An emerging threat of drug-resistant fungal infections
- August 9, 2024
- Posted by: OptimizeIAS Team
- Category: DPN Topics
An emerging threat of drug-resistant fungal infections
Subject: Science and Tech
Sec: Health
Context:
The rise of drug-resistant fungal infections, notably Trichophyton indotineae, is emerging as a significant health concern in India. This resilient dermatophyte, linked to the misuse of topical steroids, poses challenges for both patients and healthcare providers.
More on News:
Many who face infections caused by Trichophyton indotineae, commonly known as ringworm or jock itch. First identified in India, this fungus has now spread to several countries worldwide. The inappropriate use of steroid creams has exacerbated the problem, making this strain particularly hard to treat.
This dermatophyte, found in various regions including Australia and Oman, belongs to genotype VIII within the T. mentagrophytes/T. interdigitale species complex.
Clinical Challenges and Symptoms:
- Patients often present with persistent, treatment-resistant rashes that can easily be mistaken for eczema or other skin conditions, delaying effective treatment.
- These rashes can be red, scaly, and itchy, making them similar to more common dermatological issues.
- The diagnostic process involves not just clinical examination but also laboratory tests, such as fungal cultures and molecular diagnostics, to confirm the presence of resistant fungal strains.
- Misdiagnosis and delayed treatment can lead to the spread of the infection, not only worsening the individual’s condition but also increasing the risk of transmission within the community.
Treatment options :
- Trichophyton indotineae is a newly-identified dermatophyte species that has been found in near-epidemic form on the Indian subcontinent.
- This fungus, identical to genotype VIII within the T. mentagrophytes/T. interdigitale species complex, was described in 2019 by sequencing the Internal Transcribed Spacer (ITS) region of ribosomal DNA.
- More than 10 ITS genotypes of T. interdigitale and T. mentagrophytes can now be identified. T. indotineae causes inflammatory and itchy, often widespread dermatophytosis affecting the groins, gluteal region, trunk, and face, affecting patients of all ages and genders.
- Alternative treatments such as itraconazole may be necessary. However, these alternatives often come with significant side effects, including gastrointestinal issues, liver toxicity, and interactions with other medications, and will require close monitoring by healthcare providers.
- One of the major reasons this is happening is the itraconazole drug formulations available are not of good quality. This results in suboptimal dosing, even if patients take it as prescribed. Unregulated sales of steroid-containing combination creams that may temporarily reduce the itch but contribute to resistance further complicate treatment efforts.
- Regular follow-ups with healthcare providers are essential to ensure effective management.
- Monitoring the patient’s response to treatment allows for timely adjustments to the treatment plan.
Prevention strategies:
Healthcare professionals strongly advise against the unsupervised use of combination creams containing steroids and antifungals, as these can contribute to drug resistance and worsen infections.
Public awareness campaigns are crucial to inform the public about the risks of self-medication and the importance of consulting healthcare professionals for skin conditions.
Maintaining good hygiene practices.
- Keeping the skin dry and clean is essential since moisture creates an ideal environment for fungal growth.
- Regularly washing and drying areas prone to sweating, such as the feet, groin, and armpits, can help reduce this risk.
- Avoiding sharing of personal items like towels, clothing, and grooming tools is another important preventive measure.
- Wearing breathable clothing, particularly loose-fitting fabrics like cotton, helps keep the skin dry and reduces sweating.
- Proper footwear, along with regular cleaning of bed linens, towels, and clothing in hot water, can kill fungal spores and reduce the risk of infection.
Public health concerns in India:
- Indians, living in a land that has a tropical climate and high population density, are particularly vulnerable to fungal infections.
- The prevalence of Trichophyton indotineae is a growing public health concern, especially in rural areas where access to healthcare is limited.
- Public health initiatives must focus on improving diagnostic facilities and ensuring the availability of effective treatments.