{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,31]],"date-time":"2026-07-31T23:28:53Z","timestamp":1785540533205,"version":"3.56.0"},"reference-count":37,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2026,6,5]],"date-time":"2026-06-05T00:00:00Z","timestamp":1780617600000},"content-version":"vor","delay-in-days":4,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,6,1]],"date-time":"2026-06-01T00:00:00Z","timestamp":1780272000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/501100012166","name":"National Key Research and Development Program of China","doi-asserted-by":"publisher","award":["2022YFC2504804"],"award-info":[{"award-number":["2022YFC2504804"]}],"id":[{"id":"10.13039\/501100012166","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Mycoses"],"published-print":{"date-parts":[[2026,6]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>\n                      The emergence of\n                      <jats:italic>Trichophyton indotineae<\/jats:italic>\n                      as a multidrug\u2010resistant dermatophyte has challenged conventional therapeutic approaches for dermatophytosis, leading to a significant therapeutic dilemma. The absence of formal epidemiological cutoff values (ECVs) under the Clinical and Laboratory Standards Institute (CLSI) framework has led to inconsistent interpretation of antifungal susceptibility testing (AFST) data, highlighting the urgent need for standardised susceptibility interpretation criteria and effective therapeutic strategies.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>\n                      This study aimed to (1) establish CLSI\u2010based estimated tentative ECVs (ET\u2010ECVs) to facilitate reliable minimum inhibitory concentration (MIC) interpretation; (2) analyse resistance rates of\n                      <jats:italic>T. indotineae<\/jats:italic>\n                      to terbinafine, itraconazole and voriconazole using a large\u2010scale global dataset and (3) explore and identify effective therapeutic options following first\u2010line treatment failure.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      This systematic review compiled global susceptibility data for\n                      <jats:italic>T. indotineae<\/jats:italic>\n                      through comprehensive literature searches, including only studies that performed CLSI\u2010 or European Committee on Antimicrobial Susceptibility Testing (EUCAST)\u2010standardised AFST. Furthermore, the clinical efficacy of voriconazole was specifically evaluated by summarising and analysing reported treatment cases.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>A total of 67 studies from 14 countries, comprising 981 isolates, were included. The proposed CLSI ET\u2010ECVs for terbinafine, itraconazole and voriconazole were 0.125, 0.25 and 1\u2009mg\/L, respectively, showing full alignment with EUCAST tentative epidemiological cutoff values (TECOFFs). Integrated resistance rates were 77.6% for terbinafine, 17.0% for itraconazole and 1.4% for voriconazole. Cross\u2010resistance analysis revealed that terbinafine resistance predominated, with 14.3% of isolates co\u2010resistant to itraconazole. In\u00a0vitro susceptibility data demonstrated high activity of voriconazole and clinical case summaries further confirmed its favourable therapeutic efficacy, with complete remission reported in all evaluated cases.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>\n                      This study defined the CLSI ET\u2010ECVs for interpreting\n                      <jats:italic>T. indotineae<\/jats:italic>\n                      MICs, highlighted the resistance burden to first\u2010line agents and provided in\u00a0vitro evidence supporting further evaluation of\u00a0voriconazole as a potential effective alternative therapy. These findings may provide critical warnings regarding the high\u2010resistance landscape and help guide antifungal susceptibility interpretation for this emerging multidrug\u2010resistant pathogen.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/myc.70195","type":"journal-article","created":{"date-parts":[[2026,6,5]],"date-time":"2026-06-05T11:07:12Z","timestamp":1780657632000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["The Global Antifungal Susceptibility Epidemiology of\n                    <i>Trichophyton indotineae<\/i>\n                    Indicating Voriconazole as an Alternative Therapy for Recalcitrant Dermatophytosis"],"prefix":"10.1111","volume":"69","author":[{"given":"Ge","family":"Song","sequence":"first","affiliation":[{"name":"Department of Dermatology, Beijing Shijitan Hospital Capital Medical University  Beijing 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