Iranian National Survey on Tinea Capitis: Antifungal Susceptibility Profile, Epidemiological Characteristics, and Report of Two Strains with a Novel Mutation in SQLE Gene with Homology Modeling

Abastabar, Mahdi; Babaei, Maryam; Mohammadi, Rasoul; Valadan, Reza; Javidnia, Javad; Zaedi, Arezoo; Âghili, Seyed Reza; Haghani, Iman; Khojasteh, Shaghayegh; Reazaei-Matehkolaei, Ali; Kiasat, Neda; Hesari, Kambiz Kamyab; Ghasemi, Zahra; Azish, Maryam; Zarrinfar, Hossein; Armaki, Mojtaba Taghizadeh; Keikha, Naser; Kharazi, Mahboobeh; Khodadadi, Hossein; Hedayati, Mohammad Taghi; Shokohi, Tahereh

doi:10.1007/s11046-022-00657-2

Cited by 12 publications

(6 citation statements)

References 41 publications

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“…T. mentagrophytes III* harbored missense mutations in SQLE gene corresponding to amino acid substitutions L 419 Phe and T. mentagrophytes VII harbored Lys 276 Asn 9 . Abastabar et al also reported L 419 Phe substitutions in TRB resistant T. mentagrophytes strain, in accordance with our results which documented two mutations 31 . Phe 311 Leu was described for the first time in our T. indotineae isolate ( SQLE accession no.WNA16469).…”

Section: Discussionsupporting

confidence: 93%

Epidemiological trends, antifungal drug susceptibility and SQLE point mutations in etiologic species of human dermatophytosis in Al-Diwaneyah, Iraq

Mahmood,

Shams-Ghahfarokhi,

Salehi

et al. 2024

Sci Rep

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Dermatophytes show a wide geographic distribution and are the main causative agents of skin fungal infections in many regions of the world. Recently, their resistance to antifungal drugs has led to an obstacle to effective treatment. To address the lack of dermatophytosis data in Iraq, this study was designed to investigate the distribution and prevalence of dermatophytes in the human population and single point mutations in squalene epoxidase gene (SQLE) of terbinafine resistant isolates. The identification of 102 dermatophytes isolated from clinical human dermatophytosis was performed through morphological and microscopic characteristics followed by molecular analysis based on ITS and TEF-1α sequencing. Phylogeny was achieved through RAxML analysis. CLSI M38-A2 protocol was used to assess antifungal susceptibility of the isolates to four major antifungal drugs. Additionally, the presence of point mutations in SQLE gene, which are responsible for terbinafine resistance was investigated. Tinea corporis was the most prevalent clinical manifestation accounting for 37.24% of examined cases of dermatophytosis. Based on ITS, T. indotineae (50.98%), T. mentagrophytes (19.61%), and M. canis (29.41%) was identified as an etiologic species. T. indotineae and T. mentagrophytes strains were identified as T. interdigitale based on TEF-1α. Terbinafine showed the highest efficacy among the tested antifungal drugs. T. indotineae and T. mentagrophytes showed the highest resistance to antifungal drugs with MICs of 2–4 and 4 μg/mL, while M. canis was the most susceptible species. Three of T. indotineae isolates showed mutations in SQLE gene Phe397Leu substitution. A non-previously described point mutation, Phe311Leu was identified in T. indotineae and mutations Lys276Asn, Phe397Leu and Leu419Phe were diagnosed in T. mentagrophytes XVII. The results of mutation analysis showed that Phe397Leu was a destabilizing mutation; protein stability has decreased with variations in pH, and point mutations affected the interatomic interaction, resulting in bond disruption. These results could help to control the progression of disease effectively and make decisions regarding the selection of appropriate drugs for dermatophyte infections.

