Dermatophyte Isolates Research Articles

Predominance of Trichophyton soudanense as Agent of Dermatophytoses in Cape Verdean School-Age Children.

Dermatophytoses are infectious skin diseases of public health importance because of their transmissibility and high prevalence, especially among children. This is the first study aiming to estimate and report the burden of dermatophytoses on school-age children on the island of Santiago in Cape Verde, an African country that is an archipelago. A total of 249 students attending the afternoon shift of three elementary schools in the city of Achada Igreja were examined. Of these, 60 had suspected lesions of dermatophyte infection. However, from the samples collected from these 60 students, including hair, nails, and skin scrapings, only 18 dermatophyte isolates were obtained, corresponding to a point prevalence of 7.2%. Morphological species identification demonstrated three different species: Trichophyton soudanense, Trichophyton rubrum, and Trichophyton violaceum; re-identification by sequencing the internal transcribed spacer (ITS) 1 and 2 regions of ribosomal DNA, and the 5.8S rDNA encoding gene (ITS-5.8S region), revealed T. soudanense as the most prevalent species, with only one case of T. rubrum. This is the first epidemiological data describing dermatophytoses and dermatophytes in Cape Verde among school-age children on one of the archipelago islands. It reinforces the need of using culture and accurate identification methodologies when gathering epidemiological data on dermatophytoses.

Isolation and Diagnosis of Dermatophytes of the Hand Tinea and Sensitivity Study to the Antifungals Griseofulvin

The study was conducted during the month of October 2022 until April 2023, with the aim of isolating and diagnosing the fungi that cause skin diseases from patients visiting the dermatology consultation affiliated with Salah al-Din General Hospital who were diagnosed as infected by dermatologists for the period from 1/6/2022 to 1/ 12/2023 For both sexes, aged between 10 and 60 years, by taking skin samples from the area of infection after wiping them with cotton saturated with 70% alcohol for the purpose of sterilization to get rid of any contaminants. Which was diagnosed clinically by a dermatologist in the dermatology consultation at Salah al-Din General Hospital and outpatient clinics. To evaluate the effectiveness of anti-griseofulvin in inhibiting the isolated fungi, the percentage of dermatophyte infections recorded by positive direct microscopic examination was only (88) patients, representing (88%) of the total number of patients. While the number of negative cases by negative direct microscopic examination was (59), or (59%). As for positive laboratory culture results, there were (79) patients, in the rate of (79%). While the number of negative cases by laboratory culture was (21), in the rate of (21%). The fungal genera that cause skin infections, such as Trychophyton and Microsporum, were isolated, with the genus Trichophyton being the most frequent, with 76 isolates belonging to several species, such as T. mentagrophytes, with a number of 29 isolates, then the fungus T. rubrum, with a number of isolates of 22, then the fungus T. terreste, with a number of isolates of 15, and then fungus T. schoenleinii, with a number of 10 isolates, while only three isolates of the M. canis type were recorded in the genus Microsporum. The results of the susceptibility test of the isolated fungi to Griseofulvin showed that the fungus T. mentagrophytes is more sensitive to the antichrysofulvin, as the average diameter of inhibition reached 32 mm compared to the control, followed by T. rubrum, which had an average diameter of inhibition of 16 mm compared to the control.

In vitro antifungal activity of eucalyptol and its interaction with antifungal drugs against clinical dermatophyte isolates including Trichophyton indotineae

