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. 2020 Sep 29;6(4):195.
doi: 10.3390/jof6040195.

Belgian National Survey on Tinea Capitis: Epidemiological Considerations and Highlight of Terbinafine-Resistant T. mentagrophytes with a Mutation on SQLE Gene

Rosalie Sacheli  1 , Saadia Harag  2 , Florence Dehavay  2 , Séverine Evrard  3 , Danielle Rousseaux  4 , Akole Adjetey  1 , Laurence Seidel  5 , Kim Laffineur  6 , Katrien Lagrou  7 , Marie-Pierre Hayette  1
Affiliations

Belgian National Survey on Tinea Capitis: Epidemiological Considerations and Highlight of Terbinafine-Resistant T. mentagrophytes with a Mutation on SQLE Gene

Rosalie Sacheli et al. J Fungi (Basel). .

Abstract

Background: In this last decade, a huge increase in African anthropophilic strains causing tinea capitis has been observed in Europe. The Belgian National Reference Center for Mycosis (NRC) conducted a surveillance study on tinea capitis in 2018 to learn the profile of circulating dermatophytes.

Methods: Belgian laboratories were invited to send all dermatophyte strains isolated from the scalp with epidemiological information. Strain identification was confirmed by ITS (Internal Transcribed Spacer) sequencing. Mutation in the squalene epoxidase (SQLE) gene was screened by PCR.

Results: The main population affected by tinea capitis was children from 5-9 years. Males were more affected than females. The majority of the strains were collected in the Brussels area followed by the Liege area. Among known ethnic origins, African people were more affected by tinea capitis than European people. The major aetiological agent was Microsporum audouinii, followed by Trichophyton soudanense. One strain of Trichophyton mentagrophytes has been characterized to have a mutation on the squalene epoxidase gene and to be resistant to terbinafine.

Conclusions: African anthropophilic dermatophytes are mainly responsible for tinea capitis in Belgium. People of African origin are most affected by tinea capitis. The monitoring of terbinafine resistance among dermatophytes seems necessary as we have demonstrated the emergence of resistance in T. mentagrophytes.

Keywords: Belgium; dermatophytes; prevalence; resistance; terbinafine; tinea capitis.

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Conflict of interest statement

Authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Geographical distribution all around Belgium of cases of tinea capitis collected during the study (n = 336, one localization not known).
Figure 2
Figure 2
Description of the prevalence of dermatophytes species among the 337 cases of recorded tinea capitis.
Figure 3
Figure 3
Macromorphology (A) and micromorphology (B) of the N. incurvata strain isolated in the study.
Figure 4
Figure 4
(A) Mutation Phe397Leu on the SQLE gene of T. mentagrophytes strain n° 13-180730-0023 surrounded in red. (B) MIC determination for terbinafine; the MIC value is surrounded in red and is equal to 4 mg/L.
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