Major challenges and perspectives in the diagnostics and treatment of dermatophyte infections

Abstract

Dermatophytes are the aetiological factors of a majority of superficial fungal infections. What distinguishes them from other pathogenic filamentous fungi is their unique ability to degrade keratin. The remarkable ability of this group of fungi to survive in different ecosystems results from their morphological and ecological diversity as well as high adaptability to changing environmental conditions. Paradoxically, despite the progress in medicine, the prevalence of dermatophyte infections is increasing from year to year. At the beginning of the third millennium, practical diagnostic and therapeutic options are still very limited. This review focuses on understanding the major problems in this aspect of dermatophyte infections and indicates future strategies and perspectives for novel approaches to identification and drugs for elimination of dermatophytes. Particular importance is placed on development of a strategy for a diagnostic pathway and implementation of rapid and reliable diagnostics methods designed by international teams. Furthermore, among compounds that currently arouse great interest, representatives of terpenoids, alkaloids, saponins, flavonoids and essential oils deserve attention. Many of these compounds are undergoing clinical trials as potential antifungal agents, and future research should focus on attempts at determination of the applicability of tested substances. Finally, the advantages and disadvantages in implementation of new diagnostic paths and medicinal substances for routine use are indicated. Journal of Applied Microbiology

Population differentiation, antifungal susceptibility, and host range of Trichophyton mentagrophytes isolates causing recalcitrant infections in humans and animals

“…Given the growing prevalence of superficial dermatophyte infections, especially in immunocompromised patients, these diseases are regarded as a public health issue worldwide [8].…”

“…Epidemiological studies have documented a varied prevalence rate of dermatophytosis ranging from 14 to 26.8% in North America, Asia, and Europe and from 5 to 31.6% in Africa (Ethiopia, Kenya, Nigeria, and Tanzania) [3][4][5][6][7]. An alarming upward trend in the incidence of superficial dermatophytosis has been especially noticed in Europe and Asia over the past 5-10 years [8,9]. Although the high prevalence of dermatophytosis is a consequence of climate change and new living habits of society, a dramatic change in the clinical features of patients is also noted, as these infections are characterized by recalcitrant response to treatment and increasing relapse rates [10,11].…”

“…Considering the enormous number of taxonomic differences between dermatophytes that can be tested and the importance of species-level identification, the "gold standard" to use for routine mycological identification has still become the topic of a debate, and no uniform position of microbiologists has been developed [8,12,13]. Nonetheless, the advent of molecular methods in mycology facilitates identification of dermatophytes to the species level in a rapid and accurate manner [14][15][16].…”

Application Of The Maldi-Tof Ms Technique For Identification Of Dermatophytes

“…Infekcje grzybicze skóry, włosów i paznokci stanowią najliczniejszą i najbardziej rozpowszechnioną grupę wszystkich grzybic [22]. Częstość występowania zakażeń grzybiczych o charakterze powierzchownym wzrosła w ostatnich dziesięcioleciach do takiego poziomu, że grzybice skóry dotykają obecnie ponad 20-25% światowej populacji, przez co są jedną z najczęstszych postaci infekcji [15]. W literaturze naukowej opisanych jest ponad 50 gatunków dermatofitów sklasyfikowanych przede wszystkim w rodzajach Trichophyton [22].…”

“…Wysoka prewalencja dotyczy również dermatofitoz zoofilnych [35]. Obecnie mykolodzy zaliczają do grupy dermatofitów zoofilnych ponad 30 przedstawicieli [15], a najczęściej wymienianymi gatunki o dużym znaczeniu epidemiologicznym są Trichophyton mentagrophytes (C.P. Robin 1895), Trichophyton verrucosum (E. Bodin 1902) i Micro sporum canis (E. Bodin ex Guég.…”