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Published on: February 23, 2018
Comparison of DermaGenius and In-House qPCR Methods for Detection of Recalcitrant Dermatophyte Infections: A
Murat Durdu1, Engin Kaplan2, Oğuzhan Bingöl3
1Department of Dermatology, Dr. Turgut Noyan Application and Research Center, Başkent University, Adana, Türkiye.
Mycoses
|June 17, 2026
Summary
Rapid molecular diagnostics effectively detect Trichophyton indotineae and terbinafine resistance in recalcitrant dermatophytosis. Early identification aids in avoiding ineffective treatments and guiding rational antifungal therapy decisions.
Area of Science:
- Medical Mycology
- Molecular Diagnostics
- Dermatology
Background:
- Chronic and recalcitrant dermatophytosis is a growing concern due to increasing antifungal resistance, particularly to terbinafine and azoles.
- Trichophyton indotineae is a key pathogen causing treatment failure, extensive infections, and relapses in dermatophytosis.
- Emerging resistance necessitates improved diagnostic tools for timely and accurate identification of causative agents and resistance mechanisms.
Purpose of the Study:
- To evaluate and compare two rapid molecular diagnostic approaches for detecting recalcitrant dermatophyte infections.
- To assess the practical value of a commercial multiplex qPCR assay (DermaGenius RMP) and a T. indotineae-specific in-house qPCR assay.
- To focus on early detection of terbinafine resistance associated with T. indotineae in routine dermatology practice.
Main Methods:
- Analysis of 64 dermatophyte isolates from patients with chronic or treatment-resistant dermatophytosis.
- Species identification and detection of squalene epoxidase (SQLE) gene mutations using DermaGenius RMP and an in-house T. indotineae-specific qPCR assay.
- Confirmatory ITS/SQLE sequencing and CLSI microbroth dilution antifungal susceptibility testing were performed.
Main Results:
- High concordance (93.8%) between the two qPCR methods for T. indotineae identification.
- Most recalcitrant cases were caused by T. indotineae, with SQLE mutations detected in over 90% of isolates, correlating with clinical resistance.
- DermaGenius RMP provided rapid, standardized detection of resistance mutations; the in-house assay offered specific T. indotineae identification. Notably, some terbinafine-susceptible isolates harbored the SQLE F397L substitution.
Conclusions:
- Rapid molecular diagnostics, especially qPCR assays, offer crucial early information for managing dermatophytosis.
- Both evaluated qPCR assays demonstrated comparable performance for T. indotineae detection.
- Prompt identification of T. indotineae and resistance mutations can prevent ineffective therapies, reduce chronicity, and inform rational treatment strategies.
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