Kallel, A., Azaiz, Z., Jemel, S., Bada, N., Chouchen, A., Belhadj-Salah, N., Fakhfakh, N., Belhadj, S., Kallel, K.
• Format: Journal Article
• Language: English
• Published: France Elsevier Masson SAS 01.12.2018
• Subjects: Adolescent; Adult; Aged; Aged, 80 and over; Candida; Candida - isolation & purification; Child; Child, Preschool; Dermatophytes; Female; Hospitals, Teaching; Humans; Infant; Male; Middle Aged; Mycology - methods; Nails - microbiology; Nails - pathology; Onychomycosis; Onychomycosis - diagnosis; Onychomycosis - epidemiology; Onychomycosis - microbiology; Onychomycosis - pathology; Retrospective Studies; Trichophyton - isolation & purification; Tunisia; Tunisia - epidemiology; Young Adult; Tunisia; Dermatophytes; Tunisia; Candida; Onychomycosis
• ISSN: 1156-5233; 1773-0449
• DOI: 10.1016/j.mycmed.2018.07.005

Onychomycosis is a fungal infection of nails caused by dermatophytes, yeasts or non-dermatophyte molds. The aim of our study was to describe the epidemiological features of onychomycoses encountered in the Tunis region. A retrospective study concerned 3458 cases of onychomycosis, confirmed by direct examination and/or a positive culture, was conducted in Parasitology – Mycology Laboratory, Rabta hospital, over a five-year period (2012–2016). Our patients were aged 1 to 85; more than half of the patients were aged over 60 years with a female predominance (67%). Toenail infections were most common, observed in 2702 cases (78%). Direct examination was positive in 3284 cases (95%), culture in 2409 cases (69.6%); these two examinations were positive simultaneously in 2235 cases (64.6%). The causative agents of these onychomycoses were dominated by the genus Candida in fingernails: Candida albicans (55.6%), Candida tropicalis (8.5%) and Candida parapsilosis (8.2%) were the most frequently incriminated species; while in toenail lesions, Trichophyton rubrum was by far the most frequently isolated species (96.8%). Our results join the literature; onychomycosis is a pathology of the adult, mainly candidosic etiology in hands and dermatophytic in feet.