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Dermatophyte Infections Worldwide: Increase in Incidence and Associated Antifungal Resistance
Caroline Kruithoff1, Ahmed Gamal2, Thomas S McCormick2
1Heritage College of Osteopathic Medicine, Ohio University, Cleveland, OH 44122, USA.
Abstract:
The increase in incidence of superficial fungal infections combined with the emergence of antifungal resistance represents both a global health challenge and a considerable economic burden. Recently, dermatophytes, the main culprit causing superficial fungal infections, have started to exhibit antifungal resistance. This can be observed in some of the most common species such as Trichophyton rubrum and Trichophyton mentagrophytes. Importantly, the new subspecies, known as Trichophyton indotineae, has been reported to show high resistance to terbinafine, a first-line treatment for dermatophyte infections. Compounding these issues is the realization that diagnosing the causative infectious agents requires using molecular analysis that goes beyond the conventional macroscopic and microscopic methods. These findings emphasize the importance of conducting antifungal susceptibility testing to select the appropriate antifungal necessary for successful treatment. Implementing these changes may improve clinical practices that combat resistant dermatophyte infections.
Insights
Superficial fungal infections are rising, with emerging antifungal resistance in species like Trichophyton indotineae posing a significant health challenge. Antifungal susceptibility testing is crucial for effective treatment of these resistant infections.
Area of Science:
- Medical Mycology
- Infectious Diseases
- Antimicrobial Resistance
Background:
- Superficial fungal infections are increasing globally.
- Antifungal resistance in dermatophytes, such as Trichophyton rubrum and Trichophyton mentagrophytes, is a growing concern.
- Emergence of Trichophyton indotineae with high terbinafine resistance complicates treatment.
Purpose of the Study:
- To highlight the challenge of antifungal resistance in superficial fungal infections.
- To emphasize the need for advanced diagnostic methods beyond conventional techniques.
- To advocate for antifungal susceptibility testing in clinical practice.
Main Methods:
- Review of current literature on dermatophyte infections and antifungal resistance.
- Analysis of emerging species and their resistance profiles.
- Discussion of diagnostic methodologies and treatment strategies.
Main Results:
- Dermatophytes, including Trichophyton rubrum and Trichophyton mentagrophytes, show increasing antifungal resistance.
- Trichophyton indotineae exhibits significant resistance to terbinafine, a primary antifungal treatment.
- Molecular diagnostics are necessary for accurate identification of causative agents.
Conclusions:
- Antifungal resistance in superficial mycoses presents a global health and economic burden.
- Accurate diagnosis using molecular methods is essential.
- Antifungal susceptibility testing is critical for guiding effective treatment of resistant dermatophyte infections.
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