T. indotineae: A New Emergent Fungal Pathogen Driven by Global Travel
Abstract
Background: The global spread of Trichophyton indotineae, a multidrug-resistant dermatophyte, remains insufficiently understood due to limited data on migration-associated dissemination and emerging local transmission. This study reviewed available evidence and integrated international migration statistics to assess the worldwide distribution of this pathogen and the influence of human mobility on its expansion.
Methods: A systematic search in Scopus and PubMed (September 9, 2025) included epidemiological studies, case reports, and letters. Extracted variables comprised country of diagnosis, probable country of infection, and reported transmission scenarios. Migration data from the International Organization for Migration were incorporated to explore links between population movements and fungal spread, including indirect or undocumented routes.
Results: Of the 224 publications identified, 89 met the inclusion criteria, reporting a total of 1215 cases outside India across 36 countries. Europe accounted for 545 cases, followed by North America with 90 cases and Oceania with 87 cases, while South America and Africa reported only sporadic detections. Fifty studies described imported infections, whereas 11 documented autochthonous transmission. Integrated analysis revealed three primary dissemination corridors: intra-Asian, Asia-Europe, and Asia-America.
Conclusions: Trichophyton indotineae is now globally disseminated and strongly shaped by travel and migration. Coordinated…
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Evidence Hub reads this as a systematic review, done in people. Its evidence level is 1 of 5 (Highest · pooled evidence). Pooled evidence from several studies sits at the top of the evidence pyramid.
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