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Trichophyton indotineae-An Emerging Pathogen Causing Recalcitrant Dermatophytoses in India and Worldwide-A
Silke Uhrlaß1, Shyam B Verma2, Yvonne Gräser3
1Laboratory for Medical Microbiology, 04571 Rötha OT Mölbis, Germany.
Journal of Fungi (Basel, Switzerland)
|July 27, 2022
Summary
A new fungal species, Trichophyton indotineae, is causing widespread skin infections globally. It is resistant to terbinafine, making itraconazole the recommended treatment for this emerging dermatophytosis.
Area of Science:
- Medical Mycology
- Infectious Diseases
- Dermatology
Background:
- Trichophyton indotineae, a novel dermatophyte species, has emerged in near-epidemic proportions on the Indian subcontinent and is spreading globally.
- This species is genetically identical to genotype VIII within the Trichophyton mentagrophytes/Trichophyton interdigitale complex, identified via Internal Transcribed Spacer (ITS) sequencing.
- T. indotineae causes inflammatory, itchy dermatophytosis affecting various body parts and impacts all demographics, displacing prevalent dermatophytes in its region.
Purpose of the Study:
- To characterize the newly identified dermatophyte species, Trichophyton indotineae.
- To investigate the antifungal resistance patterns and clinical implications of T. indotineae infections.
- To identify effective treatment strategies for T. indotineae-related dermatophytoses.
Main Methods:
- Genetic identification through Internal Transcribed Spacer (ITS) sequencing of ribosomal DNA.
- Clinical observation and diagnosis of dermatophytosis caused by T. indotineae.
- In vitro and in vivo assessment of antifungal drug efficacy, particularly against terbinafine.
Main Results:
- Trichophyton indotineae is identified as a distinct species, genetically corresponding to T. mentagrophytes/T. interdigitale genotype VIII.
- The fungus causes widespread, inflammatory dermatophytosis and has become dominant in the Indian subcontinent.
- T. indotineae exhibits significant in vitro and in vivo resistance to terbinafine due to squalene epoxidase gene mutations.
Conclusions:
- Trichophyton indotineae represents a significant emerging threat in fungal infections.
- Terbinafine resistance is a key challenge in treating T. indotineae infections.
- Itraconazole is currently the most effective treatment option for terbinafine-resistant dermatophytoses caused by T. indotineae.
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