The emergence and worldwide spread of the species Trichophyton indotineae causing difficult-to-treat dermatophytosis: A new challenge in the management of dermatophytosis

Article Microbiology

In Vitro Antifungal Combination of Terbinafine with Itraconazole against Isolates of Trichophyton Species

Anne-Laure Bidaud et al.

Summary: A combination of terbinafine with itraconazole was found to have synergistic effects against both terbinafine-susceptible and terbinafine-resistant isolates of Trichophyton spp. from India.

ANTIMICROBIAL AGENTS AND CHEMOTHERAPY (2022)

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Article Microbiology

Increasing Terbinafine Resistance in Danish Trichophyton Isolates 2019-2020

Karen Marie Thyssen Astvad et al.

Summary: Terbinafine resistance in Trichophyton species is increasing in Denmark, with a high prevalence of non-wildtype isolates and known/novel SQLE mutations. T. rubrum is the most common species, but T. mentagrophytes/interdigitale SC isolates also contribute to resistance. Population-based studies and susceptibility testing are important for understanding and addressing this emerging problem.

JOURNAL OF FUNGI (2022)

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Article Microbiology

Gene Amplification of CYP518: a New Mechanism of Resistance to Azole Compounds in Trichophyton indotineae

Tsuyoshi Yamada et al.

Summary: Trichophyton indotineae strains resistant to itraconazole and voriconazole were found to be associated with overexpression of TinCYP518 due to additional copies of this gene. RNA interference of TinCYP518 restored drug susceptibility in resistant strains, while overexpression of TinCYP518 conferred resistance in susceptible strains of T. indotineae.

ANTIMICROBIAL AGENTS AND CHEMOTHERAPY (2022)

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Article Immunology

Phylogeny, Antifungal Susceptibility, and Point Mutations of SQLE Gene in Major Pathogenic Dermatophytes Isolated From Clinical Dermatophytosis

Nasrin Pashootan et al.

Summary: This study aimed to evaluate the antifungal susceptibility of clinical dermatophytes and study mutations in terbinafine-resistant isolates. The results showed terbinafine to be the most effective antifungal drug and Trichophyton mentagrophytes to be the most resistant species.

FRONTIERS IN CELLULAR AND INFECTION MICROBIOLOGY (2022)

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Article Medicine, Research & Experimental

First detection of Trichophyton indotineae causing tinea corporis in Central Vietnam

Thi Minh Chau Ngo et al.

Summary: Trichophyton indotineae, a new species of dermatophytes, was reported to have high level of terbinafine resistance, becoming a significant concern in treating dermatophytosis. The first case of Trichophyton indotineae infection in Central Vietnam was successfully treated with oral itraconazole and ketoconazole topical cream, as the isolate showed susceptibility to itraconazole, voriconazole, and terbinafine.

MEDICAL MYCOLOGY CASE REPORTS (2022)

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Article Immunology

Extensive Dermatophytosis Caused by Terbinafine-Resistant Trichophyton indotineae, France

Arnaud Jabet et al.

Summary: Extensive dermatophytosis caused by terbinafine-resistant Trichophyton indotineae was diagnosed in France. Analysis of sequences suggests that this species is widely distributed in Asia and Europe, and animals may serve as reservoirs.

EMERGING INFECTIOUS DISEASES (2022)

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Article Immunology

Emergence of Difficult-to-Treat Tinea Corporis Caused by Trichophyton mentagrophytes Complex Isolates, Paris, France

Sarah Delliere et al.

Summary: This study describes 7 cases of extensive tinea corporis since 2018 in a hospital in Paris, France, that failed to cure with terbinafine. Molecular analysis indicated the presence of Trichophyton mentagrophytes internal transcribed spacer type VIII (T. indotineae), a squalene epoxidase gene mutant strain that is spreading on the Indian subcontinent.

EMERGING INFECTIOUS DISEASES (2022)

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Review Dermatology

Multidrug-resistantTrichophyton mentagrophytesgenotype VIII in an Iranian family with generalized dermatophytosis: report of four cases and review of literature

Azam Fattahi et al.

Summary: This study presented a series of familial cases of generalized dermatophytosis caused by multidrug-resistant T. mentagrophytes genotype VIII. Different family members showed varying responses to different antifungal drugs, highlighting the importance of personalized treatment in such cases. The transmission of this resistant strain to other countries is a serious issue that needs to be addressed.

INTERNATIONAL JOURNAL OF DERMATOLOGY (2021)

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Article Infectious Diseases

In vitro activity of the novel antifungal olorofim against dermatophytes and opportunistic moulds including Penicillium and Talaromyces species

Ashutosh Singh et al.

Summary: Olorofim demonstrates potent in vitro activity against drug-resistant dermatophytes and opportunistic moulds, with exceptions in Alternaria alternata. When compared to other systemic antifungal drugs, Olorofim exhibits lower activity against Penicillium and Talaromyces species. Particularly, Olorofim shows strong activity against Trichophyton isolates, including those resistant to terbinafine and azoles.