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Section: Discussionsupporting

confidence: 93%

Epidemiological trends, antifungal drug susceptibility and SQLE point mutations in etiologic species of human dermatophytosis in Al-Diwaneyah, Iraq

Mahmood,

Shams-Ghahfarokhi,

Salehi

et al. 2024

Sci Rep

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“…Consistently with most other reports, we observed that males had a significantly higher predisposition to TC (male-to-female ratio of 1.5) [1,[20][21][22]. Male preponderance could be related to their short hair, which facilitates the implantation of spores and their transmission, as well as the need for frequent trimming of the hair, probably by contaminated scissors and blades [1].…”

Section: Discussionsupporting

confidence: 90%

Changing Epidemiology of Tinea Capitis in Athens, Greece: The Impact of Immigration and Review of Literature

Charpantidis

Siopi

Pappas

et al. 2023

JoF

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Mass population movements have altered the epidemiology of tinea capitis (TC) in countries receiving refugees. Periodic monitoring of the local pathogen profiles may serve as a basis for both the selection of appropriate empirical antifungal therapy and the implementation of preventive actions. Therefore, we investigated the impact of an unprecedented immigration wave occurring in Greece since 2015 on the epidemiological trends of TC. All microbiologically confirmed TC cases diagnosed during the period 2012–2019 in a referral academic hospital for dermatological disorders in Athens, Greece, were retrospectively reviewed. A total of 583 patients were recorded, where 348 (60%) were male, 547 (94%) were children and 160 (27%) were immigrants from Balkan, Middle Eastern, Asian as well as African countries. The overall annual incidence of TC was 0.49, with a significant increase over the years (p = 0.007). M. canis was the predominant causative agent (74%), followed by T. violaceum (12%), T. tonsurans (7%) and other rare dermatophyte species (7%). M. canis prevalence decreased from 2014 to 2019 (84% to 67%, p = 0.021) in parallel with a three-fold increase in T. violaceum plus T. tonsurans rates (10% to 32%, p = 0.002). An increasing incidence of TC with a shift towards anthropophilic Trichophyton spp. in Greece could be linked to the immigration flows from different socioeconomic backgrounds.

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“…For example, an amino acid substitution of F397L in the SQLE protein was detected in 306, 71, and 11 T. indotineae, T. interdigitale , and mentagrophytes cases, respectively. The L393F amino acid mutation in the SQLE protein was detected in 28 and 19 T. indotineae and T. interdigitale cases, respectively 12,13,30,31,38–62 …”

Section: Discussionmentioning

confidence: 99%

Terbinafine‐resistant T. indotineae due to F397L/L393S or F397L/L393F mutation among corticoid‐related tinea incognita patients

Tamimi,

Fattahi,

Ghaderi

et al. 2024

J Deutsche Derma Gesell

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SummaryTinea incognita (TI) can mimic other dermatoses, presenting a diagnostic challenge for dermatologists. In some uncertain cases, it is crucial to accurately identify the causative agent using internal transcribed spacer (ITS) sequencing. The global issue of drug‐resistant dermatophytosis is increasing, with Trichophyton (T.) indotineae being the main cause. This study presents four cases of TI (diagnosed as eczema) by terbinafine‐resistant T. indotineae strains and reviews the current global TI epidemiology based on geographical continent and related conditions. Furthermore, squalene epoxidase (SQLE)‐associated resistance mechanisms are evaluated. Lesions caused by terbinafine‐resistant T. indotineae strains do not respond to allylamine antifungals, thus allowing the infection to spread. Among T. indotineae isolates, the SQLE F397L substitution is the most prevalent mutation contributing to azole resistance. F397L and L393F replacements in SQLE were detected in all isolates that exhibited high‐level resistance. L393S was seen in isolates with low‐resistant strains. Interestingly, and for the first time, an L393F amino acid substitution in the SQLE gene product was detected in the Iranian clinical T. indotineae strain. Also, a genomics‐based update on terbinafine resistance that focuses on T. indotineae is discussed in this study.

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Iranian National Survey on Tinea Capitis: Antifungal Susceptibility Profile, Epidemiological Characteristics, and Report of Two Strains with a Novel Mutation in SQLE Gene with Homology Modeling

Cited by 12 publications

References 41 publications

Epidemiological trends, antifungal drug susceptibility and SQLE point mutations in etiologic species of human dermatophytosis in Al-Diwaneyah, Iraq

Epidemiological trends, antifungal drug susceptibility and SQLE point mutations in etiologic species of human dermatophytosis in Al-Diwaneyah, Iraq

Changing Epidemiology of Tinea Capitis in Athens, Greece: The Impact of Immigration and Review of Literature

Terbinafine‐resistant T. indotineae due to F397L/L393S or F397L/L393F mutation among corticoid‐related tinea incognita patients

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