Alarming India‐wide phenomenon of antifungal resistance in dermatophytes: A multicentre studyстатья из журнала
Аннотация: Abstract Background An alarming increase in recalcitrant dermatophytosis has been witnessed in India over the past decade. Drug resistance may play a major role in this scenario. Objectives The aim of the present study was to determine the prevalence of in vitro resistance to terbinafine, itraconazole and voriconazole in dermatophytes, and to identify underlying mutations in the fungal squalene epoxidase ( SQLE ) gene. Patients/Methods We analysed skin samples from 402 patients originating from eight locations in India. Fungi were identified by microbiological and molecular methods, tested for antifungal susceptibility (terbinafine, itraconazole, voriconazole), and investigated for missense mutations in SQLE . Results Trichophyton (T.) mentagrophytes internal transcribed spacer (ITS) Type VIII was found in 314 (78%) samples. Eighteen (5%) samples harboured species identified up to the T interdigitale/mentagrophytes complex, and T rubrum was detected in 19 (5%) samples. 71% of isolates were resistant to terbinafine. The amino acid substitution Phe397Leu in the squalene epoxidase of resistant T mentagrophytes was highly prevalent (91%). Two novel substitutions in resistant Trichophyton strains, Ser395Pro and Ser443Pro, were discovered. The substitution Ala448Thr was found in terbinafine‐sensitive and terbinafine‐resistant isolates but was associated with increased MICs of itraconazole and voriconazole. Conclusions The high frequencies of terbinafine resistance in dermatophytes are worrisome and demand monitoring and further research. Squalene epoxidase substitutions between Leu393 and Ser443 could serve as markers of resistance in the future.
Год издания: 2020
Авторы: Andreas Ebert, Michel Monod, Karine Salamin, Anke Burmester, Silke Uhrlaß, Cornelia Wiegand, Uta‐Christina Hipler, Constanze Krüger, Daniela Koch, Franziska Wittig, Shyam B. Verma, Archana Singal, Sanjeev Gupta, Resham Vasani, Abir Saraswat, R Madhu, Saumya Panda, Anupam Das, Mahendra M. Kura, Akshy Kumar, Shital Poojary, Sibylle Schirm, Yvonne Gräser, Uwe Paasch, Pietro Nenoff
Издательство: Wiley
Источник: Mycoses
Ключевые слова: Nail Diseases and Treatments, Autoimmune Bullous Skin Diseases, Fungal Infections and Studies
Открытый доступ: hybrid
Том: 63
Выпуск: 7
Страницы: 717–728