BackgroundDermatophytosis, a prevalent fungal infection, often exhibits treatment failure. It poses ongoing public health concerns, urging exploration of alternative treatment strategies. This study examines eucalyptol’s in vitro activity and its interaction with antifungal agents against dermatophyte isolates.MethodsOverall, 489 patients clinically suspected of dermatophytosis were investigated, and the causative agents were molecularly identified. The antifungal activity of eucalyptol, itraconazole, terbinafine, and griseofulvin was assessed according to the guideline of the Clinical and Laboratory Standards Institute (CLSI M38 ed3). The interaction between eucalyptol and the aforementioned antifungals was determined using a checkerboard method.ResultsDermatophytosis was confirmed in 30 out of 489 (6.13%) patients, with a female-to-male ratio of 3:2 and an age range of 8–67 years. The most commonly observed clinical manifestation was tinea corporis (34.21%), and Trichophyton indotineae (n = 14, 46%) was the most common causative agent. Antifungal susceptibility testing revealed that eucalyptol exhibited antidermatophyte properties with minimum inhibitory concentrations (MIC) ranging from 0.78 to 25 mg/mL. Itraconazole demonstrated the lowest geometric mean (GM) value (MIC range: 0.0019–0.25 µg/mL, GM: 0.015 µg/mL), while griseofulvin exhibited the highest GM value (MIC range: 0.125–8 µg/mL, GM: 2.37 µg/mL). The in vitro interaction of eucalyptol with antifungal drugs, except for its combination with terbinafine against two Trichophyton tonsurans isolates resulting in synergistic effects, showed indifference (n = 70, 77.77%) and antagonistic types (n = 18, 20%).ConclusionAmong the evaluated antifungals, itraconazole demonstrated the highest effectiveness against clinical isolates, while eucalyptol alone exhibited a more pronounced effect than when combined with antifungal agents.

Epidemiological studies and antifungal sensitivity pattern of clinical isolates of dermatophytes from localized cases of canine dermatophytosis

Epidemiological studies and antifungal sensitivity pattern of clinical isolates of dermatophytes from localized cases of canine dermatophytosis

Asymptomatic colonization of stray dogs and domestic cats with Trichophyton mentagrophytes II in Northern Iran

BackgroundDespite changes in the epidemiology of dermatophyte infections, the incidence of fungal infections associated with Trichophyton species still remains high among dogs and cats. The objective of the present study was to isolate and characterize dermatophytes from dogs and cats in Iran. Method:From December 2022 to May 2023, skin and hair samples were collected from symptomatic and asymptomatic cats and dogs in Mazandaran, a northern province of Iran. The samples were then inoculated into Mycosel™ Agar. Dermatophyte isolates were identified by sequencing the internal transcribed spacer region. Antifungal susceptibility tests were conducted using the Clinical and Laboratory Standards Institute (CLSI-M38-A3). ResultOf the 250 samples collected (from 200 dogs and 50 cats), 20 (from 19 dogs and one cat) (8.0 %) were positive for dermatophyte growth. Based on sequence and phylogenetic analysis, all isolates belonged to T. mentagrophytes II*. Of these positive samples, 14 (70.0 %), 3 (15.0 %), 2 (10.0 %), and 1 (2.0 %) were isolated from asymptomatic stray dogs, symptomatic stray dogs, symptomatic domestic dogs, and symptomatic cats, respectively. Luliconazole and terbinafine displayed potent activity against all T. mentagrophytes isolates, with Minimum inhibitory concentration (MIC) values of 0.016 µg/ml. Miconazole and griseofulvin demonstrated higher MIC (1 and 8 µg/ml). ConclusionThe present study indicated that T. mentagrophytes II* asymptomatic carriage is frequent in stray dogs in Iran. The potential risk to public health needs to be evaluated However, T. mentagrophytes genotype VIII, considered as an endemic and emerging human pathogenic clone in several countries, was not detected during the present survey.

High Prevalence of Terbinafine Resistance Among Trichophyton mentagrophytes/T. interdigitale Species Complex, a Cross-Sectional Study from 2021 to 2022 in Northern Parts of Iran.

Treatment-resistant dermatophytosis caused by the members of the Trichophyton mentagrophytes/Trichophyton interdigitale species group (TMTISG) is increasing worldwide. We aimed to determine the prevalence of TMTISG in patients with dermatophytosis in two centers from north of Iran and detect the possible mutations in the squalene epoxidase (SQLE) gene in relevant terbinafine (TRB) resistant pathogenic isolates. From November 2021 to December 2022, 1960 patients suspected to dermatophytosis and referred to two mycology referral laboratories in the north of Iran were included in the study. Identification of all dermatophyte isolates was confirmed by RFLP of rDNA internal transcribed spacer (ITS) regions. Antifungal susceptibility testing against five common antifungals using the CLSI-M38-A3 protocol was performed. The TMTISG isolates resistant to TRB, were further analyzed to determine the possible mutations in the SQLE gene. Totally, 647 cases (33%) were positive for dermatophytosis of which 280 cases (43.3%) were identified as members of TMTISG. These were more frequently isolated from tinea corporis 131 (44.56%) and tinea cruris 116 (39.46%). Of 280 TMTISG isolates, 40 (14.3%) were resistant to TRB (MIC ≥ 4µg/mL), all found to be T. indotineae in ITS sequencing. In SQLE sequencing 34 (85%) of TRB-resistant isolates had coincident mutations of Phe397Leu and Ala448Thr whereas four and two isolates had single mutations of Phe397Leu and Leu393Ser, respectively. Overall, the resistance of Iranian TMTISG isolates to TRB greatly occurred by a mutation of Phe397Leu in the SQLE gene as alone or in combination with Ala448Thr. Nevertheless, for the occurrence of in vitro resistance, only the presence of Phe397Leu mutation seems to be decisive.

