Emergence of Terbinafine Resistant Trichophyton mentagrophytes in Iran, Harboring Mutations in the Squalene Epoxidase (SQLE) Gene

Taghipour, Simin and Shamsizadeh, Forough and Pchelin, Ivan M. and Rezaei-Matehhkolaei, Ali and Zarei Mahmoudabadi, Ali and Valadan, Reza and Ansari, Saham and Katiraee, Farzad and Pakshir, Keyvan and Zomorodian, Kamiar and Abastabar, Mahdi (2020) Emergence of Terbinafine Resistant Trichophyton mentagrophytes in Iran, Harboring Mutations in the Squalene Epoxidase (SQLE) Gene. Infection And Drug Resistance, 13. ISSN 1178-6973

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Abstract

Introduction: Trichophyton mentagrophytes and T. interdigitale are important causative agents of superficial mycoses, demonstrating emergent antifungal drug resistance. We studied the antifungal susceptibility profiles in Iranian isolates of these two species. Methods: A total of 96 T. interdigitale and 45 T. mentagrophytes isolates were subjected to molecular typing by ribosomal ITS region. Antifungal susceptibility profiles for terbinafine, griseofulvin, clotrimazole, efinaconazole, luliconazole, amorolfine and ciclopirox were obtained by CLSI broth microdilution method. The squalene epoxidase (SQLE) gene was subjected to sequencing for mutations, if any, in isolates exhibiting elevated MICs for terbinafine. Results: Luliconazole and efinaconazole showed the lowest MIC values against T. mentagrophytes and T. interdigitale isolates. There were five isolates with terbinafine MICs >= 32 mu g/mL in our sample. They belonged to T. mentagrophytes type VIII and harbored two alternative SQLE gene sequence variants, leading to Phe397Leu and Ala448Thr or Leu393Ser and Ala448Thr substitutions in the enzyme. All terbinafine resistant strains could be inhibited by luliconazole and efinaconazole. Conclusion: This study documented a step in the global spread of resistance mechanisms in T. mentagrophytes. However, treatment alternatives for resistant isolates were available. Keywords:Trichophyton mentagrophytes; SQLE; terbinafine; antifungal drug resistance; Iran

Item Type: Article
Subjects: QW Microbiology and Immunology
QX Parasitology
Divisions: Faculty of Medicine > Basic Sciences Academic Groups > Department of Parasitology and Mycology
Depositing User: zeynab . bagheri
Date Deposited: 20 Apr 2020 04:13
Last Modified: 20 Apr 2020 04:13
URI: http://eprints.skums.ac.ir/id/eprint/8168

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