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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 Publisher Pubmed



Haghani I1, 2 ; Babaie M1, 2 ; Hoseinnejad A3, 4 ; Rezaeimatehkolaei A4 ; Mofarrah R5 ; Yahyazadeh Z1, 2 ; Kermani F6 ; Javidnia J1, 2 ; Shokohi T1, 2 ; Azish M7 ; Kamyab Hesari K8 ; Saeedi M9 ; Ghasemi Z8 ; Khojasteh S10 Show All Authors
Authors
  1. Haghani I1, 2
  2. Babaie M1, 2
  3. Hoseinnejad A3, 4
  4. Rezaeimatehkolaei A4
  5. Mofarrah R5
  6. Yahyazadeh Z1, 2
  7. Kermani F6
  8. Javidnia J1, 2
  9. Shokohi T1, 2
  10. Azish M7
  11. Kamyab Hesari K8
  12. Saeedi M9
  13. Ghasemi Z8
  14. Khojasteh S10
  15. Hajheydari Z11
  16. Mosayebi E1, 2
  17. Valadan R12
  18. Seyedmousavi S13
  19. Abastabar M1, 2
  20. Hedayati MT1, 2
Show Affiliations
Authors Affiliations
  1. 1. Invasive Fungi Research Center, Communicable Diseases Institute, Mazandaran University of Medical Sciences, Sari, Iran
  2. 2. Department of Medical Mycology, School of Medicine, Mazandaran University of Medical Sciences, Sari, Iran
  3. 3. Student Research Committee, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
  4. 4. Department of Medical Mycology, School of Medicine, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
  5. 5. Department of Dermatology, Faculty of Medicine, Sari Branch, Islamic Azad University, Sari, Iran
  6. 6. Department of Parasitology and Mycology, Infectious Diseases and Tropical Medicine Research Center, Health Research Center, School of Medicine, Babol University of Medical Sciences, Babol, Iran
  7. 7. Department of Parasitology and Medical Mycology, School of Medicine, Dezful University of Medical Sciences, Dezful, Iran
  8. 8. Department of Dermatopathology, Razi Hospital, Tehran University of Medical Sciences, Tehran, Iran
  9. 9. Department of Pharmaceutics, Faculty of Pharmacy, Mazandaran University of Medical Sciences, Sari, Iran
  10. 10. Molecular Medicine Research Center, Hormozgan Health Institute, Hormozgan University of Medical Sciences, Bandar Abbas, 7916613885, Iran
  11. 11. Department of Dermatology, Faculty of Medicine, Mazandaran University of Medical Sciences, Sari, Iran
  12. 12. Molecular and Cell Biology Research Center (MCBRC), Mazandaran University of Medical Sciences, Sari, Iran
  13. 13. Microbiology Service, Department of Laboratory Medicine, Clinical Center, National Institutes of Health, Bethesda, MD, United States

Source: Mycopathologia Published:2024


Abstract

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 ≥ 4 µg/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. Graphical Abstract: (Figure presented.) © The Author(s), under exclusive licence to Springer Nature B.V. 2024.
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