Role of Sertaconazole in the Treatment of Dermatophytosis

Dermatophytosis is a major health burden worldwide and is now increasing day by day. Dermatophytosis is also becoming increasingly unresponsive to topical conventional antifungals now a day. Newer topical antifungals may be more effective in these patients. Sertaconazole is a new, broad spectrum, fungicidal and fungistatic imidazole with added antipruritic and anti-inflammatory activity that may be effective and beneficial in improving the quality of life for the patient with dermatophytoses. It is indicated in the European Union(EU) for the treatment of superficial skin mycoses such as dermatophytosis (including tinea corporis, tinea cruris, tinea manus, tinea barbae and tinea pedis), cutaneous candidiasis, pityriasis versicolor and seborrhoeic dermatitis of the scalp, and in the US for tinea pedis only. Sertaconazole has broad-spectrum antifungal activity against dermatophytes of the Trichophyton, Epidermophyton and Microsporum genera, and yeasts of the genera Candida and Cryptococcus; additionally, it is effective against opportunistic filamentous fungi and Gram-positive bacteria. Moreover, the antifungal activity of sertaconazole is maintained in clinical isolates of dermatophytes that show reduced susceptibility to other azoles. While the drug has good dermal penetration, this is not associated with systemic absorption. In clinical trials in patients with superficial mycoses, 2% sertaconazole cream applied twice daily was effective in the eradication of a range of dermatophytoses, and a significantly greater proportion of patients were cured compared with those receiving 2% miconazole cream twice-daily treatment. Both as a topical cream and suppository preparation, sertaconazole was generally well tolerated. Sertaconazole is a well-established antifungal agent, which is now available in a variety of formulations, and remains a useful treatment option particularly in patients with fungal infections resistant to other azoles. Medicine Today 2023 Vol.36 (1): 62-66

Clinicomycological Study of Dermatophyte Infections in Patients Attending Dermatology Outpatient Department in a Tertiary Care Hospital

Context: Dermatophytosis is a fungal disease characterized by the infection of skin, hair, and nails. There is an upsurge of complicated superficial dermatophytosis and an increase in the incidence of chronic, relapsing, recurrent cases in India that are also often unresponsive to conventional doses of drugs. Aims: The aim of this study was to study the prevalence of dermatophyte species in the particular study area and it is susceptibility to itraconazole, terbinafine, and fluconazole. Settings and Design: All dermatophytes isolates obtained were subjected to 10% KOH mount, fungal culture, and antifungal sensitivity testing for fluconazole, itraconazole, and terbinafine. Materials and Methods: Newly diagnosed cases of dermatophytosis without treatment for the past 3 months were included in the study. KOH preparation was observed and subjected to fungal culture. Then, the susceptibility of the dermatophytes to oral antifungals (itraconazole, terbinafine, and fluconazole) was done. Results: Out of 28 patients with tinea, 14 males and 12 females were tested KOH positive. Out of them, 23 patients showed positive for dermatophyte growth. In them, 15 isolates were Trichophyton mentagrophytes and 8 isolates were Trichophyton rubrum. Antifungal drug susceptibility testing data indicated that, for the two species, MIC of itraconazole ranged between 0.03 and 16 μg/ml, terbinafine between 0.03 and 16 μg/ml, and fluconazole between 0.25 and 64 μg/ml. Conclusions: The study provided information regarding the prevalent species of dermatophyte in our study area and it is high sensitivity to itraconazole compared to terbinafine and the lowest for fluconazole. This gives us guidance as to which antifungal to use empirically in our clinical practice to treat tinea infection.

