A Review of Antifungal Susceptibility Testing for Dermatophyte Fungi and It’s Correlation with Previous Exposure and Clinical Responses

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Background: An increase in the number of recurrent and recalcitrant dermatophytoses calls for a tool to guide the clinician to correlate in vitro minimum inhibitory concentration (MIC) data, antifungal treatment with clinical outcomes. This systematic review aims to explore a possible correlation between one aspect of this, previous antifungal exposure, and clinical outcomes. Methods: A systematic literature search for articles on previous antifungal treatment, treatment outcome, susceptibility methods used, organism (genus/species), and MIC values was conducted. Results: A total of 720 records were identified of which 19 articles met the inclusion criteria. Forty percent of the cases had contact with or travel to India, 28% originated from or had traveled to other countries where treatment unresponsive tinea infections had been reported. Tinea corporis was the most common clinical presentation and the species involved were Trichophyton (T.) indotineae and T. rubrum, followed by T. mentagrophyte/interdigitale complex and T. tonsurans. Nearly all patients had previously been exposed to one or more antifungals. The studies were too heterogeneous to perform a statistical analysis to test if previous antifungal exposure was related to resistance. Conclusions: Only a few studies were identified, which had both sufficient and robust data on in vitro susceptibility testing and clinical treatment failure. Further research on the value of susceptibility testing to improve clinical practice in the management of dermatophyte infections is needed.

OriginalsprogEngelsk
Artikelnummer1290
TidsskriftJournal of Fungi
Vol/bind8
Udgave nummer12
DOI
StatusUdgivet - 2022

Bibliografisk note

Funding Information:
P.C. acknowledge Director of the Indian Institute of Technology (BHU) Varanasi, India for encouragement and providing the necessary facility for completion of this work. The authors would like to thank the Central Instrument Facility (CIF), Indian Institute of Technology (BHU), Varanasi for the characterization studies. D. would like to thank the Prime Minister’s Research Fellowship (PMRF), the Ministry of Education, Government of India for financial support. Author S.M. acknowledge INSPIRE Fellowship (IF170804), Department of Science and Technology, Government of India for providing research supports. Author acknowledges the support from DST-funded I-DAPT Hub Foundation, IIT BHU [DST/NMICPS/TIH11/IIT(BHU)2020/02].

Publisher Copyright:
© 2022 by the authors.

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