| Autor: |
Astvad KMT; Unit of Mycology, Statens Serum Institut, DK-2300 Copenhagen, Denmark., Hare RK; Unit of Mycology, Statens Serum Institut, DK-2300 Copenhagen, Denmark., Jørgensen KM; Unit of Mycology, Statens Serum Institut, DK-2300 Copenhagen, Denmark., Saunte DML; Unit of Mycology, Statens Serum Institut, DK-2300 Copenhagen, Denmark.; Department of Dermatology, Zealand University Hospital, DK-4000 Roskilde, Denmark.; Department of Clinical Medicine, Faculty of Health Science, University of Copenhagen, DK-2100 Copenhagen, Denmark., Thomsen PK; Department of Clinical Microbiology, Aalborg University Hospital, DK-9220 Aalborg, Denmark., Arendrup MC; Unit of Mycology, Statens Serum Institut, DK-2300 Copenhagen, Denmark.; Department of Clinical Medicine, Faculty of Health Science, University of Copenhagen, DK-2100 Copenhagen, Denmark.; Department of Clinical Microbiology, Rigshospitalet, DK-2100 Copenhagen, Denmark. |
| Abstrakt: |
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. mentagrophytes/T. interdigitale SC for 19%. Approximately 60% of T. rubrum and T. mentagrophytes/interdigitale 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. mentagrophytes/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-resistant 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. |
