Sains Malaysiana 42(3)(2013): 359–363

 

 

Mikrorganisma Penyebab Jangkitan Kulat Kuku dalam Kalangan Pesakit Kencing Manis

(Microorganisms Responsible for Onychomycosis Among Diabetic Patients)

 

M. Leelavathi*, M.N. Azimah & N.F. Kharuddin

Department of Family Medicine, Faculty of Medicine, Universiti Kebangsaan Malaysia

Jalan Yaacob Latif, Bandar Tun Razak, 56000 Cheras, Kuala Lumpur, Malaysia

 

M.N. Tzar

Department of Medical Microbiology and Immunology, Faculty of Medicine

Universiti Kebangsaan Malaysia, Jalan Yaacob Latif, Bandar Tun Razak

56000 Cheras, Kuala Lumpur, Malaysia

 

Received: 7 March 2012/Accepted: 4 October 2012

 

ABSTRAK

Pesakit kencing manis lebih mudah mendapat jangkitan disebabkan oleh sistem imun yang lemah. Antara jangkitan yang dialami adalah infeksi kulat kuku yang lebih dikenali sebagai onikomikosis. Satu kajian keratan rentas telah dijalankan di Pusat Perubatan Primer, Universiti Kebangsaan Malaysia untuk mengenalpasti prevalen onikomikosis dan patogen penyebab utama onikomikosis dalam kalangan pesakit kencing manis. Kajian ini dijalankan sepanjang bulan Oktober 2010 hingga bulan Mei 2011. Keratan kuku diambil dari kuku kaki yang tidak normal. Sekiranya kuku adalah normal, sampel diambil daripada ibu jari kaki kanan. Sampel kuku diketip selepas dibersihkan dengan 70% alkohol, dimasukkan ke dalam sampul kertas dan diproses dalam masa dua jam. Sebahagian sampel diproses dengan larutan kalium hidroksida (20%) (KOH) dan sebahagian lagi dikultur pada plat media agar Sabouraud dekstros. Seramai 78 (51.7%) pesakit perempuan dan 73 (48.3%) pesakit lelaki telah menyertai kajian ini. Purata umur pesakit adalah 60.7 ± 9.1 tahun. Kebanyakan pesakit terdiri daripada etnik Melayu (60.3%, n=91), diikuti oleh Cina (24.5%, n=37), India (13.9%, n=21) dan lain-lain (1.3% n=2). Prevalen jangkitan kulat kuku dalam kalangan subjek adalah 81.5%. Kebanyakan spesies kulat yang dikesan adalah kulapuk selain dermatofit (39.7%, n=60), terutamanya Aspergillus (12.6%, n=19) diikuti dengan yis (20.5%, n=31) dan dermatofit (0.7%, n=1). Keputusan kajian ini berbeza daripada kajian-kajian negara barat kerana spesies dermatofit dan yis lebih kerap ditemui. Kesimpulannya, prevalen jangkitan kulat kuku dalam kalangan pesakit kencing manis dalam kajian ini adalah tinggi. Jangkitan ini perlu dikesan dengan lebih awal dan seterusnya dirawat untuk mengelak daripada komplikasi diabetes pada kaki berlaku. Organisma penyebab utama onikomikosis dalam kalangan pesakit kencing manis dalam kajian ini adalah kulat selain dermatofit dan ini adalah sama dalam kalangan pesakit diabetes dan populasi umum.

 

Kata kunci: Kencing manis; kulapuk selain dermatofit; kulat; onikomikosis

 

ABSTRACT

Diabetic patients are susceptible to infections due to compromised immune system. Among common infections include fungal infection of the nail, also known as onychomycosis. A cross sectional study was done to determine the prevalence and the common fungal element responsible of onychomycosis among patients with types 1 and 2 diabetes at the Pusat Perubatan Primer, Universiti Kebangsaan Malaysia. This study was conducted from October 2010 to May 2011. Nail clippings were taken from discolored or structurally abnormal toenail and from the right first toe nail if the nail appeared normal. The nail was first cleaned using 70% alcohol then clipped into small pieces using nail clipper. Nail sample was processed within 2 h of collection for microscopic examination using potassium hydroxide (KOH) and cultured on sabouraud dextrose agar. A total of 78 (51.7%) female and 73 (48.3%) male patients participated in this study. Most (60.3%, n=91) of them belong to Malay ethnic group followed by Chinese (24.5%, n=37), Indian (13.9%, n=21) and other (1.3%, n=2) ethnicities. The prevalence of onychomycosis among subjects was 81.5%. The most commonly isolated fungi from diabetic patient’s toenails were non-dermatophyte moulds (39.7%, n=60,) especially Aspergillus (12.6%, n=19) followed by yeast (20.5%, n=31) and dermatophytes (0.7%, n=1). In contrast, Western studies demonstrate dermatophytes and yeasts as organisms commonly responsible for onychomycosis among diabetics. In conclusion, the prevalence of onychomycosis among diabetics in this study is high hence they are at high risk of developing diabetic foot complications and amputations. The common causative microorganism for onychomycosis among diabetics in this study is non-dermatophyte mould.

 

Keywords: Diabetes; fungus; non-dermatophyte mould; onychomycosis

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*Corresponding author; email: drleelaraj@gmail.com

 

 

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