Mycoses最新文献

{"title":"Genotypic Diversity and Molecular Basis of Fluconazole Resistance in Candida parapsilosis Clinical Isolates Collected Over 7 Years in a Tertiary-Care Hospital in North India.","authors":"Vrinda Sharma, Sourav Das, Bram Spruijtenburg, Theun de Groot, Eelco Meijer, Harsimran Kaur, Shivaprakash M Rudramurthy, Anup Ghosh","doi":"10.1111/myc.70062","DOIUrl":"https://doi.org/10.1111/myc.70062","url":null,"abstract":"<p><strong>Background: </strong>The recent rise in the global incidence of fluconazole resistance in C. parapsilosis has become a significant public health concern. Epidemiological studies suggest that fluconazole resistance in C. parapsilosis spreads through endemic clones. We, therefore, investigated the molecular epidemiology of fluconazole-resistant C. parapsilosis in our centre.</p><p><strong>Methods: </strong>C. parapsilosis isolates from 2016 through 2022 were investigated for antifungal susceptibility. Fluconazole-resistant isolates were analysed for ERG11 mutation using Sanger sequencing. Gene expression profiles of ERG11, CDR1 and MDR1 were assessed by real-time qPCR. The epidemiological relationship of resistant and susceptible isolates of C. parapsilosis was investigated using short tandem repeat typing. Additionally, biofilm production and cell wall ergosterol contents were also quantified and compared.</p><p><strong>Results: </strong>Among 572 C. parapsilosis isolates, 48 (8.4%) were resistant to fluconazole. Of 28 recoverable resistant isolates, 17.9% (5/28) were wild-type and 82.1% (23/28) harboured the following ERG11 mutations: Y132F (n = 3), K143R (n = 10) and K143R + R398I (10/28). Significant fold-changes were observed in ERG11 (p = 0.037) and MDR1 (p = 0.008) gene expressions in fluconazole resistant compared to susceptible isolates. Contrary to global reports, STR typing suggested a limited clonal transmission of resistant C. parapsilosis with multiple introductions of resistant isolates in our centre. On fluconazole exposure, ergosterol content significantly increased (p < 0.01) in resistant isolates, particularly in isolates harbouring ERG11^{K143R + R398I} mutations. In contrast, fluconazole-susceptible isolates formed comparatively higher baseline biofilm (p < 0.05) than resistant isolates with ERG11^K143R mutation.</p><p><strong>Conclusion: </strong>The current study underscores the need for continuous molecular surveillance and tailored therapeutic options for effective management of fluconazole resistance in C. parapsilosis.</p>","PeriodicalId":18797,"journal":{"name":"Mycoses","volume":"68 5","pages":"e70062"},"PeriodicalIF":4.1,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144024469","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cyp51A Dysfunction Leads to Higher Susceptibility to Azoles Including Fluconazole in Aspergillus fumigatus.","authors":"Hidetaka Majima, Teppei Arai, Naoto Maruguchi, Katsuhiko Kamei, Akira Watanabe","doi":"10.1111/myc.70052","DOIUrl":"10.1111/myc.70052","url":null,"abstract":"<p><strong>Background: </strong>Azoles target Cyp51A and Cyp51B in Aspergillus fumigatus. Mutations in cyp51A are known as the primary mechanisms of azole resistance. However, not all of them cause azole resistance. Among them, mutations related to improved susceptibility have not been reported so far. We found that two isolates that carry frameshift or nonsense mutations in cyp51A are more susceptible to azoles, even to fluconazole (FLCZ) (IC₅₀: frameshift, 32 μg/mL; nonsense, 32 μg/mL) compared to other azole-susceptible strains (IC₅₀: > 256 μg/mL).</p><p><strong>Objectives: </strong>We investigated the contribution of these two mutations to azole sensitivity and their effect on Cyp51A functions.</p><p><strong>Methods: </strong>We transformed an experimental strain, AfS35, by replacing cyp51A^WT with each of the mutated cyp51A and measured its MICs to azoles. We also evaluated the functions of mutated Cyp51A after suppression of Cyp51B, based on the notion that Cyp51A and Cyp51B complement each other.