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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
Diserahkan: 18 Oktober 2011 / Diterima: 22 Disember 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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*Pengarang surat-menyurat; email: drleelaraj@yahoo.com
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