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Müller VL, Kreuter A, Uhrlaß S, Nenoff P. [Trichophyton mentagrophytes genotype VII increasingly causes anogenital infections]. DERMATOLOGIE (HEIDELBERG, GERMANY) 2024; 75:48-54. [PMID: 38189829 DOI: 10.1007/s00105-023-05275-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 11/27/2023] [Indexed: 01/09/2024]
Abstract
In the course of globalization, migration and global warming, we are increasingly confronted with pathogens that do not occur naturally in our latitudes or appear in a different form. We know keratinophilic dermatophytes as the cause of tinea pedis, onychomycosis and also tinea corporis and capitis. Transmission usually occurs via domestic or farm animals and via autoinoculation. In recent years dermatophytes have gained additional importance as a possible sexually transmitted disease between immunocompetent persons. For the first time, dermatophytosis was described as a sexually transmitted infection in travelers who developed pronounced pubogenital or anogenital tinea after travelling in Southeast Asia, including Thailand, mostly after intensive sexual contact. Molecular and cultural analyses have identified Trichophyton (T.) mentagrophytes ITS (internal transcribed spacer) genotype VII as the main pathogen. Although this dermatophyte genotypically belongs to the zoophilic complex, direct (sexual) and occasionally indirect human-to-human contact with infected persons is suspected to be the current route of transmission. The infection can lead to inflammatory and purulent dermatophytosis, causing a high level of suffering. In this respect, a rapid and reliable diagnosis is essential in order to be able to initiate targeted treatment. The discovery of infection pathways and the awareness of the need to take rare diseases into account in our everyday lives will increasingly accompany us over the next few years and present us with new challenges, particularly in terms of prevention and treatment.
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Affiliation(s)
- Valentina Laura Müller
- Klinik für Dermatologie, Venerologie und Allergologie, Helios St. Johannes Klinikum Duisburg, Dieselstr. 185, 47166, Duisburg, Deutschland.
| | - Alexander Kreuter
- Klinik für Dermatologie, Venerologie und Allergologie, Helios St. Johannes Klinikum Duisburg, Dieselstr. 185, 47166, Duisburg, Deutschland
- Klinik für Dermatologie, Venerologie und Allergologie, Helios St. Elisabeth Klinik Oberhausen/Universität Witten-Herdecke, Oberhausen, Deutschland
| | - Silke Uhrlaß
- labopart - Medizinische Laboratorien, Labor Leipzig-Mölbis, Rötha OT Mölbis, Deutschland
| | - Pietro Nenoff
- labopart - Medizinische Laboratorien, Labor Leipzig-Mölbis, Rötha OT Mölbis, Deutschland
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Jabet A, Dellière S, Seang S, Chermak A, Schneider L, Chiarabini T, Teboul A, Hickman G, Bozonnat A, Brin C, Favier M, Tamzali Y, Chasset F, Barete S, Hamane S, Benderdouche M, Moreno-Sabater A, Dannaoui E, Hennequin C, Fekkar A, Piarroux R, Normand AC, Monsel G. Sexually Transmitted Trichophyton mentagrophytes Genotype VII Infection among Men Who Have Sex with Men. Emerg Infect Dis 2023; 29:1411-1414. [PMID: 37347803 PMCID: PMC10310379 DOI: 10.3201/eid2907.230025] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/24/2023] Open
Abstract
Transmission of dermatophytes, especially Trichophyton mentagrophytes genotype VII, during sexual intercourse has been recently reported. We report 13 such cases in France. All patients were male; 12 were men who have sex with men. Our findings suggest sexual transmission of this pathogen within a specific population, men who have sex with men.
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Verma SB, Panda S, Nenoff P, Singal A, Rudramurthy SM, Uhrlass S, Das A, Bisherwal K, Shaw D, Vasani R. The unprecedented epidemic-like scenario of dermatophytosis in India: II. Diagnostic methods and taxonomical aspects. Indian J Dermatol Venereol Leprol 2021; 87:326-332. [PMID: 33871195 DOI: 10.25259/ijdvl_302_20] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2020] [Accepted: 12/01/2020] [Indexed: 11/04/2022]
Abstract
Trichophyton (T.) mentagrophytes now accounts for an overwhelming majority of clinical cases in India, a new "Indian genotype" (T. mentagrophytes ITS genotype VIII) having been isolated from skin samples obtained from cases across a wide geographical distribution in this country. The conventional diagnostic methods, like fungal culture, are, however, inadequate for diagnosing this agent. Thus, molecular methods of diagnosis are necessary for proper characterization of the causative agent. The shift in the predominant agent of dermatophytosis from T. rubrum to T. mentagrophytes, within a relatively short span of time, is without historic parallel. The apparent ease of transmission of a zoophilic fungus among human hosts can also be explained by means of mycological phenomena, like anthropization.
