Antifungal resistance in dermatophytosis: A global health concern
Antifungal resistance in dermatophytes
DOI:
https://doi.org/10.62310/liab.v2i1.76Keywords:
Antimicrobials, Fungi, Mechanism of action, Resistance, InfectionAbstract
Dermatophytosis is a common dermatological problem in animals as well as humans which is associated with interference in immune function. Unlike the antibacterial resistance which is frequently reported, antifungal resistance is less commonly reported, but there are reports of emerging antifungal resistance in humans and animals. The problem of antifungal resistance can be more severe in comparison to any other drug resistance due to the limited number of antifungals available for therapeutic purpose. A number of mechanisms have been put forward to explain the phenomenon of antifungal drug resistance, such as, drug efflux by fungal cells, drug detoxification by fungal cells, resistance imposed by structural elements of the fungal cell, target gene mutations, etc. Currently, only three types of antifungal drugs are available – Azoles, Polyenes, and allylamines; therefore it is mandatory to use the antifungals rationally to contain the problem of rising antifungal resistance. To counter the problem of antifungal resistance indiscriminate over the counter use of antifungal drugs in the treatment of dermatophytosis need to be strongly discouraged. Furthermore, at the research level, whole genome sequencing of dermatophytes from around the world will aid in a better understanding of fungal pathophysiology and associated drug resistance, potentially leading to new approaches to overcome antifungal resistance. And, lastly the use of combination therapy offers an advantage of synergistic action of different antifungals with enhanced spectrum activity which could play instrumental role in reducing the antifungal resistance.
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Begum J, Mir NA, Lingaraju MC, Buyamayum B, Dev K. (2020). Recent advances in the diagnosis of dermatophytosis. Journal of Basic Microbiology 60: 293-303.
Bhatia V, Sharma P. (2015). Determination of minimum inhibitory concentrations of itraconazole, terbinafine and ketoconazole against dermatophyte species by broth microdilution method. Indian Journal of Medical Microbiology 33: 533–537.
Bontems O, Fratti M, Salamin K, Guenova E, Monod M. (2020). Epidemiology of dermatophytosis in Switzerland according to a survey of dermatophytes isolated in Lausanne between 2001 and 2018. Journal of Fungi (Basel) 6(2): 95.
Brilhante RSN, Correia EEM, Guedes GMM, Pereira VS, de Oliveira JS, Bandeira SP, de Alencar LP, de Andrade ARC, Castelo-Branco DSCM, Cordiero RA, Pinheiro AQ, Chaves LJQ, Neto WAP, Sidrim JJC, Rocha MFG. (2017). Quantitative and structural analyses of the in vitro and ex vivo biofilm-forming ability of dermatophytes. Journal of Medical Microbiology 66: 1045-1052.
CDC (2019). Antifungal resistance. In: Fungal diseases. https:// www.cdc.gov/fungal/antifungal-resistance.html (Online document, last reviewed on May 18, 2020)
Dabas Y, Xess I, Singh G, Pandey M, Meena S. (2017). Molecular identification and antifungal susceptibility patterns of clinical dermatophytes following CLSI and EUCAST guidelines. Journal of Fungi 3(2): 17.
Dogra S, Shaw D, Rudramurthy SM. (2019). Antifungal drug susceptibility testing of dermatophytes: Laboratory findings to clinical implications. Indian Dermatology Online Journal 10: 225-233.
El-Awady R, Saleh E, Hashim A, Soliman N, Dallah A, Elrashedd A, Elakraa G. (2016). The role of eukaryotic and prokaryotic ABC transporter family in failure of chemotherapy. Frontiers in Pharmacology 7:535.
Esch KJ, Brewer MT, Petersen CA. (2014). Pathogenesis of Important Zoonoses. In: Ed. McManus L, Mitchell R, editors, Pathobiology of Human Disease. Academic Press, USA. Pp. 1083-1100.
Ghelardi E, Celandroni F, Gueye SA, Salvetti S, Senesi S, Bulgheroni A, Mailland F. (2014). Potential of ergosterol synthesis inhibitors to cause resistance or cross-resistance in Trichophyton rubrum. Antimicrobial Agents in Chemotherapy 58: 2825–2829.
Gnat S, Lagowski S, Nowakiewicz A. (2020). Major challenges and perspectives in the diagnostics and treatment of dermatophyte infections. Journal of Applied Microbiology 129(2): 212-232.
Garcia-Rubio R, Monteiro MC, Mellado E. (2018). Azole Antifungal Drugs: Mode of Action and resistance. In: Reference Module in Life Sciences. https://doi.org/10.1016/ B978-0-12-809633-8.20731-0
Gupta C, Das S, Ramachandran VG, Saha R, Bhattacharya SN, Dar SA, Atri D. (2016). Possible role of Trichophytin antigen in inducing impaired immunological clearance of fungus in onychomycosis. Mycopathologia 181: 247–251.
Jacob TR, Peres NTA, Martins MP, Lang EAS, Sanches PR, Rossi A, Martinez-Rossi NM. (2015). Heat shock protein 90 (Hsp90) as a molecular target for the development of novel drugs against the dermatophyte Trichophyton rubrum. Frontiers in Microbiology 6: 1241.
