Antifungal Susceptibility Testing of Dermatophytes



The cases of dermatophytoses have increased over the past few decades. In the last few years, a number of newer less toxic antifungal drugs have become available for clinical use. The increased use of antifungal, often for prolonged periods, has led to the recognition of the phenomenon of acquired antifungal resistance among previously susceptible strains or species and to the increased incidence of infections with less common species. Our study mainly focused on the in vitro susceptibility of clinical isolates of dermatophytes. The microbroth dilution method was performed according to CLSI standards. In the present study, antifungal susceptibility testing was done by microdilution method of dermatophytes against five antifungal agents namely, ketoconazole (imidazoles) fluconazole, itraconazole (triazoles), griseofulvin and terbinafine and their activity against significant number of strains, representing a wide spectrum of dermatophyte species is assessed. Dermatophytic strains: A total of 119 strains of dermatophytes belonging to 10 species were tested. They were T. rubrum (n = 40), T. mentagrophytes (n = 19), T. violaceum (n = 15), M. gypseum (n = 12), E. flocossum (n = 9), M. audouinii (n = 8), T. schoenleinii (n = 5), M. canis (n = 5), T. tonsurans (n = 4) and T. verrucosum (n = 2). The MIC ranges of all the 119 isolates of dermatophytes tested for antifungal susceptibility showed that terbinafine had the lowest MIC range 0.001–0.64 μg/ml followed by ketoconazole at a MIC range 0.01–3.84 μg/ml. The itraconazole showed a MIC range 0.082–20.45 μg/ml whereas the griseofulvin and fluconazole showed a highest MIC range 0.32–5.12 μg/ml. The MIC 50 of terbinafine was low at 0.02 μg/ml followed by ketaconazole 0.24 μg/ml. The MIC 50 of itraconazole and griseofulvin was 1.28 μg/ml .The highest MIC 50 with 2.56 μg/ml was recorded for fluconazole. The MIC90 of terbinafine was low at 0.32 μg/ml followed by ketaconazole with 1.92 μg/ml. The MIC 90 itraconazole was 2.50 μg/ml and for griseofulvin it was 2.56 μg/ml. The highest MIC 90 of flucanozole was high at 10.24 μg/ml. In our study, we observed that terbinafine had the lowest MIC values compared to ketoconazole, itraconazole, griseofulvin and fluconazole.


Antifungal Drug Antifungal Susceptibility Tinea Capitis Sabouraud Dextrose Agar Tinea Pedis 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


