法国男男性行为者中须癣毛癣菌ITS基因型VII感染：一种持续存在的现象。
Trichophyton mentagrophytes ITS genotype VII infections among men who have sex with men in France: An ongoing phenomenon.
作者信息
Jabet A, Bérot V, Chiarabini T, Dellière S, Bosshard P P, Siguier M, Tubiana R, Favier M, Canestri A, Makhloufi S, Nouchi A, de Risi-Pugliese T, Boquel F, Crémer G, Khoury R, Sidali O, Hamane S, Benderdouche M, Palous M, Chasset F, Gräser Y, Hubka V, Fekkar A, Hennequin C, Piarroux R, Normand A-C, Monsel G
机构信息
Department of Parasitology and Mycology, La Pitié-Salpêtrière Hospital, Assistance Publique-Hôpitaux de Paris (AP-HP), Pierre-Louis Institute of Epidemiology and Public Health (IPLESP), INSERM, Sorbonne University, Paris, France.
Department of Parasitology and Mycology, Saint-Antoine Hospital, Assistance Publique-Hôpitaux de Paris (AP-HP), Pierre-Louis Institute of Epidemiology and Public Health (IPLESP), INSERM, Sorbonne University, Paris, France.
出版信息
J Eur Acad Dermatol Venereol. 2025 Feb;39(2):407-415. doi: 10.1111/jdv.20439. Epub 2024 Nov 26.
BACKGROUND
Trichophyton mentagrophytes ITS genotype VII (TMVII) has recently been identified in France as the causative agent of dermatophyte infections transmitted during sexual activity among men who have sex with men (MSM).
OBJECTIVES
Our objective was to provide new insights into the epidemiology, clinical presentation and treatment of TMVII infections based on cases diagnosed from October 2022 to September 2023 in three medical mycology laboratories in Paris. Additionally, we aimed to perform molecular characterization of TMVII strains collected in Paris, as well as in Switzerland.
METHODS
We identified all isolates from skin and hair belonging to the T. mentagrophytes complex by sequencing the ITS region. For isolates corresponding to TMVII, clinical data were retrieved from medical records. For all available TMVII strains that we isolated since January 2021, we sequenced tef1α and tubb and determined the MAT locus idiomorph.
RESULTS
We identified 32 cases of TMVII Infections. All cases occurred in men, 30 of whom reported having sex with men. Fifteen cases were sporadic cases including four among sex workers. The other 17 cases belonged to a single cluster involving a tantric masseur who infected 15 clients and his roommate. The median time from massage to lesion onset was 16 [2-52] days. Except for one patient, all other patients received systemic antifungal treatment with terbinafine. We observed five patients whose cultures remained positive even after 3-4 weeks of treatment and five patients experienced a relapse of the infection after discontinuing antifungal treatment. All French isolates exhibited identical tef1α and tubb sequences, as well as the same MAT idiomorph locus. They displayed variations in the tef1α sequence compared to isolates from Switzerland and the Czech Republic.
CONCLUSIONS
We confirm the active circulation of TMVII among MSM in France, which is associated with challenges in diagnosis, treatment and prevention.
背景
须癣毛癣菌ITS基因型VII（TMVII）最近在法国被确认为男男性行为者（MSM）性活动期间传播的皮肤癣菌感染的病原体。
目的
我们的目标是基于2022年10月至2023年9月在巴黎三个医学真菌学实验室诊断的病例，对TMVII感染的流行病学、临床表现和治疗提供新的见解。此外，我们旨在对在巴黎以及瑞士收集的TMVII菌株进行分子特征分析。
方法
我们通过对ITS区域进行测序，鉴定了所有属于须癣毛癣菌复合体的皮肤和毛发分离株。对于对应于TMVII的分离株，从病历中检索临床数据。对于我们自2021年1月以来分离的所有可用TMVII菌株，我们对tef1α和tubb进行测序，并确定MAT基因座特异性形态。
结果
我们鉴定出32例TMVII感染病例。所有病例均发生在男性中，其中30人报告有男男性行为。15例为散发病例，包括4例性工作者。其他17例属于单个聚集性病例，涉及一名密宗按摩师，他感染了15名客户及其室友。从按摩到皮损出现的中位时间为16 [2 - 52]天。除一名患者外，所有其他患者均接受了特比萘芬全身抗真菌治疗。我们观察到5例患者即使在治疗3 - 4周后培养物仍呈阳性，5例患者在停止抗真菌治疗后感染复发。所有法国分离株均表现出相同的tef1α和tubb序列，以及相同的MAT特异性形态基因座。与来自瑞士和捷克共和国的分离株相比，它们在tef1α序列上存在差异。
结论
我们证实TMVII在法国的男男性行为者中活跃传播，这与诊断、治疗和预防方面的挑战相关。
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