Affiliation:
1. Mycotic Diseases Branch, Centers for Disease Control and Prevention , Atlanta, Georgia, USA
Abstract
ABSTRACT
Dermatophyte infections (a.k.a. ringworm, tinea) affect an estimated 20%–25% of the world’s population. In North America, most dermatophytoses are caused by
Trichophyton rubrum
or
Trichophyton mentagrophytes
species complexes. Severe and antifungal-resistant dermatophytoses are a growing global public health problem. A new species of the
T. mentagrophytes
species complex,
Trichophyton indotineae
, has recently emerged and is notable for the severe infections it causes, its propensity for antifungal resistance, and its global spread. In this issue of the
Journal of Clinical Microbiology
, C. F. Cañete-Gibas, J. Mele, H. P. Patterson, et al. (J Clin Microbiol 61:e00562-23, 2023,
https://doi.org/10.1128/JCM.00562-23
) summarize the results of speciation and AFST performed on North American dermatophyte isolates received at a fungal diagnostic reference laboratory. Within their collection, 18.6% of isolates were resistant to terbinafine (a first-line oral antifungal for dermatophytoses), and similar proportions of
T. rubrum
and
T. indotineae
demonstrated terbinafine resistance. The authors also found that
T. indotineae
has been present in North America since at least 2017. These findings highlight the importance of increased surveillance efforts to monitor trends in severe and antifungal-resistant dermatophytoses and the need for antifungal stewardship efforts, the success of which is contingent upon improving laboratory capacity for dermatophyte speciation and AFST.
Publisher
American Society for Microbiology