Diagnóstico de dermatofitosis en trabajadores de la Hacienda El Murrieta

Abstract

Dermatophytosis is a cutaneous skin infection caused by dermatophyte fungi that affects more than half of the population causing damage to the keratinized surface of the skin, nails, scalp and mucous membranes, but without causing damage to the subcutaneous tissues preventing a lymphatic invasion The agricultural activities carried out in the coastal region of Ecuador condition the workers to be exposed for extended periods in conditions of temperature and humidity that serve as a source for the growth of fungal microorganisms. Actually, the misuse and easy accessibility of antifungal drugs has generated resistance to them because the treatment that is carried out is incomplete or in turn the dose administered is not adequate for the type of infection that is being treated. Fluconazole and itraconazole are two molecules belonging to the family of azoles used to treat dermatophytic cutaneous diseases that act by inhibiting the synthesis of ergosterol present in the fungal cell membrane. The present investigation is a descriptive work of an experimental type in which standardized protocols for microbiological analysis were applied that guaranteed the quality of the results obtained. For this study, 60 nail samples from workers at the El Murrieta farm were analyzed. For the execution of the work, the three phases of diagnosed clinical were considered: pre-analytical, analytical and post-analytical and base on them techniques and methods were identified, culture and isolation of dermatophytic agents, for which the preparation of materials, equipment, reagents and culture media that were necessary for the growth of fungi. The microscopic observation was carried out with specific dyes such as potassium hydroxide (20% KOH) and lactophenol blue, which served to visualize and differentiate the fungal structures. The species were grown in Sabouraud Dextrose Agar medium with Chloramphenicol (Mycosel Agar). The isolation was performed using the microculture technique and, the sensitivity tests were performed in Müller Hinton Agar using the Epsilon test method in which fluconazole and itraconazole were confronted. The pathogens of fungal origin that were identified with 20% KOH are: Trichophyton rubrum (48%), Trichophyton mentagrophytes (2%) and Paecilomyces lilacinus (17%). Isolation of the pathogenic species causing dermatophytosis was performed and the fungal structures were visualized with lactophenol blue, differentiating T. rubrum and T. mentagrophytes. After the identification of dermatophytic fungi, sensitivity tests were performed on the 30 isolated samples resulting in the following: T. rubrum 26 sensitive and 3 resistant samples for fluconazole, while for itraconazole, 25 samples were sensitive, 1 sensitive depending on of dose and 3 resistant; and T, mentagrophytes the only sample analyzed was sensitive both drugs. All these values were compared with the cut-off points established in the standardized CLSI standards for filamentous fungi.