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Dermal fungal infections seem to have increased over recent years. There is further a shift from anthropophilic dermatophytes to a growing prevalence of zoophilic species and the emergence of resistant strains. New antifungals are needed to combat these fungi and their resting spores. This study aimed to investigate the sporicidal effects of sertaconazole nitrate using microplate laser nephelometry against the microconidia of Trichophyton, chlamydospores of Epidermophyton, blastospores of Candida, and conidia of the mold Scopulariopsis brevicaulis. The results obtained were compared with those from ciclopirox olamine and terbinafine. The sporicidal activity was further determined using infected three-dimensional full skin models to determine the antifungal effects in the presence of human cells. Sertaconazole nitrate inhibited the growth of dermatophytes, molds, and yeasts. Ciclopirox olamine also had good antifungal activity, although higher concentrations were needed compared to sertaconazole nitrate. Terbinafine was highly effective against most dermatophytes, but higher concentrations were required to kill the resistant strain Trichophyton indotineae. Sertaconazole nitrate, ciclopirox olamine, and terbinafine had no negative effects on full skin models. Sertaconazole nitrate reduced the growth of fungal and yeast spores over 72 h. Ciclopirox olamine and terbinafine also inhibited the growth of dermatophytes and molds but had significantly lower effects on the yeast. Sertaconazole nitrate might have advantages over the commonly used antifungals ciclopirox olamine and terbinafine in combating resting spores, which persist in the tissues, and thus in the therapy of recurring dermatomycoses., (© 2021 The Authors. MicrobiologyOpen published by John Wiley & Sons Ltd.)

Background: An alarming increase in recalcitrant dermatophytosis has been witnessed in India over the past decade. Drug resistance may play a major role in this scenario., Objectives: The aim of the present study was to determine the prevalence of in vitro resistance to terbinafine, itraconazole and voriconazole in dermatophytes, and to identify underlying mutations in the fungal squalene epoxidase (SQLE) gene., Patients/methods: We analysed skin samples from 402 patients originating from eight locations in India. Fungi were identified by microbiological and molecular methods, tested for antifungal susceptibility (terbinafine, itraconazole, voriconazole), and investigated for missense mutations in SQLE., Results: Trichophyton (T.) mentagrophytes internal transcribed spacer (ITS) Type VIII was found in 314 (78%) samples. Eighteen (5%) samples harboured species identified up to the T interdigitale/mentagrophytes complex, and T rubrum was detected in 19 (5%) samples. 71% of isolates were resistant to terbinafine. The amino acid substitution Phe397Leu in the squalene epoxidase of resistant T mentagrophytes was highly prevalent (91%). Two novel substitutions in resistant Trichophyton strains, Ser395Pro and Ser443Pro, were discovered. The substitution Ala448Thr was found in terbinafine-sensitive and terbinafine-resistant isolates but was associated with increased MICs of itraconazole and voriconazole., Conclusions: The high frequencies of terbinafine resistance in dermatophytes are worrisome and demand monitoring and further research. Squalene epoxidase substitutions between Leu393 and Ser443 could serve as markers of resistance in the future., (© 2020 The Authors. Mycoses published by Blackwell Verlag GmbH.)

Tinea capitis describes a dermatophyte infection of scalp and hair that predominately occurs in children. The diagnostic workup includes microscopic examination, culture and/or molecular tests. Treatment is guided by the specific organism involved and should consist of systemic agents as well as adjuvant topical treatment. The aim of the present update of the interdisciplinary German S1 guidelines is to provide dermatologists, pediatricians and general practitioners with a decision tool for selecting and implementing appropriate diagnostic and therapeutic measures in patients with tinea capitis. The guidelines were developed based on current international guidelines, in particular the 2010 European Society for Pediatric Dermatology guidelines and the 2014 British Association of Dermatologists guidelines, as well as on a review of the literature conducted by the guideline committee. This multidisciplinary committee consists of representatives from the German Society of Dermatology (DDG), the German-Speaking Mycological Society (DMykG), the German Society for Hygiene and Microbiology (DGHM), the German Society of Pediatric and Adolescent Medicine (DGKJ) and the German Society for Pediatric Infectious Diseases (DGPI). The Division of Evidence-based Medicine (dEBM) provided methodological assistance. The guidelines were approved by the participating medical societies following a comprehensive internal and external review., (© 2020 The Authors | Journal compilation © Blackwell Verlag GmbH, Berlin.)

In Germany, infections due to the zoophilic dermatophyte Trichophyton (T.) species of Arthroderma benhamiae are being more frequently diagnosed. The source of infection of this emerging pathogen overlaps with that of the zoophilic species T. interdigitale. The most common source are guinea pigs. T. species of Arthroderma benhamiae causes inflammatory dermatophytosis in children and adolescents. In addition to tinea capitis, it may cause both tinea corporis, tinea manus and frequently tinea faciei. In Germany, T. species of Arthroderma benhamiae is a frequent zoophilic dermatophyte, which in regions is probably more frequent than Microsporum canis. The mycological identification of the isolates with their yellow stained colonies is based on their macroscopic and microscopic features. However, some exhibit colony features consistent with those of T. interdigitale. These strains only can be identified unambiguously by means of molecular techniques. Using detection methods such as PCR-ELISA or real-time PCR, the dermatophyte can be identified directly from clinical material. Sequencing of the internal transcribed spacer region (ITS) of the ribosomal DNA has been approved as culture confirmation test for T. species of Arthroderma benhamiae. In addition, matrix-assisted laser desorption/ionization time-of-flight mass spectrometry (MALDI TOF MS) is useful. Widespread dermatophytosis due to T. species of Arthroderma benhamiae, in particular of tinea capitis, requires oral antifungal agents. Terbinafine is most effective, alternatives are fluconazole and itraconazole., (© 2014 Deutsche Dermatologische Gesellschaft (DDG). Published by John Wiley & Sons Ltd.)

