Volume 68, Issue 1 e70011

ORIGINAL ARTICLE

Terbinafine Resistance in Trichophyton Species From Patients With Recalcitrant Infections Detected by the EUCAST Broth Microdilution Method and DermaGenius Resistance Multiplex PCR Kit

Liv Duus,

Liv Duus

orcid.org/0009-0003-2582-2924

Department of Clinical Microbiology, Aarhus University Hospital, Aarhus, Denmark

Contribution: Writing - original draft, Software, Data curation, Investigation, Visualization, Formal analysis

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Pernille Kræmer Schachsen,

Pernille Kræmer Schachsen

Department of Clinical Microbiology, Aarhus University Hospital, Aarhus, Denmark

Contribution: Writing - review & editing, Conceptualization, Investigation, Methodology, Validation, Data curation

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Jan Berg Gertsen,

Jan Berg Gertsen

Department of Clinical Microbiology, Aarhus University Hospital, Aarhus, Denmark

Contribution: Conceptualization, Investigation, Methodology, Writing - review & editing

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Karen Marie Thyssen Astvad,

Karen Marie Thyssen Astvad

Unit of Mycology, Statens Serum Institut, Copenhagen, Denmark

Contribution: Writing - review & editing

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Lise Kristensen,

Corresponding Author

Lise Kristensen

[email protected]

Department of Clinical Microbiology, Aarhus University Hospital, Aarhus, Denmark

Correspondence:

Lise Kristensen ([email protected])

Contribution: Conceptualization, Investigation, Writing - original draft, Supervision, Data curation, Methodology, Validation

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Liv Duus,

Liv Duus

orcid.org/0009-0003-2582-2924

Department of Clinical Microbiology, Aarhus University Hospital, Aarhus, Denmark

Contribution: Writing - original draft, Software, Data curation, Investigation, Visualization, Formal analysis

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Pernille Kræmer Schachsen,

Pernille Kræmer Schachsen

Department of Clinical Microbiology, Aarhus University Hospital, Aarhus, Denmark

Contribution: Writing - review & editing, Conceptualization, Investigation, Methodology, Validation, Data curation

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Jan Berg Gertsen,

Jan Berg Gertsen

Department of Clinical Microbiology, Aarhus University Hospital, Aarhus, Denmark

Contribution: Conceptualization, Investigation, Methodology, Writing - review & editing

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Karen Marie Thyssen Astvad,

Karen Marie Thyssen Astvad

Unit of Mycology, Statens Serum Institut, Copenhagen, Denmark

Contribution: Writing - review & editing

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Lise Kristensen,

Corresponding Author

Lise Kristensen

[email protected]

Department of Clinical Microbiology, Aarhus University Hospital, Aarhus, Denmark

Correspondence:

Lise Kristensen ([email protected])

Contribution: Conceptualization, Investigation, Writing - original draft, Supervision, Data curation, Methodology, Validation

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First published: 29 December 2024

https://doi.org/10.1111/myc.70011

Citations: 4

Funding: The authors received no specific funding for this work.

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ABSTRACT

Background

Emerging terbinafine resistance in Trichophyton species has been reported globally. The prevalence in clinical samples from patients with treatment failure is unknown in Denmark.

Objectives

Prospective study of terbinafine resistance in Trichophyton isolates from patients with recalcitrant skin or nail infections.

Patients/Methods

Clinical samples (nails or skin scrapings) from patients with recalcitrant infections were included. Isolates were tested with the EUCAST broth microdilution method, E.Def 11.0 and DermaGenius Resistance Multiplex PCR kit (PathoNostics, The Netherlands).

Results

Thirty-three isolates were included in the study, 27 (81.8%) T. rubrum, 2 (6.1%) T. interdigitale, 1 (3.0%) T. mentagrophytes and 3 (9.1%) T. indotineae. Sixteen of 31 isolates (52%) were terbinafine resistant with the EUCAST broth microdilution method, 13 T. rubrum and 3 T. indotineae. Two isolates did not grow in the broth culture medium. The DermaGenius Resistance Multiplex PCR kit showed mutations associated with terbinafine resistance in 11 isolates. All of the 11 isolates with detected mutations by PCR also displayed terbinafine resistance by the EUCAST method.

Conclusions

Terbinafine resistance was detected in 52% of Trichophyton isolates from recalcitrant infections by the EUCAST broth microdilution. T. rubrum was the most common species among the resistant isolates (81.3%). The DermaGenius Resistance Multiplex PCR kit was a reliable tool for the detection of mutations associated with terbinafine resistance and is suitable as an initial screening for terbinafine resistance before results from EUCAST broth microdilution testing is available. Susceptibility testing of Trichophyton spp. from skin and nail samples is highly relevant from patients with terbinafine treatment failure.

Conflicts of Interest

P.K.S., L.D. and L.K.: none. K.M.T.A.: Gilead: speaker honoraria. J.B.G.: Board member NSMM (unpaid) and travel grants from Gilead and ADVANZ PHARMA.

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Volume68, Issue1

January 2025

e70011

Terbinafine Resistance in Trichophyton Species From Patients With Recalcitrant Infections Detected by the EUCAST Broth Microdilution Method and DermaGenius Resistance Multiplex PCR Kit

ABSTRACT

Background

Objectives

Patients/Methods

Results

Conclusions

Conflicts of Interest

References

Citing Literature

References

Information

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Terbinafine Resistance in Trichophyton Species From Patients With Recalcitrant Infections Detected by the EUCAST Broth Microdilution Method and DermaGenius Resistance Multiplex PCR Kit

ABSTRACT

Background

Objectives

Patients/Methods

Results

Conclusions

Conflicts of Interest

References

Citing Literature

References

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