Firooz Alireza, Lotfali Ensieh, Fattahi Mahsa, Fattahi Maryam, Miramin Mohammadi Akram, Shahrzad Kavkani Mahshid
Center for Research and Training in Skin Diseases and Leprosy, Tehran University of Medical Sciences, Tehran, Iran.
Department of Medical Parasitology and Mycology, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Case Rep Dermatol Med. 2021 Nov 29;2021:9611072. doi: 10.1155/2021/9611072. eCollection 2021.
A 26-year-old male patient referred to our center with a history of extremely itchy crusted skin lesions in his groins for one year. Moreover, his friend, a 25-year-old male, also developed similar lesions in the groin after using the shared pool, whose condition also did not improve with similar treatment. A regular mycology test (direct and culture test) was performed, as well as molecular examination. The antifungal susceptibility assay to terbinafine, itraconazole, posaconazole, fluconazole, and voriconazole was conducted according to the Clinical and Laboratory Standards Institute M38 third ed. The sequencing study identified as the causative organism in both patients. The abovementioned organism isolated from both patients displayed resistance against terbinafine and fluconazole (MIC ≥ 4 g/ml and MIC ≥ 8 g/ml, respectively). Moreover, the susceptibility of both subjects to posaconazole (0.313 g/ml), voriconazole (0.25-0.0625 g/ml), and (1 g/ml) itraconazole increased. The present report aimed to emphasize the increase in antifungal resistance and a demand for antifungal stewardship, to control this public health threat.
一名26岁男性患者因腹股沟出现极度瘙痒的结痂性皮肤病变一年前来我院就诊。此外，他的朋友，一名25岁男性，在使用公共泳池后腹股沟也出现了类似病变，接受类似治疗后病情同样未改善。进行了常规真菌学检查（直接检查和培养检查）以及分子检测。根据临床和实验室标准协会M38第三版对特比萘芬、伊曲康唑、泊沙康唑、氟康唑和伏立康唑进行了抗真菌药敏试验。测序研究确定该菌为两名患者的病原体。从两名患者中分离出的上述病原体对特比萘芬和氟康唑耐药（MIC分别≥4μg/ml和≥8μg/ml）。此外，两名受试者对泊沙康唑（0.313μg/ml）、伏立康唑（0.25 - 0.0625μg/ml）和伊曲康唑（1μg/ml）的敏感性增加。本报告旨在强调抗真菌耐药性的增加以及对抗真菌管理的需求，以控制这一公共卫生威胁。
