Increasing incidence of Trichophyton tonsurans in Munich—A single‐centre observation

Abstract

Background: Tinea capitis and tinea corporis are highly prevalent fungal skin infections, which globally are mainly caused by Microsporum canis and Trichophyton rubrum, respectively. While in the United States and Great Britain Trichophyton tonsurans is widely prevalent as a causative pathogen, it so far only plays a minor role in Germany. Objectives: Since the frequency of pathogenic species varies regionally and temporally, this study assesses the proportion of Trichophyton tonsurans infections in the dermatology department of a large university hospital in Germany from 2019 to 2022 and thoroughly characterises the affected patient population. Patients/Methods: This retrospective study at the Technical University of Munich analyses mycological culture results regarding the identified dermatophyte and infection site. Detailed patient and disease-related information on Trichophyton tonsurans positive patients was obtained. Results: In 2022, 23 patients of 111 dermatophyte culture-positive patients tested positive for Trichophyton tonsurans. This accounted for 20.7% and represented a tenfold increase from 2.1% in 2019. Contact sports were only practiced by 21.7% of patients, and no common hotspot or other linkage could be identified between the cases. Additionally, 47.8% of the patients received a systemic treatment, with 30.4% visiting the clinic more than three times. In 2022, 21.7% were diagnosed with a simultaneous infection of the capillitium and body, whereas this was only observed in 7.1% of cases in 2019 to 2021. Conclusions: This study suggests an increase of Trichophyton tonsurans infections via several routes of transmission.

Pediatric Tinea Capitis: A Retrospective Cohort Study from 2010 to 2021

“…Worldwide, T. tonsurans has been associated with several outbreaks in the pediatric population [ 35 ]. For example, in a recent single center study in Germany, a ten-fold increase in the number of tinea capitis cases due to T. tonsurans was found during 2019–2022 [ 36 ]. New emerging pathogens have also been described in other countries around the world, potentially reflecting migrating populations importing certain pathogens to new areas [ 24 , 30 , 31 , 33 , 34 ].…”

Brote de tinea capitis tricofítica en un grupo de niños escolares en un área rural del departamento del Cauca, Colombia

“…Actualmente, se recomienda el estudio clínico y el de laboratorio: la sensibilidad disminuida o la resistencia in vitro de los dermatofitos a los antimicóticos de uso común (terbinafina, itraconazol, voriconazol y amorolfina), y la resistencia del paciente, ya que el tratamiento de estas afecciones no depende únicamente de la concentración inhibitoria mínima del hongo, sino también, de la reacción del huésped 41 - 45 .…”

“…Por lo tanto, es importante establecer medidas educativas encaminadas a disminuir la frecuencia y la prevalencia de esta dermatofitosis, así como a prevenir su transmisión y sus recidivas en la población general, en especial, en la población más afectada que son los niños en edad escolar(40).Actualmente, se recomienda el estudio clínico y el de laboratorio: la sensibilidad disminuida o la resistencia in vitro de los dermatofitos a los antimicóticos de uso común (terbinafina, itraconazol, voriconazol y amorolfina), y la resistencia del paciente, ya que el tratamiento de estas afecciones no depende únicamente de la concentración inhibitoria mínima del hongo, sino también, de la reacción del huésped(41)(42)(43)(44)(45).En cuanto a la prevención, debe considerarse que los artroconidios de los dermatofitos pueden ser viables por meses o años en el medio ambiente, por lo que se recomienda hacer la desinfección regular de fómites como cepillos, peines y máquinas de peluquería con una solución acuosa de hipoclorito de sodio al 2 %; además, se debe remover todo el material que contenga queratina, como piel muerta y pelos, lo que facilita la desinfección. Cuando sea posible, se debe asear con aspiradora todos los posibles fómites en el hogar, como sillas y otros muebles(40).…”

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

“…A possible explanation is the changing profiles of immigration waves in our country during the last decades, as previously stated. Notably, T. tonsurans has been constantly recognized as an emerging cause of TC in numerous industrialized countries [20,[31][32][33][34][35], yet it remains a random causative agent in the Greek population (4%); whether the rise in isolation rate observed in 2019 (14% versus 3% in 2014) denotes a generally increasing trend, remains to be further evaluated in the following years.…”