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. 2022 Jan;28(1):224-228.
doi: 10.3201/eid2801.210810.

Emergence of Difficult-to-Treat Tinea Corporis Caused by Trichophyton mentagrophytes Complex Isolates, Paris, France

Sarah Dellière, Brune Joannard, Mazouz Benderdouche, Anselme Mingui, Maud Gits-Muselli, Samia Hamane, Alexandre Alanio, Antoine Petit, Germaine Gabison, Martine Bagot, Stéphane Bretagne

Emergence of Difficult-to-Treat Tinea Corporis Caused by Trichophyton mentagrophytes Complex Isolates, Paris, France

Sarah Dellière et al. Emerg Infect Dis. 2022 Jan.

Abstract

We describe 7 cases of extensive tinea corporis since 2018 in a hospital in Paris, France, after failure to cure with terbinafine. Molecular analysis indicated Trichophyton mentagrophytes internal transcribed spacer type VIII (T. indotineae). This strain, which has mutations in the squalene epoxidase gene, is spreading on the Indian subcontinent.

Keywords: France; Trichophyton indotineae; Trichophyton mentagrophytes complex; antifungal drug resistance; antimicrobial resistance; fungi; human-to-human transmission; skin infections; squalene epoxidase; terbinafine.

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Figures

Figure 1
Figure 1
Morphologic features of difficult-to-treat dermatophytosis caused by Trichophyton mentagrophytes complex internal transcribed spacer type VIII (T. indotineae) in patients in Paris, France. A) Scaly plaques with erythema and surrounding papulae and vesicles of the arms (patient 1); B) centrifuge annular erythema of the trunk after topical and oral corticosteroids (patient 6); C) erythematous and scaly plaques (patient 3); D) pruritic cutaneous lesions of the groin and axillary pits to which was applied steroids (patient 5).
Figure 2
Figure 2
Phylogenetic tree of clinically resistant Trichophyton mentagrophytes complex internal transcribed spacer (ITS) type VIII (T. indotineae) isolates from patients in Paris, France (red) and control isolates (green) compared with reference isolates. Isolates were classified on the basis of the ITS regions of rDNA classified among existing isolates from type I to type IX strains retrieved from GenBank (3). All resistant isolates and control isolates 2 and 8 had non–wild-type SQLE sequence and different MIC profiles (Table 2). Tree was constructed based on maximum-likelihood (Tamura-Nei model) analysis including sequences of the reference Trichophyton mentagrophytes neotype strain (IHEM 4268NT). Reference isolates are identified by GenBank accession number; T. quinckeanum (Genbank accession nos. KJ606088.1 and KY680503.1) was used as outgroup.
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References

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