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Antifungal Resistance in Dermatophytes: Genetic Considerations, Clinical Presentations and Alternative Therapies

Rosalie Sacheli1, Marie-Pierre Hayette1

  • 1Belgian National Reference Center, Department of Clinical Microbiology, University Hospital of Liege, 4000 Liège, Belgium.

Journal of Fungi (Basel, Switzerland)
|November 27, 2021
PubMed

Insights

Emerging antifungal resistance in dermatophytes, particularly terbinafine and azole resistance in strains like T. rubrum, necessitates exploring alternative treatments for challenging infections.

Area of Science:

  • Medical Mycology
  • Antimicrobial Resistance
  • Dermatology

Background:

  • Dermatophyte infections are common globally.
  • Increasing reports highlight the emergence of antifungal resistance in key dermatophyte species.
  • This resistance poses significant challenges to effective treatment.

Purpose of the Study:

  • To review the current global status of antifungal resistance in dermatophytes.
  • To discuss resistance mechanisms, focusing on terbinafine and azoles.
  • To present clinical manifestations and alternative therapies for resistant dermatophyte infections.

Main Methods:

  • Comprehensive literature review of studies on dermatophyte antifungal resistance.
  • Analysis of reported resistance mechanisms, including genetic mutations (e.g., squalene epoxidase gene).
  • Compilation of clinical case presentations and treatment outcomes.

Main Results:

  • Significant resistance to terbinafine and azoles is documented in dermatophytes worldwide.
  • Specific mutations in the squalene epoxidase gene are associated with terbinafine resistance.
  • Clinical data show difficulties in managing infections caused by resistant strains.

Conclusions:

  • Antifungal resistance in dermatophytes is a growing global health concern.
  • Understanding resistance mechanisms is crucial for developing new therapeutic strategies.
  • Alternative treatment options are essential for managing resistant dermatophyte infections effectively.
Keywords:
azolesdermatophytesresistanceterbinafine

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