Epidemiology of Superficial Fungal Infections in Portugal: 3-Year Review (2014-2016)
Abstract
Introduction: Superficial fungal infections are the most frequent infectious dermatoses and their incidence continues to increase. Dermatophytes are the principal agents presenting, however, a variable geographic distribution.
Material and Methods: This study aimed to characterize the epidemiology of superficial fungal infections diagnosed in Dermatology departments/ units of the Portuguese National Health System between January 2014 and December 2016, through a retrospective analysis of the results of positive cultures performed during this period.
Results: A total of 2375 isolates from 2319 patients were studied. The most frequently isolated dermatophyte was Trichophyton rubrum (53.6%), which was also the main cause of glabrous skin tinea (52.4%) and of onychomycosis (51.1%). In relation to tinea capitis, Microsporum audouinii was the most prevalent agent globally (42.6%), followed by Trichophyton soudanense (22.1%). While in the Lisbon metropolitan area these dermatophytes were the main causative agents, in the North and Center regions of Portugal, Microsporum canis was the most frequent agent (58.5%). Yeasts were the main agents isolated from onychomycosis of the hands (76.7%).
Conclusion: The results of this study are globally in agreement with the scientific literature. Trichophyton rubrum is the most frequent dermatophyte overall. As for tinea capitis, in the Lisbon metropolitan area, the imported anthropophilic species assume particular importance.
Downloads
References
Kelly BP. Superficial fungal infections. Pediatr Rev. 2012 Apr;33(4):e22-37.
Ameen M. Epidemiology of superficial fungal infections. Clin Dermatol. 2010 Mar 4;28(2):197-201.
Havlickova B, Czaika VA, Friedrich M. Epidemiological trends in skin mycoses worldwide. Mycoses. 2008 Sep;51 Suppl 4:2-15.
Rocha J, Duarte ML, Oliveira P, Brito C. Dermatofitias no distrito de Braga - estudo retrospetivo dos últimos 11 anos (1999 - 2009). Trab Soc Port Dermatol Venerol 2011; 69 (1): 69-78.
Cabrita J, Sequeira H: Dermatófitos em Portugal (1982-1988). Trab Soc Port Dermatol Venereol 48: 31-8 (1990).
Borman AM, Campbel CK, Johnson EM: Analysis of the dermatophyte species isolated in the British Isles between 1980 and 2005 and review of world dermatophyte trends over the last three decades. Med Mycol 45(2): 131-41 (2007).
Panackal AA, Halpern EF, Watson AJ: Cutaneous fungal infections in the United States: Analysis of the National Ambulatory Medical Care Survey (NA- MCS) and National Hospital Ambulatory Medical Care Survey (NHAMCS), 1995-2004. Int J Dermatol 48: 704-12 (2009).
Seebacher C, Bouchara JP. Updates on the epidemiology of dermatophyte infections. Mycopathologia. 2008; 166:335-52.
Campos S, Lestre S, Galhardas C, Apetato Margarida. Tinhas do couro cabeludo - estudo retrospetivo de 5 anos (2008-2012) no Hospital Santo António dos Capuchos. Revista SPDV 2014; 72(3): 333-340.
Serrano P, Furtado C, Anes I, Costa I. Micoses superficiais numa consulta de Dermatologia Pediátrica - revisão de 3 anos. Trab Soc Port Dermatol Venereol. 2005; 63(3): 341-8.
Raquel Sabino et al, Tinea capitis: análise retrospetiva de casos diagnosticados entre 2004 e 2013. Observações -Boletim epidemiológico do INSA, Lisboa.
Valdigem GL, Pereira T, Macedo C, Duarte ML, Oliveira P, Ludovico P, Sousa-Basto A, Leão C, Rodrigues F. A twenty-year survey of dermatophytoses in Braga, Portugal. Int J Dermatol. 2006 Jul;45(7):822-7.
Duarte ML, Macedo C, Estrada I, Sousa Basto A: Panorama etiológico das dermatofitias no distrito de Braga: Revisão de 15 anos (1983-1998). Trab Soc Port Dermatol Venereol 58(1): 55-61 (2000).
Machado S, Velho G, Selores M, Lopes V, Amorim ML, Amorim J, Massa A: Micoses superficiais na Consulta de Dermatologia Pediátrica do Hospital Geral de Santo António - revisão de 4 anos. Trab Soc Port Derm Ven 60(1): 59-63 (2002).
Lobo I, Velho G, Machado S, Lopes V, Ramos H; Selores M: Micoses superficiais na Consulta de Dermatologia Pediátrica do Hospital Geral de Santo António - revisão de 11 anos. Trab Soc Port Derm Ven 66(1): 53-7 (2008).
Cunha AP, Barros AM, Alves S, Pereira M, Santos P, Mota A, Azevedo F, Resende C: Micoses cutâneas superficiais em crianças - revisão de 5 anos. Trab Soc Port Derm Ven 62(3): 371 (abstract) (2004).
Coelho JD, Rocha-Páris F, Galhardas C, Feio AB. Estudo retrospetivo dos fungos patogénicos isolados no Departamento de Micologia do Hospital de Desterro em 2006 e 1º trimestre de 2007. Trab Soc Port Dermatol Venerol 2007; 65 (4): 481-486.
E. Tavares, M.G. Catorze, C. Galhardas, M.J. Pereira, O. Bordalo e Sá, M. M. Rocha. Panorama epidemiológico da infeção por dermatófitos na área de influência do Hospital Distrital de Santarém - estudo retrospetivo de 13 anos. RPDI 2012, Vol. 8 Nº 1.
Feng X, Ling B, Yang X, Liao W, Pan W, Yao Z. Molecular Identification of Candida Species Isolated from Onychomycosis in Shanghai, China. Mycopathologia. 2015 Dec;180(5-6):365-71.
Cursi IB, Freitas LB, Neves Mde L, Silva IC. Onycomychosis due to Scytalidium spp.: a clinical and epidemiologic study at a University Hospital in Rio de Janeiro, Brazil. An Bras Dermatol. 2011 Jul-Aug;86(4):689-93.
Nenoff P, Krüger C, Ginter-Hanselmayer G, Tietz HJ. Mycology - an update. Part 1: Dermatomycoses: causative agents, epidemiology and pathogenesis. J Dtsch Dermatol Ges. 2014 Mar;12(3):188-209.
Martínez-Herrera EO, Arroyo-Camarena S, Tejada-García DL, Porras-López CF, Arenas R. Onychomycosis due to opportunistic molds. An Bras Dermatol. 2015 May-Jun;90(3):334-7.
All articles in this journal are Open Access under the Creative Commons Attribution-NonCommercial 4.0 International License (CC BY-NC 4.0).