</p><p><strong>Results: </strong>Induction of mutated cyp51A in AfS35 led to higher susceptibility to FLCZ (IC₅₀: frameshift, 32-64 μg/mL; nonsense, 32 μg/mL). Transformants carrying either of the mutated cyp51A could not survive when cyp51B was suppressed, indicating that these cyp51A mutations result in Cyp51A dysfunction. Furthermore, a cyp51A-deleted mutant strain also showed increased susceptibility to FLCZ (IC₅₀: 32 μg/mL), similar to cyp51A dysfunctional strains, while a cyp51B-deleted mutant strain showed unchanged susceptibility (IC₅₀: > 256 μg/mL) from AfS35.</p><p><strong>Conclusions: </strong>It was suggested that FLCZ can inhibit Cyp51B rather than Cyp51A and that this unequal inhibition leads to higher azole susceptibility of the two isolates harbouring Cyp51A dysfunction.</p>","PeriodicalId":18797,"journal":{"name":"Mycoses","volume":"68 4","pages":"e70052"},"PeriodicalIF":4.1,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143772736","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Therapeutic Outcomes in Patients With Trichophyton indotineae: A Systematic Review and Meta-Analysis of Individual Patient Data.","authors":"Charussri Leeyaphan, Phuwakorn Saengthong-Aram, Jomgriditip Laomoleethorn, Phichayut Phinyo, Lalita Lumkul, Sumanas Bunyaratavej","doi":"10.1111/myc.70048","DOIUrl":"10.1111/myc.70048","url":null,"abstract":"<p><strong>Background: </strong>Trichophyton indotineae has emerged as a significant global dermatophyte, associated with recalcitrant dermatophytosis and increasing antifungal resistance.</p><p><strong>Materials and methods: </strong>This study evaluates therapeutic outcomes in T. indotineae infections. We conducted a systematic review and meta-analysis of individual patient data adhering to PRISMA guidelines, including studies published before December 2023 from six electronic databases. Only studies with confirmed T. indotineae by rDNA sequencing and therapeutic outcome data were included.</p><p><strong>Results: </strong>A total of 27 publications with 81 cases were included. T. indotineae infections affected both genders equally, with 25% having prior steroid use, which was significantly associated with non-improvement. Resistance to terbinafine was observed in 85.3% of cases. Oral itraconazole was significantly associated with a cure. The restricted median time to complete clinical cure was 11.50 weeks, with a recurrence rate of 19.7%.</p><p><strong>Conclusions: </strong>The effective management of T. indotineae infections is essential, given the significant challenges posed by antifungal resistance.</p>","PeriodicalId":18797,"journal":{"name":"Mycoses","volume":"68 4","pages":"e70048"},"PeriodicalIF":3.1,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11971648/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143788646","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical and Hospital Environmental Fusarium in Taiwan: Molecular Identification, Antifungal Susceptibilities, and Phylogenetic Analyses.","authors":"Yi-Chun Chen, Jie-Hao Ou, Chi-Jung Wu, Shu-Fang Kuo, Susan Shin-Jung Lee, Ming-I Hsieh, Yin-Shiou Lin, Pei-Lun Sun, Chen-Hsiang Lee","doi":"10.1111/myc.70056","DOIUrl":"https://doi.org/10.1111/myc.70056","url":null,"abstract":"<p><strong>Background: </strong>Fusarium species are emerging pathogens known to cause both superficial and disseminated human infections. Aerosolized Fusarium species in healthcare settings have been associated with nosocomial fusariosis, particularly in patients with severe immunosuppression.</p><p><strong>Objectives: </strong>To analyse the phylogenetic relationships of clinical and hospital environmental Fusarium isolates and assess their susceptibility to available antifungal agents.</p><p><strong>Methods: </strong>Clinical Fusarium isolates were procured from four hospitals in Taiwan, with environmental air and water sampling collected at Kaohsiung Chang Gung Memorial Hospital (KCGMH). All clinical and hospital environmental Fusarium isolates were identified through gene sequencing of translation elongation factor 1-α and internal transcribed spacer regions of ribosomal DNA. Antifungal susceptibility testing followed the CLSI M38-A3 broth microdilution method.