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Affiliation(s)
| | - Saumya Panda
- Department of Dermatology, Belle Vue Clinic, Kolkata, West Bengal, India
| | - Pietro Nenoff
- Department of Dermatology and Laboratory Medicine, Laboratory of Medical Microbiology, Moelbis, Germany
| | - Archana Singal
- Department of Dermatology and STD, University College of Medical Sciences and GTB Hospital, Delhi, India
| | - Shivaprakash M Rudramurthy
- Department of Medical Microbiology, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Silke Uhrlass
- Department of Dermatology and Laboratory Medicine, Laboratory of Medical Microbiology, Moelbis, Germany
| | - Anupam Das
- Department of Dermatology, KPC Medical College and Hospital, Kolkata, West Bengal, India
| | - Kavita Bisherwal
- Department of Dermatology, Venereology and Leprosy, Lady Harding Medical College and SSK Hospital, Delhi, India
| | - Dipika Shaw
- Department of Medical Microbiology, PGI, Chandigarh, India
| | - Resham Vasani
- Department of Dermatology, Bhojani Clinic, Mumbai, Maharashtra, India
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Klinger M, Theiler M, Bosshard P. Epidemiological and clinical aspects of
Trichophyton mentagrophytes/Trichophyton interdigitale
infections in the Zurich area: a retrospective study using genotyping. J Eur Acad Dermatol Venereol 2021; 35:1017-1025. [DOI: 10.1111/jdv.17106] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2020] [Accepted: 12/16/2020] [Indexed: 12/13/2022]
Affiliation(s)
- M. Klinger
- Department of Dermatology University Hospital Zurich Zurich Switzerland
- Faculty of Medicine University of Zurich Zurich Switzerland
| | - M. Theiler
- Pediatric Skin Center Dermatology Department University Children‘s Hospital Zurich Zürich Switzerland
| | - P.P. Bosshard
- Department of Dermatology University Hospital Zurich Zurich Switzerland
- Faculty of Medicine University of Zurich Zurich Switzerland
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5
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Thakur R, Kalsi AS. Updates on Genital Dermatophytosis. Clin Cosmet Investig Dermatol 2020; 13:743-750. [PMID: 33061514 PMCID: PMC7537836 DOI: 10.2147/ccid.s262704] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2020] [Accepted: 08/12/2020] [Indexed: 11/23/2022]
Abstract
Dermatophytes are a group of keratinophilic fungi, which normally cause superficial infection of skin, hair and nails. Based on ecology, they are classified into three groups: anthropophilic, zoophilic and geophilic. Superficial dermatophytic infection of the genital region is called genital dermatophytosis, tinea genitalis or pubo-genital dermatophytosis. In this review, we would like to discuss briefly, the various clinical presentations of genital dermatophytosis, current changes in the taxonomy and nomenclature, introduction of new diagnostic techniques and briefly describe some common dermatophytes and their sources. Also, there are serious concerns associated with the recent development of antifungal resistance among the dermatophytes. We are also facing the scenario of hard-to-treat dermatophytosis.
