Abstract
Dermatophytes are among the most common fungal agents causing superficial skin infections worldwide. Epidemiology of these infections is evolving and variable in every country. This report presents the Belgian epidemiological data regarding the distribution of dermatophytes species isolated by the two national reference centers for mycosis during a period of 5 years (2012–2016). Trichophyton rubrum was the most frequently isolated species, considering all sampling sites (60.3% on average between 2012 and 2016). More precisely, this dermatophyte was the major agent of Tinea unguium and Tinea corporis during this period, followed by species of the Trichophyton mentagrophytes complex. Moreover, Microsporum audouinii was the main etiological agent of Tinea capitis (TC) with a frequency of 52.5% on average between 2012 and 2016. Other African dermatophytes species such as Trichophyton soudanense and Trichophyton violaceum were also agents of TC with a respective prevalence of 11.6% and 11.5% on average. This study highlights a different dermatophyte distribution in Belgium in comparison with other European countries.
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17 September 2021
A Correction to this paper has been published: https://doi.org/10.1007/s11046-021-00590-w
References
Weitzman I, Summerbell RC. The dermatophytes. Clin Microbiol Rev. 1995;8:240–59.
Havlickova B, Czaika VA, Friedrich M. Epidemiological trends in skin mycoses worldwide. Mycoses. 2008;51(Suppl. 4):2–15.
Seebacher C, Bouchara JP, Mignon B. Updates on the epidemiology of dermatophyte infections. Mycopathologia. 2008;166:335–52.
de Hoog GS, Dukik K, Monod M, Packeu A, Stubbe D, Hendrickx M, et al. Toward a novel multilocus phylogenetic taxonomy for the dermatophytes. Mycopathologia. 2017;182:5–31.
Sahni K, Singh S, Dogra S. Newer topical treatments in skin and nail dermatophyte infections. Indian Dermatol Online J. 2018;9:149–58.
Kolivras A, Lateur N, De Maubeuge J, Scheers C, Wiame L, Song M. Tinea capitis in Brussels: epidemiology and new management strategy. Dermatology. 2003;206:384–7.
Phalet K, Swyngedouw M. Measuring immigrant integration: the case of Belgium. Studi Emigr. 2003;152:773–803.
Sacheli R, Hayette MP. No Title. Annu Reports Belgian Natl Ref Cent Mycoses n.d. https://nrchm.wiv-isp.be/fr/centres_ref_labo/mycosis/Rapports/Forms/AllItems.aspx.
Larone DH. Medically important fungi. A guide to identification. 2nd ed. Washington, D. C: American Society for Microbiology; 1993. p. 240.
Ferrer C, Colom F, Frasés S, Mulet E, Abad JL, Alió JL. Detection and identification of fungal pathogens by PCR and by ITS2 and 5.8S ribosomal DNA typing in ocular infections. J Clin Microbiol. 2001;39:2873–9.
Drakensjö IT, Chryssanthou E. Epidemiology of dermatophyte infections in Stockholm, Sweden: a retrospective study from 2005–2009. Med Mycol. 2011;49:484–8.
Borman AM, Campbell CK, Fraser M, Johnson EM. Analysis of the dermatophyte species isolated in the British Isles between 1980 and 2005 and review of worldwide dermatophyte trends over the last three decades. Med Mycol. 2007;45:131–41.
Nenoff P, Krüger C, Ginter-Hanselmayer G, Tietz H-J. Mycology - an update. Part 1: dermatomycoses: causative agents, epidemiology and pathogenesis. J Dtsch Dermatol Ges. 2014;12:188–209.
Budak A, Bogusz B, Tokarczyk M, Trojanowska D. Dermatophytes isolated from superficial fungal infections in Krakow, Poland, between 1995 and 2010. Mycoses. 2013;56:422–8.
Asticcioli S, Di Silverio A, Sacco L, Fusi I, Vincenti L, Romero E. Dermatophyte infections in patients attending a tertiary care hospital in northern Italy. New Microbiol. 2008;31:543–8.
Zhan P, Liu W. The changing face of dermatophytic infections worldwide. Mycopathologia. 2017;182:77–86.
Ghannoum MA, Hajjeh RA, Scher R, Konnikov N, Gupta AK, Summerbell R, et al. A large-scale North American study of fungal isolates from nails: the frequency of onychomycosis, fungal distribution, and antifungal susceptibility patterns. J Am Acad Dermatol. 2000;43:641–8.