Isolation and identification of dermatophytes from dogs and cats in Chennai by conventional and UniPlex PCR assay

Isolation and identification of dermatophytes from dogs and cats in Chennai by conventional and UniPlex PCR assay

ЧУВСТВИТЕЛЬНОСТЬ ВОЗБУДИТЕЛЕЙ ДЕРМАТОФИТИЙ К ПРОТИВОГРИБКОВЫМ СРЕДСТВАМ, АНТИСЕПТИКАМ И ДЕЗИНФЕКТАНТАМ

Dermatophytes form the group of fungal pathogens of humans, which includes 43 species, of which the most important representatives are the genera Trichophyton and Microsporum. In recent years, patients with the established diagnoses of “mycosis pedis“, "skin mycosis of the palms“ and "onychomycosis”, and associations of dermatophytes and moulds as well as dermatophytes as an aetiological factor in mixed infections and yeast-like fungi often play a role. The main objective of the current study was to determine the susceptibility of dermatophytosis pathogens (Trichophyton spp., Microsporum spp.) isolated from samples of biological from patients with mycoses to modern antifungals, antiseptics and disinfectants. Within the framework of this study, 142 clinical isolates of dermatophytes identified as Trichophyton spp. (n=68) and Microsporum spp. (n=74) were obtained from patients with diagnoses of "B35.3 Mycosis of the feet", "B35.0 Microsporia". It was found that the most active antifungal agents against clinical isolates of dermatophytes are itraconazole, terbinafine and amphotericin B. Among the studied clinical isolates of Trichophyton spp. in Microsporum spp. conditionally resistant strains to the studied antimycotics have been identified. Most of the studied clinical isolates of dermatophytes were high sensitive to antiseptics based on iodine, fucorcinol, undecylenic and boric acids. Disinfectants based on aldehydes, guanidine derivatives, triamines, and glycolic acid showed the greatest activity against clinical isolates of dermatophytes. Based on our data, preference should be given to amphotericin B, itraconazole and terbinafine-based drugs when prescribing ethiotropic therapy for patients with dermatomycosis. It is advisable to use antipseptics and disinfectants for dermatomycosis, taking into account the sensitivity of micromycetes to them.

Epidermophyton floccosum kao uzročnik Tinea pedis - prikaz slučaja

Tinea pedis or athlete's foot is a surface fungal epidermal infection caused by dermatophytic fungi of the species Trichophyton (T.) rubrum, T. mentagrophytes var. interdigitale, Epidermophyton floccosum or T. tonsurans. It occurs most often in adult men, rarely in women and children. It is estimated that at least 70% of all people have a fungal foot infection at least once in their lifetime. Case report: a 43-year-old male with a clinical picture of Tinea pedis was referred to the Institute of Public Health of Serbia "Dr Milan Jovanović Batut" for laboratory diagnostics of the fungal infection of the right foot. In terms of patient history, he reported having dry, flaky changes to the skin of his right foot for two years, as well as erosion in the III and IV interdigital spaces of the foot. Due to itching, burning, and flaking of the skin on his feet, he reported to the attending physician who put him on betamethasone/gentamicin cream. The itching decreased, but the changes did not recede. Right foot toenails were not showing visible signs of infection. Direct microscopic examination of the right foot scrapings found micellar fibres and arthrospores, while culturing on dermatophyte-appropriate media allowed for the isolation of Epidermophyton floccosum. The isolate was identified based on microscopic morphology of the cultured organism, macroscopic appearance of the culture on dermatophyte isolation media, as well as using MALDI-TOF mass spectrometric diagnostics. Mycological confirmation of foot infection with the Epidermophyton floccosum fungus, with adequate treatment, reduces the risk of developing an onychomycosis, which is harder to treat.