The skin is the interface between the body and the environment. Each skin type has a specific skin physiology and is more or less adapted for protection against multiple stress factors. Textiles on the other hand are the tissues with the longest contact to the human skin. They play a critical role especially in skin conditions with an increased rate of bacterial and fungal infections like atopic dermatitis and hyperhidrosis, and in diabetic patients and aged skin. The present study demonstrates the antifungal and antibacterial effects of SeaCell Active in an in vitro test system against Candida albicans (DSM 11225), Candida tropicalis (ATCC 1169), and Candida krusei (ATCC 6258). Furthermore, the antibacterial activity of fibers with different amounts of SeaCell Active fibers in a dose-dependent manner against Staphylococcus aureus (ATCC 22923) and Escherichia coli (ATCC 35218) could be demonstrated. If this fiber seems to be suited for bioactive textiles in specific anatomical regions and skin conditions with a susceptibility for fungal and bacterial infections due to Candida species, namely Staphylococcus aureus and Escherichia coli, must be examined by means of further investigations, especially in vivo tests in human, considering allergic and toxic effects of the fiber.

To determine the in vitro susceptibility of fungal organisms to beta-cyclodextrin (CD) complexes with the antifungal agents econazole-nitrate (EC) and ciclopirox-olamine (CI), a fast, rapid and simple method using laser nephelometry in 96-microtiter plate is used. The antimycotic influence of the complexes against Candida albicans DSM 11225 and Candida krusei ATCC 6258 species was determined using this method. A rapid inhibition and even killing of both fungi was observed only above certain concentrations of complex ranged between 12.5 and 100 microg/ml for beta-CD-econazole complex (CD-EC), while for the complex with ciclopirox-olamine (CD-CI) the range was between 150 and 400 microg/ml. The stability constants of the CD complexes with the two antimycotic derivatives are given. In addition, the nephelometric method allows the determination of solubilities of active agents. Thus, the improvement of solubility of both antimycotic agents in PBS buffer solution was observed by complexation with CD.

Summary: The disease burden of chronic‐relapsing and therapy‐refractory superficial dermatophytosis dramatically increased in India within the past 5‐6 years. In order to evaluate the prevalence of this trend, 201 skin scrapings were collected from patients from all parts of India and were tested for dermatophytes using both fungal culture and a PCR‐ELISA directly performed with native skin scrapings. Fungal culture material was identified by genomic Sanger sequencing of the internal transcribed spacer (ITS) region and the translation elongation factor (TEF)‐1α gene. In total, 149 (74.13%) out of the 201 samples showed a dermatophyte‐positive culture result. Out of this, 138 (92.62%) samples were identified as Trichophyton (T.) mentagrophytes and 11 (7.38%) as Trichophyton rubrum. The PCR‐ELISA revealed similar results: 162 out of 201 (80.56%) samples were dermatophyte‐positive showing 151 (93.21%) T mentagrophytes‐ and 11 (6.79%) T rubrum‐positive samples. In this study, we show for the first time a dramatic Indian‐wide switch from T rubrum to T mentagrophytes. Additionally, sequencing revealed a solely occurring T mentagrophytes "Indian ITS genotype" that might be disseminated Indian‐wide due to the widespread abuse of topical clobetasol and other steroid molecules mixed with antifungal and antibacterial agents. [ABSTRACT FROM AUTHOR]

Candida-related infections have become a major problem in hospitals. The species identification of yeast is the prerequisite for the initiation of adequate antifungal therapy. In the present study, the connection between inherent UV resonance Raman (RR) spectral profiles of Candida species and taxonomic differences was investigated for the first time. UV RR in combination with statistical modeling was applied to extract taxonomic information from the spectral fingerprints for subsequent differentiation. The identification accuracies of independent batch cultures were determined by applying a leave-one-batch-out cross validation. The quality of differentiation can be divided into three levels. Within a defined taxonomic group comprising the species C. glabrata, C. guilliermondii, and C. haemulonii, the identification accuracy was low. On the next level, the identification results of C. albicans and C. tropicalis were characterized by high sensitivities of 98 and 95% but simultaneously challenged by false-positive predictions due to the misallocation of C. spherica (as C. albicans) and C. viswanathii (as C. tropicalis). The highest level of identification accuracies was reached for the species C. dubliniensis, C. krusei, C. africana, C. novergica, and C. parapsilosis. Reliable identification results were observed with accuracies ranging from 93 up to 100%. The species allocation based on the UV RR spectral profiles could be reproduced by the identification of independent batch cultures. We conclude that the introduced spectroscopic approach is capable of transforming the high-dimensional UV RR data of Candida species into clinically useful decision parameters.Graphical abstract [ABSTRACT FROM AUTHOR]