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Affiliation(s)
- Rameshwari Thakur
- Microbiology and Infection Control, Shivam Orthocare, Una, Himachal Pradesh, India
- Department of Microbiology, Muzaffarnagar Medical College, Muzaffarnagar, Uttar Pradesh, India
| | - Avneet Singh Kalsi
- Research, Muzaffarnagar Medical College, Muzaffarnagar, Uttar Pradesh, India
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Kupsch C, Czaika V, Deutsch C, Gräser Y. Trichophyton mentagrophytes
– ein neuer Genotyp des zoophilen Dermatophyten verursacht sexuell übertragbare Infektionen. J Dtsch Dermatol Ges 2019; 17:493-502. [DOI: 10.1111/ddg.13776_g] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2018] [Accepted: 08/28/2018] [Indexed: 11/29/2022]
Affiliation(s)
- Christiane Kupsch
- Nationales Konsiliarlabor für DermatophytenInstitut für Mikrobiologie und InfektionsimmunologieCharité – Universitätsmedizin Berlin
| | | | - Cornelia Deutsch
- Klinik für DermatologieVenerologie und AllergologieCharité – Universitätsmedizin Berlin
| | - Yvonne Gräser
- Nationales Konsiliarlabor für DermatophytenInstitut für Mikrobiologie und InfektionsimmunologieCharité – Universitätsmedizin Berlin
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Kirsten H, Haiduk J, Nenoff P, Uhrlaß S, Ziemer M, Simon JC. [Tinea barbae profunda due to Trichophyton mentagrophytes : Case report and review]. Hautarzt 2019; 70:601-611. [PMID: 31001659 DOI: 10.1007/s00105-019-4407-7] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Tinea barbae is a rare dermatomycocis, by definition follicular bound in the beard area of adult men. Manifestation usually starts with erythema accompanied by desquamation. Deeper distribution along terminal hairs leads to folliculitis with formation of pustules and nodes as well as abscesses; fixed adherent yellowish crusts may appear. Frequently there is locoregional swelling of the lymph nodes and occasionally a deterioration of general condition with (sub)febrile temperatures. Often this leads to the initial suspected diagnosis of a bacterial folliculitis barbae or impetigo contagiosa. Tinea barbae is mostly induced by species of the genus Trichophyton (T.). The pathogens are diverse and are mostly zoophilic, sometimes anthropophilic and rarely geophilic dermatophytes. With the help of a specific anamnesis and diagnostic procedure, including mycological examinations, histology and molecular detection of dermatophytes via polymerase chain reaction (PCR), tinea barbae-in our patient induced by T. mentagrophytes-can be rapidly diagnosed. Early initiation and adequate treatment duration lead to restitutio ad integrum.
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Affiliation(s)
- H Kirsten
- Klinik für Dermatologie, Venerologie und Allergologie, Universitätsklinikum Leipzig, Philipp-Rosenthal-Str. 23, 04103, Leipzig, Deutschland.
| | - J Haiduk
- Klinik für Dermatologie, Venerologie und Allergologie, Universitätsklinikum Leipzig, Philipp-Rosenthal-Str. 23, 04103, Leipzig, Deutschland
| | - P Nenoff
- Labor für medizinische Mikrobiologie, Partnerschaft Prof. Dr. med. Pietro Nenoff & Dr. med. Constanze Krüger, Rötha OT Mölbis, Deutschland
| | - S Uhrlaß
- Labor für medizinische Mikrobiologie, Partnerschaft Prof. Dr. med. Pietro Nenoff & Dr. med. Constanze Krüger, Rötha OT Mölbis, Deutschland
| | - M Ziemer
- Klinik für Dermatologie, Venerologie und Allergologie, Universitätsklinikum Leipzig, Philipp-Rosenthal-Str. 23, 04103, Leipzig, Deutschland
| | - J C Simon
- Klinik für Dermatologie, Venerologie und Allergologie, Universitätsklinikum Leipzig, Philipp-Rosenthal-Str. 23, 04103, Leipzig, Deutschland
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Nenoff P, Verma SB, Vasani R, Burmester A, Hipler UC, Wittig F, Krüger C, Nenoff K, Wiegand C, Saraswat A, Madhu R, Panda S, Das A, Kura M, Jain A, Koch D, Gräser Y, Uhrlaß S. The current Indian epidemic of superficial dermatophytosis due to Trichophyton mentagrophytes-A molecular study. Mycoses 2019; 62:336-356. [PMID: 30561859 DOI: 10.1111/myc.12878] [Citation(s) in RCA: 115] [Impact Index Per Article: 23.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2018] [Revised: 12/09/2018] [Accepted: 12/12/2018] [Indexed: 01/27/2023]
Abstract
The disease burden of chronic-relapsing and therapy-refractory superficial dermatophytosis dramatically increased in India within the past 5-6 years. In order to evaluate the prevalence of this trend, 201 skin scrapings were collected from patients from all parts of India and were tested for dermatophytes using both fungal culture and a PCR-ELISA directly performed with native skin scrapings. Fungal culture material was identified by genomic Sanger sequencing of the internal transcribed spacer (ITS) region and the translation elongation factor (TEF)-1α gene. In total, 149 (74.13%) out of the 201 samples showed a dermatophyte-positive culture result. Out of this, 138 (92.62%) samples were identified as Trichophyton (T.) mentagrophytes and 11 (7.38%) as Trichophyton rubrum. The PCR-ELISA revealed similar results: 162 out of 201 (80.56%) samples were dermatophyte-positive showing 151 (93.21%) T mentagrophytes- and 11 (6.79%) T rubrum-positive samples. In this study, we show for the first time a dramatic Indian-wide switch from T rubrum to T mentagrophytes. Additionally, sequencing revealed a solely occurring T mentagrophytes "Indian ITS genotype" that might be disseminated Indian-wide due to the widespread abuse of topical clobetasol and other steroid molecules mixed with antifungal and antibacterial agents.
