The sensitivity of dermatophytosis pathogens to antifungal substances, antiseptics and disinfectants

Dermatophytes form the group of fungal pathogens of humans, which includes 43 species, of which the most important representatives are the genera Trichophyton and Microsporum. In recent years, patients with the established diagnoses of “mycosis pedis”, “skin mycosis of the palms” and “onychomycosis”, and associations of dermatophytes and moulds as well as dermatophytes as an aetiological factor in mixed infections and yeast-like fungi often play a role.

The main objective of the current study was to determine the susceptibility of dermatophytosis pathogens (Trichophyton spp., Microsporum spp.) isolated from samples of biological from patients with mycoses to modern antifungals, antiseptics and disinfectants.

Within the framework of this study, 142 clinical isolates of dermatophytes identified as Trichophyton spp. (n = 68) and Microsporum spp. (n = 74) were obtained from patients with diagnoses of “B35.3 Mycosis of the feet”, “B35.0 Microsporia”. It was found that the most active antifungal agents against clinical isolates of dermatophytes are itraconazole, terbinafine and amphotericin B. Among the studied clinical isolates of Trichophyton spp. in Microsporum spp. conditionally resistant strains to the studied antimycotics have been identified. Most of the studied clinical isolates of dermatophytes were high sensitive to antiseptics based on iodine, fucorcinol, undecylenic and boric acids. Disinfectants based on aldehydes, guanidine derivatives, triamines, and glycolic acid showed the greatest activity against clinical isolates of dermatophytes.

Based on our data, preference should be given to amphotericin B, itraconazole and terbinafine-based drugs when prescribing ethiotropic therapy for patients with dermatomycosis. It is advisable to use antipseptics and disinfectants for dermatomycosis, taking into account the sensitivity of micromycetes to them.

1. Lobanova, E. G., Chekalina N. D. Protivogribkovye sredstva. – 2021. – Access of mode: https:/www.rlsnet.ru/library/articles/dermatologiya/protivogribkovye-sredstva-40.

2. Ruppel’, V. V. Dermatofitiya. Kak diagnostirovat’ i lechit’ v usloviyah veterinarnoj kliniki [Electronic resource] / V. V. Ruppel’ // Dermatologiya. – 2018. – № 2. – Access of mode: https:/spbvet.info/zhurnaly/2-2018/dermatofitiya-kak-diagnostirovat-i-lechit-v-usloviyakh-veterinarnoy-kliniki. – Access of date: 22.03.2022.

3. Ustojchivost’ k protivogribkovym preparatam. – 2020. – Access of mode: https://www.who.int/ru/news-room/fact-sheets/detail/antimicrobial-resistance.

4. Gerasimchuk, E. V. Mikooptikfejs – sovremennyj diagnosticheskij algoritm / Medicina i vysokie tekhnologii. – 2017. – № 1. – С. 22–24.

5. Haghani, I., Shams-Ghahfarokhi M., Dalimi Asl A. et al. Molecular identification and antifungal susceptibility of clinical fungal isolates from onychomycosis (uncommon and emerging species) // Mycoses. – 2019. – № 62(2). – Р. 128–143. – doi: 10.1111/myc.12854

6. Gupta, A. K., Mays R. R., Versteeg S. G. et al. Update on current approaches to diagnosis and treatment of onychomycosis / Expert Rev Anti Infect Ther. – 2018. – № 16(12). – Р. 929–938. – doi: 10.1080/14787210.2018.1544891

7. Joyce, A., Gupta A. K., Koenig L. et al. Fungal Diversity and Onychomycosis: An analysis of 8,816 toenail samples using quantitative PCR and next-generation sequencing // J Am Podiatr Med Assoc. – 2019. – № 109(1). – Р. 57–63. – doi: 10.7547/17-070

8. Khurana, A., Masih A., Chowdhary A., Sardana K. Correlation of In Vitro Susceptibility Based on MICs and Squalene Epoxidase Mutations with Clinical Response to Terbinafine in Patients with Tinea Corporis/Cruris // Antimicrob Agents Chemother. – 2018. – Vol. 62. – Р. 1–9.

9. Saunte, D. M.L., Hare R. K., Jørgensen K. M. Emerging terbinafine resistance in Trichophyton: clinical characteristics, squalene epoxidase gene mutations and a reliable EUCAST method for detection // Antimicrob Agents Chemother. – 2019. – Vol. 63. – Р. 1–9.

10. Hsieh, A., Quenan S., Riat A., Toutous-Trellu L. A new mutation in the SQLE gene of Trichophyton mentagrophytes associated to terbinafine resistance in a couple with disse-minated tinea corporis // J Mycol Med. – 2019. – № 29. – Р. 352–355. https:/doi.org/10.1016/j.mycmed.2019.100903

11. Monod, M. Antifungal resistance in dermatophytes: emerging problem and challenge for the medical community / J Mycol Med. – 2019. – № 29. – Р. 283–284.

12. Singh, A., Masih A., Khurana A., Singh P. K. High terbinafine resistance in Trichophyton interdigitale isolates in Delhi, India harbouring mutations in the squalene epoxidase gene // Mycoses. – 2018. – Vol. 61. – Р. 477–484.

13. Taghipour, S., Shamsizadeh F., Pchelin I. M. Emergence of terbinafine resistant Trichophyton mentagrophytes in Iran, harboring mutations in the squalene epoxidase (Sqle) gene / Infect Drug Resist. – 2020. – № 13. – Р. 845–850.

14. Danielsen, A. G., Thomsen J. S., Svejgaard E. L. Severe skin rash in patients treated with terbinafine // Ugeskr Laeger. – 2006. – Vol. 168. – Р. 3825–3826.

15. Metody ocenki ustojchivosti gribov k antiseptikam i dezinfektantam: instrukciya po primeneniyu: utv. M-vom zdravoohraneniya 28.12.2018, reg. № 230-1218 [Electronic resource] / razrab. BGMU; avt.-sost.: Zh. F. Cirkunova [et al.]. – Minsk, 2018. – 6 s. – Access of mode: https:/www.bsmu.by/downloads/vrachu/instrukcii/2019/4.pdf. – Access of date: 22.03.2022.

16. How to: perform antifungal susceptibility testing of microconidia-forming dermatophytes following the new reference EUCAST method E. Def 11.0, exemplified by Trichophyton / M. C. Arendrup [et al.] // Clin. Microbiol. Infect. – 2021. – Vol. 27, № 1. – P. 55–60.