Mycotic Diseases Branch, Centers for Disease Control and Prevention , Atlanta, Georgia, USA.
J Clin Microbiol. 2023 Dec 19;61(12):e0090323. doi: 10.1128/jcm.00903-23. Epub 2023 Nov 28.
Dermatophyte infections (a.k.a. ringworm, tinea) affect an estimated 20%-25% of the world's population. In North America, most dermatophytoses are caused by or species complexes. Severe and antifungal-resistant dermatophytoses are a growing global public health problem. A new species of the species complex, , has recently emerged and is notable for the severe infections it causes, its propensity for antifungal resistance, and its global spread. In this issue of the , C. F. Cañete-Gibas, J. Mele, H. P. Patterson, et al. (J Clin Microbiol 61:e00562-23, 2023, https://doi.org/10.1128/JCM.00562-23) summarize the results of speciation and AFST performed on North American dermatophyte isolates received at a fungal diagnostic reference laboratory. Within their collection, 18.6% of isolates were resistant to terbinafine (a first-line oral antifungal for dermatophytoses), and similar proportions of and demonstrated terbinafine resistance. The authors also found that has been present in North America since at least 2017. These findings highlight the importance of increased surveillance efforts to monitor trends in severe and antifungal-resistant dermatophytoses and the need for antifungal stewardship efforts, the success of which is contingent upon improving laboratory capacity for dermatophyte speciation and AFST.
皮肤癣菌感染（又称体癣、癣）估计影响了全球 20%-25%的人口。在北美，大多数皮肤癣菌病是由 或 种复合体引起的。严重的和抗真菌耐药的皮肤癣菌病是一个日益严重的全球公共卫生问题。种复合体的一个新物种 ，最近出现，其引起的严重感染、抗真菌耐药性倾向及其在全球的传播值得注意。在本期《临床微生物学杂志》上，C. F. Cañete-Gibas、J. Mele、H. P. Patterson 等人（J Clin Microbiol 61:e00562-23, 2023, https://doi.org/10.1128/JCM.00562-23）总结了在真菌诊断参考实验室收到的北美皮肤癣菌分离株进行种鉴定和抗真菌药敏试验（AFST）的结果。在他们的样本中，18.6%的分离株对特比萘芬（治疗皮肤癣菌病的一线口服抗真菌药物）耐药， 和 同样比例的分离株表现出特比萘芬耐药。作者还发现 自 2017 年以来就存在于北美。这些发现强调了加强监测严重和抗真菌耐药性皮肤癣菌病趋势以及进行抗真菌药物管理努力的重要性，成功与否取决于提高皮肤癣菌种鉴定和 AFST 的实验室能力。