Comprative Study of two Different Microscopic Techniqes and Fungal Culture for Isolation of Dermatophytes

Introduction: Fungal infections are very common in man. They are assuming greater significance both in developed & developing countries due to advent of immunosuppressive drugs & disease hot & humid climate in tropical & subtropical countries like India makes dermatophytosis or ringworm a very common superficial fungal skin infection. Dermatophytosis is caused by dermatophytes, a group of keratinophilic fungi that require long incubation period to grow. The clinical presentation, though very typical of ringworm infection, is very often confused with other skin disorder particularly due to rampant application of broad – spectrum steroid containing skin ointments and cream leading to further misdiagnosis and mismanagement. Materials and Methods: Cross sectional lab based investigational study was conducted and skin, hair, nail sample from 110 clinically suspected cases of dermatophytosis were taken from OPD of district hospital of central India and were screened by direct microscopicexamination using 10% potassium hydroxide (KOH) with and without 40% dimethyl sulphoxide (DMSO) mount. 10% potassium hydroxide (KOH) with 40% Dimethyl sulphoxide mount (DMSO) mixed in equal proportion. Results: Direct microscopy using KOH mount is simple, rapid and easy method to visualize fungal elements. Many modification have been evolved to increase the specificity & sensitivity of KOH microscopy results like use of 5% glycerol, addition of 36% DMSO, and addition of parker’s blue(4) in this study we compered the results of conventional KOH mount and a modified technique (40%KOH with DMSO)(5). When doing direct microscopic. Conclusion: The modified KOH with DMSO mount had allowed fastest and better visualization of fungal elements at 10 minutes instead of routine 30 minutes.

Trichophyton indotineae and other terbinafine-resistant dermatophytes in North America.

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.

Analysis of ERG 11 expression in clinical isolates of dermatophytes in patients with resistant Tinea infection.

Background: Dermatophytes are keratinophilic groups of microorganisms which invade keratinized tissue.
 Objective:1 - Isolate and identify the dermatophyte species from samples collected from patients suffering from onychomycosis, tinea corporis and tinea cruris; and perform in vitro microbroth antifungal susceptibility testing.
 Objective:2 - Further, the expression of Ergosterol 11 (ERG 11) amongst the isolates from responders and non-responders to antifungal treatment was studied by Real-time PCR.
 Methods & Results: A total of 120 dermatophytosis cases attending a dermatological clinic in a tertiary care hospital were included in the study. Microscopy of KOH mount was positive in 90 isolates while 60 were culture positive. The most common dermatophytes implicated were Trichophyton mentagrophytes (75%) followed by Trichophyton rubrum (25%) which were molecularly confirmed by PCR using the species-specific primer. Higher MIC was detected for fluconazole (10 %), itraconazole (3.33 %), terbinafine (10 %) and griseofulvin (5 %), for T. mentagrophytes and T rubrum, while all strains showed lower MIC for voriconazole and luliconazole.
 Interpretation & Conclusion: The study observed a predominance of T. mentagrophytes causing chronic dermatophytosis. The rising MIC to terbinafine and griseofulvin among the isolates raises a concern for effective management. The real-time PCR analysis of ERG 11 expression in certain isolates demonstrated up-regulation in patients not responding to treatment as compared to responders, the impending failure of azoles as a line of treatment in dermatophytosis.

Antifungal Activity of Nontoxic Nanocomposite Based on Silver and Reduced Graphene Oxide against Dermatophytes and Candida spp.

Dermatomycoses are typical hair, skin, or nail infections caused mainly by dermatophytes and nondermatophytes: Trichophyton, Microsporum, Epidermophyton, and Candida. In addition to the esthetical impact, pain, and nail deformity, these mycoses can be a source of severe disease. The high cost of treatment, toxicity, and the emergence of resistant infectious agents justifies research into new drugs. This work evaluates the fungicidal activity of nanocomposites (NCs) based on reduced graphene oxide (rGO) loaded with silver (Ag) nanoparticles (rGO/Ag) against clinical isolates of dermatophytes and Candida species. This is an unprecedented study in which, for the first time, hybrid nanocompounds based on Ag/rGO were tested against Epidermophytom, Microsporum, and Trichophyton species (dermatophytes agents). In this paper, we synthesize rGO using different concentrations of Ag by hydrolysis of metal salt AgNO3 and follow the growth of nanocrystals on sheets of rGO provided by the NaBH4. The NCs were analyzed by X-ray diffraction analysis, and the NC morphology, silver distribution on the rGO surface, and crystalline information were investigated by transmission electron microscopy. Antifungal susceptibility assay was performed by the microdilution method based on modified Clinical and Laboratory Standards Institute (CLSI) protocol. Time-kill kinetics was conducted to monitor the effect of the composite to inhibit fungal cells or promote structural changes, avoiding germination. The toxicological evaluation of the NCs was born in an in vivo model based on Galleria mellonella (G. mellonella). Minimum inhibitory concentration (MIC) values of the rGO/Ag NCs ranged from 1.9 to 125 μg/mL. The best inhibitory activity was obtained for rGO/Ag12%, mainly against Candida spp. and Epidermophyton floccosum. In the presence of sorbitol, MIC values of rGO/Ag NCs were higher (ranging from 15.6 to 250 μg/mL), indicating the action mechanism on the cell wall. Both yeast and dermatophytes clinical isolates were inhibited at a minimum of 6 and 24 h, respectively, but after 2 and 12 h, they had initial antifungal interference. All hybrid formulations of rGO/Ag NCs were not toxic for G. mellonella. This study provides insights into an alternative therapeutic strategy for controlling dermatomycoses.