Gupta AK, Gupta G, Jain HC, Lynde CW, Foley KA, Daigle D, et al. The prevalence of unsuspected onychomycosis and its causative organisms in a multicentre Canadian sample of 30 000 patients visiting physicians’ offices. J Eur Acad Dermatol Venereol. 2016;30:1567–72.
Kemna ME, Elewski BEAUS. epidemiologic survey of superficial fungal diseases. J Am Acad Dermatol. 1996;35:539–42.
Hernández-Salazar A, Carbajal-Pruneda P, Fernández Martínez R, Arenas R. Dermatophytosis due to Trichophyton rubrum. Ten-year period (1996–2006) data collection in a dermatology department in Mexico City. Rev Iberoam Micol. 2007;24:122–4.
Kouotou EA, Nguena Feungue U, Kechia FA, Iwewe Somo Y, Nansseu JR, Moyou SR. Mycological profile of onychomycosis in Yaoundé, Cameroon. J Mycol Med. 2017;27:238–44.
Garg A, Venkatesh V, Singh M, Pathak KP, Kaushal GP, Agrawal SK. Onychomycosis in central India: a clinicoetiologic correlation. Int J Dermatol. 2004;43:498–502.
Lee WJ, Kim SL, Jang YH, Lee SJ, Kim DW, Bang YJ, et al. Increasing prevalence of Trichophyton rubrum identified through an analysis of 115,846 cases over the last 37 years. J Korean Med Sci. 2015;30:639–43.
Lee WJ, Park KH, Kim MS, Lee SJ, Kim DW, Bang YJ, et al. Decreasing incidence of Trichophyton mentagrophytes in Korea: analysis of 6,250 cases during the last 21-year-period (1992–2012). J Korean Med Sci. 2014;29:272–6.
Dolenc-Voljč M. Dermatophyte infections in the Ljubljana region, Slovenia, 1995–2002. Mycoses. 2005;48:181–6.
Uhrlaß S, Krüger C, Nenoff P. Microsporum canis: current data on the prevalence of the zoophilic dermatophyte in central Germany. Hautarzt. 2015;66:855–62.
Singh D, Patel DC, Rogers K, Wood N, Riley D, Morris AJ. Epidemiology of dermatophyte infection in Auckland, New Zealand. Australas J Dermatol. 2003;44:263–6.
Zamani S, Sadeghi G, Yazdinia F, Moosa H, Pazooki A, Ghafarinia Z, et al. Epidemiological trends of dermatophytosis in Tehran, Iran: a five-year retrospective study. J Mycol Med. 2016;26:351–8.
Mochizuki T, Kawasaki M, Ishizaki H, Kano R, Hasegawa A, Tosaki H, et al. Molecular epidemiology of Arthroderma benhamiae, an emerging pathogen of dermatophytoses in Japan, by polymorphisms of the non-transcribed spacer region of the ribosomal DNA. J Dermatol Sci. 2001;27:14–20.
Jankowska-Konsur A, Dylag M, Hryncewicz-Gwóźdź A, Plomer-Niezgoda E, Szepietowski JC. A 5-year survey of dermatomycoses in southwest Poland, years 2003–2007. Mycoses. 2011;54:162–7.
Popoola TOS, Ojo DA, Alabi RO. Prevalence of dermatophytosis in junior secondary schoolchildren in Ogun state, Nigeria. Mycoses. 2006;49:499–503.
Sidat MM, Correia D, Buene TP. Tinea capitis among children at one suburban primary school in the city of Maputo, Mozambique. Rev Soc Bras Med Trop. 2007;40:473–5.
Oke OO, Onayemi O, Olasode OA, Omisore AG, Oninla OA. The prevalence and pattern of superficial fungal infections among school children in Ile-Ife, south-western Nigeria. Dermatol Res Pract. 2014;2014:842917.
Sacheli R, Adjetey C, Darfouf R, Harag S, Huynen P, Meex C, et al. A one-year survey of Microsporum audouinii infections in Belgium: epidemiological and genotypic characterization. Clin Microbiol Infect. 2016;22(285):e9-17.
Donghi D, Hauser V, Bosshard PP. Microsporum audouinii tinea capitis in a Swiss school: assessment and management of patients and asymptomatic carriers. Med Mycol. 2011;49:324–8.
Zink A, Papanagiotou V, Todorova A, Seidl HP, Niedermeier A, Ring J, et al. Outbreak of Microsporum audouinii in Munich—the return of infectious fungi in Germany. Mycoses. 2014;57:765–70.
Gits-Muselli M, Benderdouche M, Hamane S, Mingui A, Feuilhade De Chauvin M, Guigue N, et al. Continuous increase of Trichophyton tonsurans as a cause of tinea capitis in the urban area of Paris, France: a 5-year-long study. Med Mycol. 2017;55:476–84.