</p><p><strong>Results: </strong>A total of 41 clinical and 4 hospital environmental Fusarium isolates were identified, belonging to five species complexes (SC): F. solani SC (FSSC) (62.8%), F. fujikuroi SC (FFSC) (14.0%), F. incarnatum-equiseti SC (11.6%), F. dimerum SC (7.0%), and F. oxysporum SC (4.7%). Phylogenetic analysis revealed that clinical Fusarium isolates from KCGMH were closely related to environmental Fusarium isolates from air samples at the same hospital. Amphotericin B exhibited high activity against most Fusarium species. With the exception of FFSC, other Fusarium SC demonstrated significantly elevated MIC values to itraconazole, voriconazole, posaconazole, and isavuconazole.</p><p><strong>Conclusions: </strong>FSSC was the most prevalent SC in Taiwan, exhibiting higher MIC values for azoles than FFSC isolates. The clinical Fusarium isolates were observed to form clusters with the corresponding environmental isolates. The potential of airborne nosocomial infections in the healthcare environment cannot be overlooked.</p>","PeriodicalId":18797,"journal":{"name":"Mycoses","volume":"68 4","pages":"e70056"},"PeriodicalIF":4.1,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144033537","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Profiling Drug Susceptibility and Species Identification of Aspergillus Isolates From Patients With Superficial Infection.","authors":"Yahui Feng, Zhichao Zhang, Wenjie Fang, Sisi Wang, Jianfeng Zhang, Dongmei Li, Wanqing Liao, Renzhe Li, Dongmei Shi","doi":"10.1111/myc.70059","DOIUrl":"https://doi.org/10.1111/myc.70059","url":null,"abstract":"<p><strong>Background: </strong>Aspergillus infections pose significant challenges in clinical management due to rising resistance rates and limited diagnostic accuracy. Superficial infections, particularly in immunocompetent individuals, are often understudied, despite their prevalence in specific populations.</p><p><strong>Objectives: </strong>This study aimed to characterise the distribution and antifungal susceptibility patterns of Aspergillus isolates from a tertiary hospital in Shandong, China, and evaluate the performance of matrix-assisted laser desorption time-of-flight (MALDI-TOF) mass spectrometry versus multi-gene sequencing for species identification.</p><p><strong>Patients/methods: </strong>A total of 120 Aspergillus isolates were collected from patients with localised aspergillosis (nails, external auditory canal, cornea, sub-throat secretions) between 2020 and 2021. Species identification was performed using MALDI-TOF and multi-gene sequencing (ITS, BenA, CaM, RPB2). Antifungal susceptibility testing was conducted for micafungin, azoles (itraconazole, voriconazole, posaconazole, fluconazole), and amphotericin B following standard protocols.</p><p><strong>Results: </strong>Species Identification: MALDI-TOF identified 52.5% of isolates to the species level, whereas multi-gene sequencing achieved 100% accuracy. Aspergillus terreus was the most prevalent species (38.3%). Antifungal Susceptibility: Micafungin showed the highest resistance rate (40%), followed by amphotericin B (reduced susceptibility in 31.7%). Azoles demonstrated low resistance (3.3%-6.7%) except for fluconazole (21.7%). Clinical Correlates: Superficial infections were most common in middle-aged/elderly patients (68.3%), frequently linked to external trauma (41.7%) or environmental exposure (35.8%).</p><p><strong>Conclusions: </strong>Multi-gene sequencing outperformed MALDI-TOF for Aspergillus identification. A. terreus dominance and micafungin resistance highlight regional epidemiological trends. Natamycin and nystatin remain cost-effective first-line topical options. Enhanced surveillance in trauma-prone and environmentally exposed populations is warranted.