In vitro Azole Susceptibility Testing of Japanese Isolates of Itraconazole-Resistant Dermatophytes.

We conducted antifungal susceptibility testing on itraconazole (ITCZ)-resistant isolates of Trichophyton interdigitale and Trichophyton rubrum collected from Japanese patients in 2021 and 2022. The aim of the present study was to determine the most effective drug against ITCZ-resistant strains of dermatophytes. In all isolates, the minimum inhibitory concentrations (MICs) were > 32 mg/l for ITCZ, < 0.03 to 0.5 mg/l for ravuconazole (RVCZ), and < 0.03 mg/l for efinaconazole (EFCZ), luliconazole (LUCZ), and terbinafine (TRBF). Thus, in tinea unguium cases with ITCZ-resistant strains, treatment should be switched to TRBF or other azoles with a stronger antifungal efficacy, such as EFCZ, LUCZ, or RVCZ, and treatment must continue until the infectious organisms are completely eliminated.

Prevalence of Dermatophytic Infections and Their Antifungal Susceptibility Pattern in the Rajshahi Region

Background: Dermatophytes are the most significant fungi because of their widespread involvement in the population and their prevalence worldwide. Bangladesh's hot and humid climate, overcrowded population, poverty, malnutrition, and ignorance make dermatophytosis a common cutaneous infection. These infections occur in both healthy and immunocompromised patients. Dermatophytes are responsible for most cutaneous fungal infections, and the estimated lifetime risk of acquiring a dermatophyte infection is 10-20%.&#x0D; Objective: To isolate and identify different dermatophytes and their antifungal susceptibility pattern in the Rajshahi region. Materials and Methods: Different clinical samples (e.g., skin scrapings, nail clipping, and hair plucking) were collected under aseptic precautions. The isolation and identification of dermatophytes were performed through a microscopic examination using 10% KOH mount, mycological culture, and species identification by lactophenol cotton blue mount from positive culture. In addition, all dermatophytes isolates were subjected to antifungal susceptibility testing using the agar-based disk diffusion method in Mueller Hinton agar media.&#x0D; Results: Out of 171 samples, Trichophyton rubrum was the predominant dermatophyte species with 76(71.7%), followed by T.mentagrophyte were 15(14.2%), E. floccosum were 12(11.3%), and M. canis were 03(2.8%). voriconazole, clotrimazole, and itraconazole were more effective drugs. Griseofulvin was the least effective drug, followed by fluconazole.&#x0D; Conclusion: This study indicates dermatophytosis is a common skin disease in northern Bangladesh. Due to the increasing trend of antifungal drug resistance among dermatophytes, treatment should be based on antifungal sensitivity testing.&#x0D; TAJ 2022; 36: No-1: 119-125

Terbinafine-Resistant Dermatophytes and the Presence of Trichophyton indotineae in North America.