  1. Ajello L (1968) A taxonomic review of the dermatophytes and related species. Sabouraudia 6:147–159CrossRefPubMedGoogle Scholar
  2. Aly R (1994) Ecology and epidemiology of dermatophyte infections. J Am Acad Dermatol 31(3):S21–S25CrossRefPubMedGoogle Scholar
  3. Anand AR, Madhavan HN, Sudha NV, Therese KL (2001) Use of PCR in the diagnosis of fungal endophthalmitis. Ophthalmology 108:386–390CrossRefGoogle Scholar
  4. Badillet G (1991) Dermatophytieset Dermatophytes- Atlas clinique et biologique, 3èmeth edn. ÉditionsVaria, Paris, p 303Google Scholar
  5. Bhaskaran CS, Shyam Sunder Rao P, Krishanamoorthy T, Tarachand P (1977) Dermatophytosis in Tripathi. Indian J Pathol Microbiol 20:251–260PubMedGoogle Scholar
  6. Chander J (2002) Text book of medical mycology, 2nd edn. Mehta Publishers, New DelhiGoogle Scholar
  7. Debono M, Gordee RS (1994) Antibiotics that inhibit fungal cell wall development. Annu Rev Microbiol 48:471–497CrossRefPubMedGoogle Scholar
  8. Degreef H (2008) Clinical forms of dermatophytosis (ringworm infection). Mycopathologia 166:257–265CrossRefPubMedGoogle Scholar
  9. Emmons CW, Bindford CH, Utz JP, Kwon-Chung KL (eds) (1977) Chapter 10: Dermatophytoses. In: Medical mycology, 3rd edn. Lea & Febiger, Philadelphia, pp 117–167Google Scholar
  10. Favre B, Hofbauer B, Hildering KS, Ryder NS (2003) Comparison of in vitro activities of 17 antifungal drugs against a panel of 20 dermatophytes by using a microdilution assay. J Clin Microbiol 41:4817–4819CrossRefPubMedPubMedCentralGoogle Scholar
  11. Fernández-Torres B, Cabañes FJ, Carrillo-Muñoz AJ, Esteban A, Inza I et al (2002) Collaborative evaluation of optimal antifungal susceptibility testing conditions for dermatophytes. J Clin Microbiol 40:3999–4003CrossRefPubMedPubMedCentralGoogle Scholar
  12. Garg AP, Muller J (1992) Inhibition of growth of dermatophytes by Indian hair oils. Mycoses 35:363–369CrossRefPubMedGoogle Scholar
  13. Georgopapadakou NH, Tkacz JS (1995) The fungal cell wall as a drug target. Trends Microbiol 3:98–104CrossRefPubMedGoogle Scholar
  14. Ghannoum MA, Rice LB (1999) Antifungal agents: mode of action, mechanisms of resistance, and correlation of these mechanisms with bacterial resistance. Clin Microbiol Rev 12:501–517PubMedPubMedCentralGoogle Scholar
  15. Gupta AK, Kohli Y (2003) In vitro susceptibility testing of ciclopirox, terbinafine, ketoconazole and itraconazole against dermatophytes and nondermatophytes, and in vitro evaluation of combination antifungal activity. Br J Dermatol 149:296–305CrossRefPubMedGoogle Scholar
  16. Hajini GH, Kandhari KC, Mohapatra LN (1970) Effect of hair oils and fatty acids on the growth of dermatophytes and their in vitro penetration of human scalp hair. Sabouradia 8:174CrossRefGoogle Scholar
  17. Kanwar AJ, Mamta, Chander J (2001) Superficial fungal infection. In: Valia RG, Valia AR (eds) IADVL textbook and atlas of dermatology, 2nd edn. Bhalani Publishing House, Mumbai, pp 215–258Google Scholar
  18. Kaur S (1970) Incidence of dermatophytosis in Chandigarh and surrounding areas. Indian J Dermatol Venereol 36:143–145Google Scholar
  19. Malik AK, Chugh TD, Prakash K (1978) Dermatophytosis in North India. Indian J Pathol Microbiol 21:53–59PubMedGoogle Scholar
  20. Maria Elisabete da Silva Barros, Daniel de Assis Santos, Junia Soares Hamdan (2007) Evaluation of susceptibility of Trichophyton mentagrophytes and Trichophyton rubrum clinical isolates to antifungal drugs using a modified CLSI microdilution method (M38-A). J Med Microbiol 56(4):514–518Google Scholar
  21. Murray PR, Baron EJ, Pfaller MA, Tenouer FC, Youlken RH (1999) Trichophyton, microsporum, epidermophyton and agents of superficial mycoses. In: Manual of clinical microbiology. ASM Press, WashingtonGoogle Scholar
  22. Nimura K, Niwano Y, Ishiduka S, Fukumoto R (2001) Comparison of in vitro antifungal activities of topical antimycotics launched in 1990s in Japan. Int J Antimicrob Agents 18:173–178CrossRefPubMedGoogle Scholar
  23. Oyeka CA (1990) Tineacapitis in Awka local Government Area of Anambra state. West Afr J Med 9:120–123PubMedGoogle Scholar
  24. Philpot CM (1977) The use of nutritional tests for the differentiation of dermatophytes. Sabouraudia 15:141–150CrossRefPubMedGoogle Scholar
  25. Remak R (1842) GelungeneInpfung des Favus. Med Z 11:37Google Scholar
  26. Sabouraud R (1970) (1864–1938) French dermatologist. JAMA 214(2):363–364Google Scholar
  27. Seeliger HPR (1985) The discovery of Achorion schoenleinii: facts and “stories.”. Mykosen 28:161–182CrossRefPubMedGoogle Scholar
  28. Shah HS, Amin AG, Kavinde MS et al (1975) Analysis of 2000 cases of dermatomycoses. Indian J Pathol Bacteriol 18:32–37PubMedGoogle Scholar
  29. Singh S, Beena PM (2003) Profile of dermatophyte infections in Baroda. Indian J Dermatol Venereol Leprol 69:281–283PubMedGoogle Scholar
  30. Vasu DRBH (1966) Incidence of dermatophytosis in Warangal, Andhra Pradesh. India. Indian J Med Res 54:468–474Google Scholar
  31. Weitzman I, Summerbell RC (1995) The dermatophytes. Clin Microbiol Rev 8:240–259PubMedPubMedCentralGoogle Scholar

Copyright information

© Springer India 2016

Authors and Affiliations

  1. 1.Kakatiya UniversityHanamkondaIndia

Personalised recommendations