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Affiliation(s)
- Pietro Nenoff
- Laboratory for Medical Microbiology, Mölbis, Germany
| | - Shyam B Verma
- Nirvan and In Skin Clinics, Vadodara, Gujarat, India
| | | | - Anke Burmester
- Klinik für Hautkrankheiten, Universitätsklinikum Jena, Jena, Germany
| | | | | | | | - Kolja Nenoff
- Laboratory for Medical Microbiology, Mölbis, Germany
| | - Cornelia Wiegand
- Klinik für Hautkrankheiten, Universitätsklinikum Jena, Jena, Germany
| | - Abir Saraswat
- Department of Dermatology, Indushree Skin Clinic, Lucknow, India
| | - Rengarajan Madhu
- Department of Dermatology (Mycology), Madras Medical College, Chennai, India
| | - Saumya Panda
- Department of Dermatology, KPC Medical College, Kolkata, India
| | - Anupam Das
- Department of Dermatology, KPC Medical College, Kolkata, India
| | - Mahendra Kura
- Department of Dermatology, Grant Medical College, Sir JJ Group of Hospitals, Mumbai, India
| | | | - Daniela Koch
- Laboratory for Medical Microbiology, Mölbis, Germany
| | - Yvonne Gräser
- Universitätsmedizin Berlin-Charité, Institut für Mikrobiologie und Hygiene, Nationales Konsiliarlabor für Dermatophyten, Berlin, Germany
| | - Silke Uhrlaß
- Laboratory for Medical Microbiology, Mölbis, Germany
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Kupsch C, Czaika VA, Deutsch C, Gräser Y. Trichophyton mentagrophytes - a new genotype of zoophilic dermatophyte causes sexually transmitted infections. J Dtsch Dermatol Ges 2019; 17:493-501. [PMID: 30775844 DOI: 10.1111/ddg.13776] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2018] [Accepted: 08/28/2018] [Indexed: 11/30/2022]
Abstract
BACKGROUND A new genotype of the zoophilic fungal species Trichophyton (T.) mentagrophytes was recently described in two studies. It was isolated from three patients who had visited Southeast Asia and one patient who had visited Egypt. In contrast to these studies, we have observed a number of cases with the dimensions of an epidemic outbreak. PATIENTS AND METHODS At the University Hospital Charité Berlin, 43 patients, mostly suffering from highly inflammatory, painful and persistent infections of the pubogenital region were observed between January 2016 and July 2017. Mycological examination was performed with fungal culture and sequencing of the ITS (internal transcribed spacer) region of the ribosomal DNA. Three additional genomic regions were spot-checked. RESULTS In 37 of the cases, a new genotype of T. mentagrophytes (referred to here as T. mentagrophytes VII) was isolated as the etiological agent, and sequencing revealed identical sequences for all isolates. Most of the infected patients had no history of travel, and only two patients reported contact with animals. CONCLUSIONS The new genotype clustered phylogenetically among the strains of the zoophilic species T. mentagrophytes with four different DNA markers. While human-to-human transmission of zoophilic dermatophytes is rare, transmission via sexual contact seemed to be quite effective here.
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Affiliation(s)
- Christiane Kupsch
- National Reference Laboratory for Dermatophytes, Institute for Microbiology, Infectious Diseases and Immunology, Charité - University Medicine Berlin, Berlin, Germany
| | | | - Cornelia Deutsch
- Department of Dermatology, Venerology and Allergology, Charité - University Medicine Berlin, Berlin, Germany
| | - Yvonne Gräser
- National Reference Laboratory for Dermatophytes, Institute for Microbiology, Infectious Diseases and Immunology, Charité - University Medicine Berlin, Berlin, Germany
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Unequal distribution of the mating type ( MAT ) locus idiomorphs in dermatophyte species. Fungal Genet Biol 2018; 118:45-53. [DOI: 10.1016/j.fgb.2018.07.003] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2018] [Revised: 07/08/2018] [Accepted: 07/14/2018] [Indexed: 11/23/2022]
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