Evaluation of susceptibility range & altered SQLE in co-relation to higher MIC of dermatophytes isolated from increasing altitudes of Uttarakhand

: Dermatophytes hyphal fragments accidently deposited on stratum corneum sometimes, in contact with other infected person; cause communicable skin infections particularly, in higher altitudes; due to availability of ample of moisture. Diagnosis specified, primarily by clinical appearance, followed by mass culture of dermatophytes in lab, their identification under microscope & molecular identification by ITS regions. Spatial locations of Uttarakhand, Commendable to most mycosis species. Unanticipated number of mycosis patients during monsoon & recalcitrant nature of dermatophytes in consecutive years after 1 infection, grab attention. Study designed to calculate susceptibility range & intensity of modification in pathogen at various altitudes. Throughout Monsoon (from July to Nov 2023-24) skin samples from public hospitals of Uttarakhand at Skin-OPDs were collected, mass lab production & subsequently identification; to perceive their appearance time & relationship with increasing height. Standard Disc diffusion & broth dilution tests were carried out to calculate MIC range of frequently used antifungal drugs at public hospitals & modified current available pathogen. MIC of Trichophyton, Epidermophyton& Microsporum (5-25µg/ml) for terbinafine, for Itraconazole (0.09-1.5µl/ml) & for Fluconazole (0.03-0.5µl/ml) found much more higher than previously reported.Arthroderma, Blastomycosis & Nanninzzia sp was also isolated from Haldwani region. Species identification confirmed by ITS1 & ITS4 regions of rDNA & squalene epoxidase was also sequenced up to 600bp in a doubt of modification in pathogenic gene of T.mentagrophytes & T.rubrum. F397L, A448T in mentagrophytes & L393F in rubrum found altered by comparatively to control agent. Initially it looks critical to observe direct output from increased suseptibility range of pathogen but associated in evaluating efficacy of drug,which is contributing in calculating C/MIC, plasma drug diffusion & retention time ratiosfinallytheir susceptibility range (MIC)for pathogen.This pharmacokinetics guide to choose,combination of drugs & dose schedules