BibTex format
@article{Rhodes:2026:10.1016/j.lanmic.2025.101273,
author = {Rhodes, J and Hui, ST and Dellière, S and Summerbell, RC and Scott, JA and Kaur, A and Barton, RC and Leitao, R and Hemmings, S and Goiriz, R and Lambourne, J and Farrer, RA and Schelenz, S and Hay, RJ and Borman, AM and Chowdhary, A and Abdolrasouli, A and Fisher, MC},
doi = {10.1016/j.lanmic.2025.101273},
journal = {The Lancet Microbe},
title = {Emerging terbinafine-resistant Trichophyton indotineae between 2018 and 2023: a multinational genomic epidemiology study},
url = {http://dx.doi.org/10.1016/j.lanmic.2025.101273},
volume = {7},
year = {2026}
}
RIS format (EndNote, RefMan)
TY - JOUR
AB - BackgroundTrichophyton species cause the greatest burden of dermatophytosis worldwide, with the Trichophyton mentagrophytes species complex being particularly associated with the emergence of new aggressive infections. One emerging species, Trichophyton indotineae is notable for its clinical resistance to terbinafine antifungal treatment and rapid global spread. In this study we aim to characterise the epidemiology of this emerging pathogen using genomics.MethodsIn this retrospective genomic epidemiology study, to better understand the epidemiology of this disease, we sourced isolates collected from patients with severe cases of dermatophytosis (identified either by internal transcribed spacer sequencing or phenotypic characterisation) in the UK, Ireland, France, Canada, and India for the period 2014–23, including the T indotineae type strain from Japan. We used whole-genome sequencing to confirm 90 isolates were T indotineae, and antifungal susceptibility testing to assess susceptibility to terbinafine.Findings103 cases of severe dermatophytosis caused by Trichophyton species collected between 2018 and 2023 in the UK, France, Canada, Ireland, and India were included in this study. Susceptibility testing indicated that 63 (70%) of 90 T indotineae isolates were resistant to terbinafine (minimum inhibitory concentration [MIC] ≥0·5 mg/L). Pairwise genetic distances showed very high identity with only 147 (range 1–414) single-nucleotide polymorphisms (SNPs) separating isolates that were nested within a monophyletic phylogeny, supporting a single evolutionary origin of T indotineae. Genome-wide analyses identified multiple non-synonymous SNPs in SQLE (ERG1), the squalene epoxidase target of terbinafine, that were associated with terbinafine in vitro resistance of 0·5 mg/L or higher. However, six isolates exhibited high MIC values without SQLE mutations, suggesting the presence of alternative resistance mechanisms.InterpretationThat no clear g
AU - Rhodes,J
AU - Hui,ST
AU - Dellière,S
AU - Summerbell,RC
AU - Scott,JA
AU - Kaur,A
AU - Barton,RC
AU - Leitao,R
AU - Hemmings,S
AU - Goiriz,R
AU - Lambourne,J
AU - Farrer,RA
AU - Schelenz,S
AU - Hay,RJ
AU - Borman,AM
AU - Chowdhary,A
AU - Abdolrasouli,A
AU - Fisher,MC
DO - 10.1016/j.lanmic.2025.101273
PY - 2026///
SN - 2666-5247
TI - Emerging terbinafine-resistant Trichophyton indotineae between 2018 and 2023: a multinational genomic epidemiology study
T2 - The Lancet Microbe
UR - http://dx.doi.org/10.1016/j.lanmic.2025.101273
VL - 7
ER -