Vingataramin Y, Akhoundi M, Bruel C, Izri A, Brun S. Epidemiological and molecular characterization of a Trichophyton tonsurans epidemic in schools of a city in the northern suburbs of Paris, France. Clin Microbiol Infect. 2019;25:529–30.
Brito-Santos F, Figueiredo-Carvalho MHG, Coelho RA, Sales A, Almeida-Paes R. Tinea capitis by Microsporum audouinii: case reports and review of published global literature 2000–2016. Mycopathologia. 2017;182:1053–60.
Saunte DM, Svejgaard EL, Hædersdal M, Frimodt-Møller N, Jensen AM, Arendrup MC. Laboratory-based survey of dermatophyte infections in Denmark over a 10-year period. Acta Derm Venereol. 2008;88:614–6.
Gawdzik A, Nowogrodzka K, Hryncewicz-Gwóźdź A, Maj J, Szepietowski J, Jankowska-Konsur A. Epidemiology of dermatomycoses in southwest Poland, years 2011–2016. Postepy Dermatol Alergol. 2019;36:604–8.
Jankowska-Konsur A, Dylag M, Szepietowski JC. Tinea capitis in southwest Poland. Mycoses. 2009;52:193–4.
Fleece D, Gaughan JP, Aronoff SC. Griseofulvin versus terbinafine in the treatment of tinea capitis: a meta-analysis of randomized, clinical trials. Pediatrics. 2004;114:1312–5.
Gupta AK, Sibbald RG, Lynde CW, Hull PR, Prussick R, Shear NH, et al. Onychomycosis in children: prevalence and treatment strategies. J Am Acad Dermatol. 1997;36:395–402.
Lateur N, Mortaki A, Andre J. Two hundred ninety-six cases of onychomycosis in children and teenagers: a 10-year laboratory survey. Pediatr Dermatol. 2003;20:385–8.
Romano C, Papini M, Ghilardi A, Gianni C. Onychomycosis in children: a survey of 46 cases. Mycoses. 2005;48:430–7.
Lange M, Roszkiewicz J, Szczerkowska-Dobosz A, Jasiel-Walikowska E, Bykowska B. Onychomycosis is no longer a rare finding in children. Mycoses. 2006;49:55–9.
Lange M, Nowicki R, Barańska-Rybak W, Bykowska B. Dermatophytosis in children and adolescents in Gdansk, Poland. Mycoses. 2004;47:326–9.
Nenoff P, Ginter-Hanselmayer G, Tietz H-J. Fungal nail infections—an update: part 1—prevalence, epidemiology, predisposing conditions, and differential diagnosis. Hautarzt. 2012;63:30–8.
Haugaard LK, Skov L, Arendrup MC, Saunte DM. Onychomycosis is rare in young children, and treatment is a task for dermatological specialists. Ugeskr Laeger. 2013;175:2343–4.
Kim DM, Suh MK, Ha GY. Onychomycosis in children: an experience of 59 cases. Ann Dermatol. 2013;25:327–34.
Bhatia VK, Sharma PC. Epidemiological studies on dermatophytosis in human patients in Himachal Pradesh, India. Springerplus. 2014;3:134.
Maraki S, Mavromanolaki VE. Epidemiology of dermatophytoses in crete, greece: a 5-year survey. Med Mycol J. 2016;57:E69–75.
Aghamirian MR, Ghiasian SA. Dermatophytoses in outpatients attending the dermatology center of Avicenna hospital in Qazvin, Iran. Mycoses. 2008;51:155–60.
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All authors contributed to the study conception and design. Material preparation, data collection and analysis were performed by RS, AA and RD. The first draft of the manuscript was written by RS, KL, LC and MPH commented and contributed on previous versions of the manuscript. MPH supervised and validated the study. All authors read and approved the final manuscript.
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The original online version of this article was revised: The authors first and last name was swapped and incorrectly published. The correct first and last name of the authors are “Rosalie Sacheli, Lize Cuypers, Laurence Seidel, Rajae Darfouf, Caroline Adjetey, Katrien Lagrou, Marie-Pierre Hayette”.
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Sacheli, R., Cuypers, L., Seidel, L. et al. Epidemiology of Dermatophytes in Belgium: A 5 Years’ Survey. Mycopathologia 186, 399–409 (2021). https://doi.org/10.1007/s11046-021-00542-4
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DOI: https://doi.org/10.1007/s11046-021-00542-4