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2. Increasing Terbinafine Resistance in Danish Trichophyton Isolates 2019–2020

Author

Astvad, Karen Marie Thyssen, Hare, Rasmus Krøger, Jørgensen, Karin Meinike, Saunte, Ditte Marie Lindhardt, Thomsen, Philip Kjettinge, Arendrup, Maiken Cavling, Astvad, Karen Marie Thyssen, Hare, Rasmus Krøger, Jørgensen, Karin Meinike, Saunte, Ditte Marie Lindhardt, Thomsen, Philip Kjettinge, and Arendrup, Maiken Cavling

Abstract

Terbinafine resistance in Trichophyton species has emerged and appears to be increasing. A new EUCAST susceptibility testing method and tentative ECOFFs were recently proposed for Trichophyton. Terbinafine resistance and target gene mutations were detected in 16 Danish isolates in 2013–2018. In this study, samples/isolates submitted for dermatophyte susceptibility testing 2019– 2020 were examined. Species identification (ITS sequencing for T. mentagrophytes/T. interdigitale species complex (SC) isolates), EUCAST MICs and squalene epoxidase (SQLE) profiles were obtained. Sixty-three isolates from 59 patients were included. T. rubrum accounted for 81% and T. men-tagrophytes/T. interdigitale SC for 19%. Approximately 60% of T. rubrum and T. mentagrophytes/inter-digitale SC isolates were terbinafine non-wildtype and/or had known/novel SQLE mutations with possible implications for terbinafine MICs. All infections with terbinafine-resistant T. men-tagrophytes/interdigitale SC isolates were caused by Trichophyton indotineae. Compared to 2013–2018, the number of patients with terbinafine-resistant Trichophyton isolates increased. For T. rubrum, this is partly explained by an increase in number of requests for susceptibility testing. Terbinafine-re-sistant T. indotineae was first detected in 2018, but accounted for 19% of resistance (4 of 21 patients) in 2020. In conclusion, terbinafine resistance is an emerging problem in Denmark. Population based studies are warranted and susceptibility testing is highly relevant in non-responding cases.

Published
2022

7. Correction: Astvad et al. Increasing Terbinafine Resistance in Danish T richophyton Isolates 2019–2020. J. Fungi 2022, 8 , 150.

Author

Astvad, Karen Marie Thyssen, Hare, Rasmus Krøger, Jørgensen, Karin Meinike, Saunte, Ditte Marie Lindhardt, Thomsen, Philip Kjettinge, and Arendrup, Maiken Cavling

Subjects
TERBINAFINE, FUNGI
Abstract

Similarly, the S443P alteration in I T. mentagrophytes i has been found in both resistant and susceptible isolates from India [13]; single A448T alternations almost exclusively in susceptible isolates of I T. mentagrophytes i or I T. indotineae i from Germany, Iran, and India [13,21,33,40]; and V444I/A448T and K276N/L419F alterations in I T. mentagrophytes i isolates from Germany or China were not associated with MIC elevations [21,33]. Finally, a space is missing between the word "the" and "S443P" in the last sentence "Similarly, theS443P alterations in I T. mentagrophytes i has been found in both resistant and susceptible isolates from India". In contrast to the alterations discussed above, some alterations are found in both susceptible and resistant isolates or exclusively in susceptible isolates, suggesting they do not affect the terbinafine susceptibility. [Extracted from the article]

Published
2022
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