title: Continuous increase of Trichophyton tonsurans as a cause of tinea capitis in the urban area of Paris, France: a 5-year-long study.
abstract: Tinea capitis (TC) is a highly contagious fungal infection of the scalp due to dermatophytes in children. To obtain information on the epidemiology of TC in the urban area of Paris, we analysed the microbiological results of 3090 patients seen with suspected TC from October 2010 to September 2015 at Saint Louis hospital, Paris, France. A peak of TC was observed in 3-6 year-old children, followed by a progressive decrease until 16 years of age. Of the 1311 positive cultures, 95% (1246) yielded one of the three anthropophilic species [Trichophyton tonsurans (33.5%), Trichophyton soudanense (38.3%), or Microsporum audouinii (28.2%)]. When considering one TC case per family, we observed a significant increase of T. tonsurans (P = .018) during these 5 years. The increase was more pronounced (P = .0047) in patients of West-African descent (n = 666), and was at the expense of M. audouinii and T. soudanense. On the other hand, the Caribbean patients (n = 85) remained predominantly (72.9%) infected by T. tonsurans. Our results show a better virulence of T. tonsurans over other species as already reported. Since T. tonsurans has not been reported in Africa, the infection of patients of West-African descent probably took place in the Paris area by exchanges with Caribbean patients. This increase of TC due to T. tonsurans was observed in the context of griseofulvin being the only licensed paediatric treatment for TC in France, which should deserve reappraisal because terbinafine may be more efficacious.
authors.affiliation: Laboratoire de Parasitologie-Mycologie; AP-HP, Groupe Hospitalier Saint-Louis-Lariboisière-Fernand-Widal.|Université Paris-Diderot, Sorbonne Paris Cité.
authors.forename: Maud
authors.initials: M
authors.lastname: Gits-Muselli
authors.affiliation: Laboratoire de Parasitologie-Mycologie; AP-HP, Groupe Hospitalier Saint-Louis-Lariboisière-Fernand-Widal.
authors.forename: Mazouz
authors.initials: M
authors.lastname: Benderdouche
authors.affiliation: Laboratoire de Parasitologie-Mycologie; AP-HP, Groupe Hospitalier Saint-Louis-Lariboisière-Fernand-Widal.
authors.forename: Samia
authors.initials: S
authors.lastname: Hamane
authors.affiliation: Laboratoire de Parasitologie-Mycologie; AP-HP, Groupe Hospitalier Saint-Louis-Lariboisière-Fernand-Widal.
authors.forename: Anselme
authors.initials: A
authors.lastname: Mingui
authors.affiliation: Laboratoire de Parasitologie-Mycologie; AP-HP, Groupe Hospitalier Saint-Louis-Lariboisière-Fernand-Widal.|Université Paris-Diderot, Sorbonne Paris Cité.
authors.forename: Martine
authors.initials: M
authors.lastname: Feuilhade de Chauvin
authors.affiliation: Laboratoire de Parasitologie-Mycologie; AP-HP, Groupe Hospitalier Saint-Louis-Lariboisière-Fernand-Widal.
authors.forename: Nicolas
authors.initials: N
authors.lastname: Guigue
authors.affiliation: Service de Biostatistique et Information Médicale, AP-HP, Groupe Hospitalier Saint-Louis-Lariboisière-Fernand-Widal.
authors.forename: Marie-Quitterie
authors.initials: MQ
authors.lastname: Picat
authors.affiliation: Service de dermatologie, Groupe Hospitalier Saint-Louis-Lariboisière-Fernand-Widal, AP-HP.
authors.forename: Emmanuelle
authors.initials: E
authors.lastname: Bourrat
authors.affiliation: Service de dermatologie, Groupe Hospitalier Saint-Louis-Lariboisière-Fernand-Widal, AP-HP.
authors.forename: Antoine
authors.initials: A
authors.lastname: Petit
authors.affiliation: Université Paris-Diderot, Sorbonne Paris Cité.|Service de dermatologie, Groupe Hospitalier Saint-Louis-Lariboisière-Fernand-Widal, AP-HP.
authors.forename: Martine
authors.initials: M
authors.lastname: Bagot
authors.affiliation: Laboratoire de Parasitologie-Mycologie; AP-HP, Groupe Hospitalier Saint-Louis-Lariboisière-Fernand-Widal.|Université Paris-Diderot, Sorbonne Paris Cité.|Inserm U976.|Institut Pasteur, Molecular Mycology Unit, National Reference Center of Invasive Mycoses and Antifungals, Paris, France.
authors.forename: Alexandre
authors.initials: A
authors.lastname: Alanio
authors.affiliation: Laboratoire de Parasitologie-Mycologie; AP-HP, Groupe Hospitalier Saint-Louis-Lariboisière-Fernand-Widal.|Université Paris-Diderot, Sorbonne Paris Cité.|Inserm U976.|Institut Pasteur, Molecular Mycology Unit, National Reference Center of Invasive Mycoses and Antifungals, Paris, France.
authors.forename: Stéphane
authors.initials: S
authors.lastname: Bretagne
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000935:Antifungal Agents / Q000627:therapeutic use; D002648:Child; D002675:Child, Preschool; D005260:Female; D006118:Griseofulvin / Q000627:therapeutic use; D006801:Humans; D007223:Infant; D008297:Male; D008864:Microsporum / Q000302:isolation & purification; D008875:Middle Aged; D009281:Naphthalenes / Q000627:therapeutic use; D010297:Paris / Q000453:epidemiology; D012189:Retrospective Studies; D000077291:Terbinafine; D014006:Tinea Capitis / Q000175:diagnosis / Q000188:drug therapy / Q000453:epidemiology* / Q000382:microbiology*; D014249:Trichophyton / Q000302:isolation & purification* / Q000472:pathogenicity; D014774:Virulence; D055815:Young Adult
chemical_list: D000935:Antifungal Agents; D009281:Naphthalenes; D006118:Griseofulvin; D000077291:Terbinafine
keywords: Microsporum audouinii var. langeronii; Tinea capitis; Trichophyton soudanense; Trichophyton tonsurans