Eleonora Dubljanin
Institute of Microbiology and Immunology, University of Belgrade, Belgrade, Serbia
Title: Epidemiologic characteristics and risk factor identification in patients with suspected onychomycosis
Biography
Biography: Eleonora Dubljanin
Abstract
Onychomycosis is a fungal infection of the fingernails and/or toenails, caused by dermatophytes, yeast and non-dermatophyte moulds. The epidemiology of onychomycosis in Serbia is yet to be fully established.
Objectives: This epidemiological study was aimed at evaluating the epidemiology of onychomycosis in a sample of the Serbian patients at risk of onychomycosis, to determine the fungal aetiological agents and to identify the possible risk factors.
Patients & Methods: The study population included 374 patients from six centers in Serbia with suspected onychomycosis. Demographic data, data about comorbidities, lifestyle, clinical aspects of onychomycosis, trauma, excessive perspiration, and personal and family history of previous onychomycosis were studied. Laboratory confirmation of diagnosis was done by direct microscopy, fungal culture and PCR.
Results: Diagnosis of onychomycosis was confirmed in 50.8% of patients, who tested positive to at least one laboratory test (direct microscopy, fungal culture or PCR). T. rubrum was predominant both on toenails (85.98%) and on fingernails (38.46%). Independent risk factors for onychomycosis were: old age (OR=2.285; p<0.001), family history of previous onychomycosis and/or tinea pedis (OR=2.452; p=0.005), excessive perspiration (OR=2.165; p=0.002), and higher degree of hyperkeratosis (OR=1.755; p=0.020).
Conclusions: Identification of the most common causative agents of onychomycosis revealed the predominance of dermatophytes and may be useful in discerning the epidemiological situation and planning preventive strategies. A significant contribution is insight in the importance of certain conventional and methods of molecular biology in the diagnosis of onychomycosis since that for the first time in Serbia molecular diagnosis was used in laboratory confirmation. These results could help in defining the optimal laboratory protocols for reliably identification of onychomycosis suitable to our local epidemiology and the economic situation.