Kanafani ZA, Perfect JR. (2008). Antimicrobial resistance: Resistance to antifungal agents: Mechanisms and clinical impact. Clinical Infectious Diseases 46: 120-128.
Khuranaa A, Sardana K, Chowdhary A. (2019). Antifungal resistance in dermatophytes: Recent trends and therapeutic implications. Fungal Genetics and Biology 132: 103255.
Lana AJD, Pippi B, Carvalho AR, Moraes RC, Kaiser S, Ortega GG, Fuentefria AM, Silveira GP. (2018). In Vitro additive effect on griseofulvin and terbinafine combinations against multidrug- resistant dermatophytes. Brazilian Journal of Pharmaceutical Sciences 54: e17149.
Martinez-Rossi NM, Bitencourt TA, Peres NTA, Lang EAS, Gomes EV, Quaresemin NR, Martins MP, Lpoes L, Rossi A. (2018). Dermatophyte Resistance to Antifungal Drugs: Mechanisms and Prospectus. Frontiers in Microbiology 9: 1108.
Martinez-Rossi NM, Peres NTA, Rossi A. (2008). Antifungal resistance mechanisms in dermatophytes. Mycopathologia 166: 369-383.
Pfaller MA. (2012). Antifungal drug resistance: mechanisms, epidemiology, and consequences for treatment. The American Journal of Medicine 125(1): S3-13.
Monod M, Feuermann M, Salamin K, Fratti M, Makino M, Alshahni MM, Makimura K, Yamada T. (2019). Trichophyton rubrum azole resistance mediated by a new ABC transporter, TruMDR3. Antimicrobial Agents in Chemotherapy 63(11): e00863-19.
Nucci M, Perfect JR. (2008). When primary antifungal therapy fails. Clinical Infectious Diseases 46(1): 1426-1433.
Newland JG, Abdel-Rahman SM. (2009). Update on terbinafne with a focus on dermatophytoses. Dermatology 2: 49-64.
Nigam PK. (2015). Antifungal drugs and resistance: Current concepts. Our Dermatology Online 6: 212-221.
Persinoti GF, de Aguiar Peres NT, Jacob TR, Rossi A, Vencio RZ, Martinez-Rossi NM. (2014). RNAsequencing analysis of Trichophyton rubrum transcriptome in response to sublethal doses of acriflavine. BMC Genomics 15(7): S1.
Rudramurthy SM, Shankarnarayan SA, Dogra S, Shaw D, Mushtaq K, Paul RA, Narang T, Chakrabarti A. (2018). Mutation in the squalene epoxidase gene of Trichophyton interdigitale and Trichophyton rubrum associated with allylamine resistance. Antimicrobial Agents in Chemotherapy 62: 1–9.
Sanglard D, Odds FC. (2002). Resistance of Candida species to antifungal agents: Molecular mechanisms and clinical consequences. Lancet Infect Diseases 2: 73-85.
Shivanna R, Inamadar AC. (2017). Clinical failure of antifungal therapy of dermatophytosis: Recurrence, resistance, and remedy. Indian Journal of Drugs in Deramtology 3: 1-3.
Singh A, Masih A, Khurana A, Singh PK, Gupta M, Hagen F, Meis JF, Chowdhary A. (2018). High terbinafine resistance in Trichophyton interdigitale isolates in Delhi, India harbouring mutations in the squalene epoxidase gene. Mycoses 61: 477–484.
Srinivasan A, Lopez-Ribot JL, Ramasubramanian AK. (2014). Overcoming antifungal resistance. Drug Discovery Today: Technologies 11: 65-71.
Sultana R, Wahiduzzaman M. (2018). Emerging threat in antifungal resistance on superficial dermatophyte infection. Bangladesh Medical Journal Khulna 51(1-2): 21-24.
Tamayo D, Munoz JF, Torres I, Almeida AJ, Restrepo A, McEwen JC, Hernandez O. (2013). Involvement of the 90 kDa heat shock protein during adaptation of Paracoccidioides brasiliensis to different environmental conditions. Fungal Genetics and Biology 51: 34–41.
Tiwari S. Thakur R. Shankar J. (2015). Role of heat-shock proteins in cellular function and in the biology of fungi. Biotechnology Research International 2015: 132635. https://doi.org/ 10.1155/2015/132635
Verma S, Madhu R. (2017). The great Indian epidemic of superficial dermatophytosis: An appraisal. Indian Journal of Dermatology 62: 227–236.
Wiederhold NP. (2017). Antifungal resistance: current trends and future strategies to combat. Infection and Drug Resistance 10: 249-259.
Yamada T, Maeda M, Alshahni MM, Tanaka R, Yaguchi T, Bontems O, Salamin K, Fratti M, Monod M. (2017). Terbinafine resistance of Trichophyton clinical isolates caused by specific point mutations in the Squalene epoxidase gene. Antimicrobial Agents in Chemotherapy 61: e00115–17.
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Accepted 2022-05-08
Published 2022-05-08