</p>","PeriodicalId":18797,"journal":{"name":"Mycoses","volume":"68 4","pages":"e70059"},"PeriodicalIF":4.1,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143971363","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparative Analysis of Chemiluminescence Immunoassay (CLIA)-Based Tests in the Diagnosis of Invasive Aspergillosis in Patients With Hematologic Malignancies.","authors":"Esra Kılıç, Elif Ayça Şahin, Özlem Güzel Tunçcan, Şeyma Yıldız, Zübeyde Nur Özkurt, Zeynep Arzu Yeğin, Ayşe Kalkancı","doi":"10.1111/myc.70064","DOIUrl":"https://doi.org/10.1111/myc.70064","url":null,"abstract":"<p><strong>Background and aim: </strong>Rapid chemiluminescence immunoassays (CLIA) have emerged as a promising alternative to traditional serological methods for the diagnosis of invasive aspergillosis (IA). The aim of this study was to compare the diagnostic performance of rapid CLIA tests in IA.</p><p><strong>Methods: </strong>Patient group consisted of 17 patients who were diagnosed with probable IA according to EORTC/MSG criteria. Patients without invasive fungal infection (IFI) were defined as the control group, whereas healthy volunteers were also included. A total of 93 serum samples were used in this study. Platelia Aspergillus Ag test and Dynamiker Aspergillus Ag Kit, CLIA tests Aspergillus Galactomannan Detection Kit and Fungus (1-3) ꞵ-D-Glucan Detection Kit, were used. Specificity, sensitivity, negative predictive value (NPV), and positive predictive value (PPV) were calculated. Receiver operating characteristic (ROC) curve was used to evaluate the overall diagnostic performance of CLIA tests comparing FDA-approved GM ELISA test.</p><p><strong>Results: </strong>The sensitivity of the CLIA galactomannan (CLIA GM) test was 70.6%, specificity 92.1%, PPV 66.7% and NPV 93.3% (p < 0.001), while the sensitivity of the CLIA beta-glucan (CLIA BDG) test was 88.2%, specificity 81.6%, PPV 51.7% and NPV 96.9% (p < 0.001). Using the PlateliaTM Aspergillus Ag Test as the reference method, the areas under the curve (AUC) of the ROC curve were 0.878 for CLIA BDG and 0.869 for CLIA GM.</p><p><strong>Conclusions: </strong>CLIA-based tests were evaluated as being rapid diagnostic tests for IA since their NPVs were found to be very high. Integrating CLIA into clinical practice may significantly improve diagnostic efficiency and patient outcomes.</p>","PeriodicalId":18797,"journal":{"name":"Mycoses","volume":"68 4","pages":"e70064"},"PeriodicalIF":4.1,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12023017/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144028089","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Deep Learning Model for Diagnosing and Classifying Subtypes of Chronic Pulmonary Aspergillosis in Chest CT.","authors":"Jinbo Wei, Lina Zhou, Dong Zhang, Guangyuan Guo, Zihui Li, Junxin Fang, Xiangyu Yan, Yijin Li, Xiaoying Zhang, Chunping Huang, Rihui Lan, Changzheng Shi, Dexiang Liu, Liangping Luo, Cheng Long, Hanwei Chen, Yufeng Ye","doi":"10.1111/myc.70061","DOIUrl":"https://doi.org/10.1111/myc.70061","url":null,"abstract":"<p><strong>Background: </strong>Diagnosing chronic pulmonary aspergillosis (CPA) and its subtypes is essential for treatment and prognosis. In clinical practice, inexperienced doctors may overlook the presence of CPA due to overreliance on radiological results. Applying deep learning technology enhances multi-classification model performance.</p><p><strong>Objective: </strong>To explore whether artificial intelligence generation technology and semisupervised learning can enhance model performance in CPA diagnosis and accurately classify CPA subtypes using small-sample datasets with skewed distributions and multiclass features.</p><p><strong>Methods: </strong>This study developed a multi-classification model for CPA diagnosis and subtype differentiation using a multi-centre CT dataset. We augmented the small, skewed dataset with generation models and trained the deep learning model through a semi-supervised algorithm. Overfitting and poor validation generalisation issues were addressed with the internal dataset. The model, trained with different strategies, was evaluated on multiple internal and external test sets, measuring diagnostic performance via sensitivity, accuracy, F1 score, Matthews correlation coefficient, CK score and overall accuracy.