Dermatophytes are common causes of skin, hair, and nail infections in humans. The most common species causing infections in humans are Trichophyton rubrum, Trichophyton mentagrophytes, and Trichophyton interdigitale. Outbreaks of recalcitrant dermatophytosis have been reported in parts of South Asia, including those caused by a hypervirulent and resistant species, Trichophyton indotineae. We evaluated the antifungal susceptibility profiles of dermatophytes received by our laboratory from institutions across North America between 2021 and 2022 and performed species identification for isolates deemed to demonstrate in vitro resistance. Susceptibility testing was performed by CLSI broth microdilution methods, and species identification was performed by DNA sequence analysis. During this 2-year period, 271 dermatophyte isolates were included, the majority of which demonstrated low MIC values for terbinafine (geometric mean [GM] and modal MIC, 0.031 μg/mL and 0.008 μg/mL, respectively) and the azoles itraconazole, posaconazole, and voriconazole (0.035 to 0.049 μg/mL and ≤0.03 μg/mL). However, 18.6% of the isolates tested were resistant to terbinafine (MIC ≥ 0.5 μg/mL), including 21 T. rubrum and 21 T. indotineae isolates. These isolates were received from several different states in the United States and two provinces in Canada. In contrast, resistance to itraconazole was relatively rare. We also searched our laboratory database for earlier isolates that were resistant to terbinafine and identified 3 additional T. indotineae isolates, the earliest of which was from 2017. These results demonstrate that terbinafine resistance in dermatophytes was relatively common over this 2-year period and that T. indotineae is present in multiple areas in North America. Continued surveillance is warranted.

Sheep serve as a reservoir of trichophyton mentagrophytes genotype V infection.

Human infections by Trichophyton mentagrophytes occur mainly due to contact with diseased animals. In Iran, T. mentagrophytes genotype V is the most prevalent variant of the fungus. We aimed to determine animal reservoir of T. mentagrophytes genotype V infection. The study was done on a total of 577 dermatophyte strains obtained from animals with signs of dermatophytosis and human patients. The list of extensively sampled animals included sheep, cows, cats and dogs. For human cases, epidemiological data were collected. All dermatophyte isolates from animals along with 70 human isolates morphologically similar to T. verrucosum and T. mentagrophytes genotype V were identified by rDNA internal transcribed spacer region restriction fragment length polymorphism analysis and DNA sequencing. A total of 334 animal dermatophyte strains were identified as Microsporum canis, T. mentagrophytes genotype V, T. verrucosum, Nannizzia gypsea, T. mentagrophytes genotype II*, T. mentagrophytes genotype VII, T. quinckeanum and N. fulva, whereas all human isolates were identified as T. mentagrophytes genotype V and originated exclusively from skin and scalp infections. Almost all T. mentagrophytes genotype V isolates were cultured from sheep, but epidemiological data on animal-to-human transmission of T. mentagrophytes genotype V infection were limited and we found evidence in favor of interhuman transmission. In Iran, sheep maintain T. mentagrophytes genotype V population and therefore serve as animal reservoir of respective infections. The role of sheep as the source of human dermatophytosis due to T. mentagrophytes genotype V isolates is yet to be proven.

Dermatophytes Isolation from Patients and In-vitro Application of Selected Natural Extracts and Oils for Anti-Dermatophytic Activity

Dermatophytosis, commonly known as ringworm, is caused by a group of fungi termed dermatophytes. It can invade the keratinized tissue of the skin, nails, and hair. Dermatophytosis is classified based on the site of infection, such as tinea pedis, tinea capitis, and tinea unguium. This study was performed at Bolan Medical College Hospital, Quetta, to isolate and identify the infectious agents of dermatophytes related infections in patients following all the codal formalities and ethical procedures. A total of 19 patients' samples were analyzed in the study, where ten samples were positive for infectious agents. The organisms were grown on specified media, such as dermatophytes test medium agar and potato dextrose agar, supplemented with antibiotics. The isolates were preliminary identified with the help of their growth on specific media and finally confirmed with the help of compound microscopic examination. Some common natural compounds, such as apple peel extract (APE), grapes peduncle extract (GPE), propolis oil (PO), and bitter apricot kernel oil (BAKO), were used against the dermatophytes isolates and were found positive for activity against a few isolates. The APE showed inhibitory activity of 31% against Trichophyton tonsurans and 80% against Epidermophyton flocosum, while the GPE showed 27% and 74%, PO showed 42% and 69%, and BAKO showed 78% and 70% activity against Trichophyton tonsurans and Epidermophyton flocosum, respectively. The bioactive compounds in these extracts were analyzed through Fourier Transformed Infrared Spectroscopy.