JOURNAL OF ANTIMICROBIAL CHEMOTHERAPY (2021)

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Article Dermatology

Epidemiological and clinical aspects of Trichophyton mentagrophytes/Trichophyton interdigitale infections in the Zurich area: a retrospective study using genotyping

M. Klinger et al.

Summary: This study in Switzerland identified multiple ITS genotypes of Trichophyton mentagrophytes and Trichophyton interdigitale, with distinct clinical presentations. Genotyping helps differentiate between the two species and identify sources of infection and potential terbinafine resistance.

JOURNAL OF THE EUROPEAN ACADEMY OF DERMATOLOGY AND VENEREOLOGY (2021)

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Article Microbiology

Antifungal Susceptibility and Mutations in the Squalene Epoxidase Gene in Dermatophytes of the Trichophyton mentagrophytes Species Complex

Xue Kong et al.

Summary: A decade-long outbreak of dermatophytosis due to a terbinafine-resistant novel species has spread to several countries, with investigations into the molecular background of the SQLE gene revealing high resistance levels in certain isolates. Antifungal susceptibility tests on isolates from different countries identified three species and highlighted the limited distribution of high terbinafine resistance.

ANTIMICROBIAL AGENTS AND CHEMOTHERAPY (2021)

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Review Dermatology

The unprecedented epidemic-like scenario of dermatophytosis in India: I. Epidemiology, risk factors and clinical features

Shyam B. Verma et al.

Summary: In recent years, dermatophytosis cases in India have seen a sharp increase, with diverse clinical presentations and increased severity. However, due to the lack of population-based surveys, it is currently not classified as an epidemic.

INDIAN JOURNAL OF DERMATOLOGY VENEREOLOGY & LEPROLOGY (2021)

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Article Dermatology

Emerging antifungal treatment failure of dermatophytosis in Europe: take care or it may become endemic

D. M. L. Saunte et al.

Summary: The study confirms the presence of clinical and mycological antifungal drug resistance in dermatophytes in Europe, with the majority of countries having observed this phenomenon.

JOURNAL OF THE EUROPEAN ACADEMY OF DERMATOLOGY AND VENEREOLOGY (2021)

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Article Dermatology

Evaluation of DermaGenius® resistance real-time polymerase chain reaction for rapid detection of terbinafine-resistant Trichophyton species

Ashutosh Singh et al.

Summary: Treatment-resistant dermatophytosis caused by Trichophyton mentagrophytes/interdigitale complex is a global public health threat, with a significant increase in resistance to terbinafine due to amino acid substitutions Phe397Leu and Leu393Phe in the SQLE protein. The newly developed DermaGenius (R) Resistance real-time PCR assay effectively identified Trichophyton species and distinguished between wild-type and SQLE mutant genotypes.

MYCOSES (2021)

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Article Microbiology

Checkerboard Analysis To Evaluate Synergistic Combinations of Existing Antifungal Drugs and Propylene Glycol Monocaprylate in Isolates from Recalcitrant Tinea Corporis and Cruris Patients Harboring Squalene Epoxidase Gene Mutation

Kabir Sardana et al.

Summary: This study aimed to test the synergistic combinations of oral and topical antifungals for treating recalcitrant tinea corporis/cruris. It was found that many isolates showed high MICs of terbinafine, but synergistic interactions were noted with combinations of itraconazole with luliconazole and other drugs.

ANTIMICROBIAL AGENTS AND CHEMOTHERAPY (2021)

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Article Dermatology

Predicting a therapeutic cut-off serum level of itraconazole in recalcitrant tinea corporis and cruris-A prospective trial

Ananta Khurana et al.

Summary: With increasing resistance to terbinafine, fluconazole, and griseofulvin, itraconazole is now commonly used as a first-line treatment for tinea corporis/cruris. However, therapeutic failures may occur with inadequate serum levels of itraconazole, while higher levels are associated with positive treatment outcomes. In India, itraconazole has shown low MICs against the prevalent strain, making therapeutic failures uncommon.

MYCOSES (2021)

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Article Microbiology

Molecular Epidemiology and Antifungal Susceptibility of Trichophyton Isolates in Greece: Emergence of Terbinafine-Resistant Trichophyton mentagrophytes Type VIII Locally and Globally

Maria Siopi et al.

Summary: The study investigated the molecular epidemiology and in vitro antifungal susceptibility patterns of Greek Trichophyton isolates over the last 10 years using the new EUCAST reference method. It was found that a high incidence of terbinafine non-WT T. mentagrophytes isolates without cross-resistance to other antifungals was discovered for the first time in Greece. This highlights the need for susceptibility testing of dermatophytes at a local scale, especially in cases of non-responding dermatophytoses.

JOURNAL OF FUNGI (2021)

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Article Mycology

Taxonomy of the Trichophyton mentagrophytes/T. interdigitale Species Complex Harboring the Highly Virulent, Multiresistant Genotype T. indotineae

Chao Tang et al.

Summary: In India, a severe outbreak of highly virulent and multi-resistant dermatophytosis by species in the Trichophyton mentagrophytes/T. interdigitale complex is ongoing, and the accurate identification of the etiologic agent is a debated issue. Molecular, morphological, and physiological characteristics were used in a taxonomic study to define species limits. The study found that while T. mentagrophytes s. str. and T. interdigitale s. str. are difficult to distinguish, they are different from the Indian genotype T. indotineae in the HMG gene sequence. These characteristics may be driving separate evolutionary trends.

MYCOPATHOLOGIA (2021)

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Article Infectious Diseases