</p><p><strong>Results: </strong>A total of 39,387 chest CT images from 660 patients were split into training, validation and internal test sets. Additionally, 3337 chest CT images from 11 patients formed external test set 1, while 120 images from other studies made up external test set 2. The optimal model successfully diagnosed six CPA patients hidden in external test set 1 and classified their subtypes. In external test set 2, it achieved an ACC of 91% and an AUC of 0.92.</p><p><strong>Conclusion: </strong>Using synthetic data and semi-supervised learning improved deep learning performance in diagnosing and classifying chronic pulmonary aspergillosis on chest CT images.</p>","PeriodicalId":18797,"journal":{"name":"Mycoses","volume":"68 4","pages":"e70061"},"PeriodicalIF":4.1,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144007865","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prevalence of Chronic Pulmonary Aspergillosis in Patients With Mycobacterial and Non-Mycobacterial Tuberculosis Infection of the Lung: A Systematic Review and Meta-Analysis.","authors":"Inderpaul Singh Sehgal, Kathirvel Soundappan, Ritesh Agarwal, Valliappan Muthu, Sahajal Dhooria, Kuruswamy Thurai Prasad, Helmut J F Salzer, Oliver A Cornely, Ashutosh Nath Aggarwal, Arunaloke Chakrabarti","doi":"10.1111/myc.70060","DOIUrl":"10.1111/myc.70060","url":null,"abstract":"<p><strong>Background: </strong>Post-mycobacterial residual lung abnormality (PMLA) from prior tuberculous (PTLA) or non-tuberculous mycobacterial (PNTLA) lung infections predisposes to chronic pulmonary aspergillosis (CPA). However, the prevalence of CPA in patients with PMLA remains uncertain. We aimed to determine the prevalence of CPA in patients with PMLA.</p><p><strong>Methods: </strong>We performed a systematic search of PubMed and Embase databases up to January 31, 2025, to identify studies reporting CPA prevalence in patients with PTLA or PNTLA (excluding those with active tuberculosis). The pooled prevalence was calculated using frequentist meta-analysis (primary outcome), with Bayesian and trim-and-fill methods as sensitivity analyses. Study heterogeneity (I²) and publication bias were assessed. We performed multivariable meta-regression to evaluate factors affecting heterogeneity.</p><p><strong>Results: </strong>Thirty-one studies (4172 PTLA and 13,905 PNTLA) were included. Frequentist meta-analysis yielded a pooled CPA prevalence of 18% (95% confidence interval [CI], 11.6-25.4). Bayesian analysis with informative priors estimated prevalence of 7.1% (95% Credible Index, 4.5-10.4), and trim-and-fill adjustment for publication bias suggested prevalence to be 3.4% (95% CI, 0.69-7.7). On a multivariable analysis, we found CPA prevalence higher in hospital-based studies, high TB burden settings and studies with prospective or cross-sectional study designs; although CPA prevalence was higher in PTLA (23.1%) than in PNTLA (7%), it was not significantly different. We detected substantial heterogeneity (I² = 98.8%) and publication bias.</p><p><strong>Conclusion: </strong>There is a high prevalence of CPA in patients with PMLA, particularly in TB-endemic regions and hospital settings. Patients with PMLA should be routinely screened for CPA in high prevalence settings.</p>","PeriodicalId":18797,"journal":{"name":"Mycoses","volume":"68 4","pages":"e70060"},"PeriodicalIF":4.1,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144035621","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Emergence of Trichophyton tonsurans-A Retrospective Multicentre Study of the Dermatophyte Spectrum in Germany.","authors":"Julia Felicitas Pilz, Martin Schaller, Martin Köberle, Alexandra Lorz, Avend Bamarni, Sebastian Sitaru, Franziska Schauer, Hans Peter Seidl, Tilo Biedermann, Alexander Zink, Kilian Eyerich, Anna Caroline Pilz","doi":"10.1111/myc.70053","DOIUrl":"10.1111/myc.70053","url":null,"abstract":"<p><strong>Background: </strong>In mid-2024, German media reported increasing fungal infections by Trichophyton tonsurans linked to visits to barbershops. However, epidemiological data confirming a rise in tinea capitis and tinea corporis due to Trichophyton tonsurans are lacking.</p><p><strong>Objectives: </strong>This study assesses dermatophyte species and clinical types of infections in German university hospitals in 2018 and 2023.</p><p><strong>Patients/methods: </strong>This retrospective, multicentre study analyses mycological culture results from three Departments of Dermatology in Freiburg, Tübingen and Munich. The dermatophyte, along with the sampled body site, age and gender of the affected patient, was recorded.</p><p><strong>Results: </strong>1915 patients (male: 66.1%; mean age: 50 ± 24 years) with a dermatophyte-positive culture were identified. The most common dermatophyte was Trichophyton rubrum (2018: 78.7%; 2023: 66.3%) with tinea pedis and tinea unguium being the most prevalent types of infection. An increase in tinea corporis and tinea capitis was observed, with tinea capitis doubling from 4.3% to 9.3%. In 2023, Trichophyton tonsurans emerged as the prevailing dermatophyte (67.6%) in tinea capitis and as the second most frequent agent in tinea corporis (26.3%). This dominance of Trichophyton tonsurans was consistently observed across all three study centres. Trichophyton tonsurans affected patients presented a median age of 18 years in 2023 (vs. 9 years in 2018) and an amplified imbalance towards the male gender.</p><p><strong>Conclusions: </strong>The pathogen spectrum and infection patterns have changed in Germany due to the increase of Trichophyton tonsurans infections. Intensified screening and hygiene measures, as well as adaptation of initial empiric treatment of tinea capitis, should be considered.</p>","PeriodicalId":18797,"journal":{"name":"Mycoses","volume":"68 4","pages":"e70053"},"PeriodicalIF":4.1,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11977040/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143803889","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Trichophyton mentagrophytes Genotype VII and Sexually Transmitted Tinea: An Observational Study in Spain.","authors":"Vicente Descalzo, María Teresa Martín, Patricia Álvarez-López, Jorge Néstor García-Pérez, Laura Alcázar-Fuoli, Luis López-Pérez, David Téllez-Velasco, Antonio Carrillo, Elena Sulleiro, Vicenç Falcó, Maider Arando","doi":"10.1111/myc.70049","DOIUrl":"10.1111/myc.70049","url":null,"abstract":"<p><strong>Background: </strong>In 2019, Trichophyton mentagrophytes genotype VII (TMVII) was identified in Germany as a cause of sexually transmitted tinea. Since 2023, it has been described in men who have sex with men (MSM) in France, Italy, and the United States. No cases have been reported in Spain.</p><p><strong>Obectives: </strong>Our study aimed to assess the occurrence of TMVII in an STI clinic in Barcelona.</p><p><strong>Patients/methods: </strong>We identified TMVII cases among all positive mycological skin/hair cultures between January 2020 and January 2025 by sequencing the internal transcribed spacer on isolates of T. mentagrophytes-interdigitale. We retrospectively collected demographic, clinical and treatment data and analysed the association between treatment received and outcome (cure vs. recurrence).</p><p><strong>Results: </strong>Among 21 positive cultures, we obtained 15 isolates of T. mentagrophytes-interdigitale, of which 14 were sequenced and identified as TMVII. Patients with TMVII were all MSM; most were HIV positive (7) or negative on preexposure prophylaxis (6). Main sites of infection were pubogenital (6), buttocks-perianal (5) and beard (2). Six patients required multiple courses of treatment due to recurrence. Twenty-one courses of antifungal therapy were analysed, with an observed cure rate of 45% (5/11) for oral terbinafine vs. 80% (7/10) for topical agents (p = 0.39), and 0% (0/6) for ≤ 2-week courses vs. 80% (12/15) for 3-to-8-week courses (p < 0.01).</p><p><strong>Conclusions: </strong>Our study confirms the presence of TMVII in Spain, supporting its circulation across Europe. Epidemiological profile and site of infection support sexual transmission. Patients responded to systemic or topical terbinafine but required longer-than-usual periods of treatment.</p>","PeriodicalId":18797,"journal":{"name":"Mycoses","volume":"68 4","pages":"e70049"},"PeriodicalIF":4.1,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143743371","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}