Trichophyton concentricum fungal infections and skin microbiomes of Indigenous Peninsular Malaysians

Yi Xian Er¹, Soo Ching Lee², Chioma Aneke³, Sean Conlan⁴, Azdayanti Muslim⁵, Clay Deming⁴, You Che⁶, Nan Jiun Yap⁷, Mian Zi Tee⁷, Nurmanisha Abdull-Majid⁷, Shezryna Shahrizal⁸, Kin Fon Leong⁹, Jungmin Han⁶, Zeyang Shen⁴, Leslie Thian Lung Than¹⁰, Morgan Park¹¹, Izandis Mohd Sayed¹²; NISC Comparative Sequencing Program¹¹; Amir Seyedmousavi³, Heidi H Kong¹³, P'ng Loke¹⁴, Julia A Segre¹⁵, Yvonne Ai Lian Lim¹⁶

Affiliations

¹ Department of Parasitology, Faculty of Medicine, Universiti Malaya, 50603 Kuala Lumpur, Malaysia; Laboratory of Parasitic Diseases, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD 20892, USA.
² Laboratory of Parasitic Diseases, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD 20892, USA.
³ Microbiology Service, Department of Laboratory Medicine, Clinical Center, National Institutes of Health, Bethesda, MD 20892, USA.
⁴ Microbial Genomics Section, Translational and Functional Genomics Branch, National Human Genome Research Institute, National Institutes of Health, Bethesda, MD 20892, USA.
⁵ Department of Medical Microbiology and Parasitology, Faculty of Medicine, Universiti Teknologi MARA (Sungai Buloh Campus), 47000 Sungai Buloh, Malaysia; Institute for Biodiversity and Sustainable Development, Universiti Teknologi MARA, 40450 Shah Alam, Selangor, Malaysia.
⁶ Dermatology Branch, National Institute of Arthritis and Musculoskeletal and Skin Diseases, National Institutes of Health, Bethesda, MD 20892, USA.
⁷ Department of Parasitology, Faculty of Medicine, Universiti Malaya, 50603 Kuala Lumpur, Malaysia.
⁸ Department of Medical Microbiology and Parasitology, Faculty of Medicine, Universiti Teknologi MARA (Sungai Buloh Campus), 47000 Sungai Buloh, Malaysia.
⁹ Dermatology Unit, Women and Children Hospital Kuala Lumpur, Jalan Pahang, 50586 Kuala Lumpur, Malaysia.
¹⁰ Department of Medical Microbiology, Universiti Putra Malaysia, UPM, 43400 Serdang, Selangor Darul Ehsan, Malaysia.
¹¹ NIH Intramural Sequencing Center, National Human Genome Research Institute, National Institutes of Health, Bethesda, MD 20892, USA.
¹² Hospital Orang Asli (Aborigines) Gombak, Jalan Pahang Lama, 53100 Kuala Lumpur, Malaysia.
¹³ Dermatology Branch, National Institute of Arthritis and Musculoskeletal and Skin Diseases, National Institutes of Health, Bethesda, MD 20892, USA. Electronic address: heidi.kong@nih.gov.
¹⁴ Laboratory of Parasitic Diseases, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD 20892, USA. Electronic address: png.loke@nih.gov.
¹⁵ Microbial Genomics Section, Translational and Functional Genomics Branch, National Human Genome Research Institute, National Institutes of Health, Bethesda, MD 20892, USA. Electronic address: jsegre@nhgri.nih.gov.
¹⁶ Department of Parasitology, Faculty of Medicine, Universiti Malaya, 50603 Kuala Lumpur, Malaysia; Centre for Malaysian Indigenous Studies, Universiti Malaya, 50603 Kuala Lumpur, Malaysia. Electronic address: limailian@um.edu.my.

PMID: 40532696
PMCID: PMC12335371 (available on 2026-06-17)
DOI: 10.1016/j.cell.2025.05.034

Trichophyton concentricum fungal infections and skin microbiomes of Indigenous Peninsular Malaysians

Yi Xian Er et al. Cell. 2025.

. 2025 Aug 7;188(16):4257-4274.e13.

doi: 10.1016/j.cell.2025.05.034. Epub 2025 Jun 17.

Authors

Affiliations

¹ Department of Parasitology, Faculty of Medicine, Universiti Malaya, 50603 Kuala Lumpur, Malaysia; Laboratory of Parasitic Diseases, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD 20892, USA.
² Laboratory of Parasitic Diseases, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD 20892, USA.
³ Microbiology Service, Department of Laboratory Medicine, Clinical Center, National Institutes of Health, Bethesda, MD 20892, USA.
⁴ Microbial Genomics Section, Translational and Functional Genomics Branch, National Human Genome Research Institute, National Institutes of Health, Bethesda, MD 20892, USA.
⁵ Department of Medical Microbiology and Parasitology, Faculty of Medicine, Universiti Teknologi MARA (Sungai Buloh Campus), 47000 Sungai Buloh, Malaysia; Institute for Biodiversity and Sustainable Development, Universiti Teknologi MARA, 40450 Shah Alam, Selangor, Malaysia.
⁶ Dermatology Branch, National Institute of Arthritis and Musculoskeletal and Skin Diseases, National Institutes of Health, Bethesda, MD 20892, USA.
⁷ Department of Parasitology, Faculty of Medicine, Universiti Malaya, 50603 Kuala Lumpur, Malaysia.
⁸ Department of Medical Microbiology and Parasitology, Faculty of Medicine, Universiti Teknologi MARA (Sungai Buloh Campus), 47000 Sungai Buloh, Malaysia.
⁹ Dermatology Unit, Women and Children Hospital Kuala Lumpur, Jalan Pahang, 50586 Kuala Lumpur, Malaysia.
¹⁰ Department of Medical Microbiology, Universiti Putra Malaysia, UPM, 43400 Serdang, Selangor Darul Ehsan, Malaysia.
¹¹ NIH Intramural Sequencing Center, National Human Genome Research Institute, National Institutes of Health, Bethesda, MD 20892, USA.
¹² Hospital Orang Asli (Aborigines) Gombak, Jalan Pahang Lama, 53100 Kuala Lumpur, Malaysia.
¹³ Dermatology Branch, National Institute of Arthritis and Musculoskeletal and Skin Diseases, National Institutes of Health, Bethesda, MD 20892, USA. Electronic address: heidi.kong@nih.gov.
¹⁴ Laboratory of Parasitic Diseases, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD 20892, USA. Electronic address: png.loke@nih.gov.
¹⁵ Microbial Genomics Section, Translational and Functional Genomics Branch, National Human Genome Research Institute, National Institutes of Health, Bethesda, MD 20892, USA. Electronic address: jsegre@nhgri.nih.gov.
¹⁶ Department of Parasitology, Faculty of Medicine, Universiti Malaya, 50603 Kuala Lumpur, Malaysia; Centre for Malaysian Indigenous Studies, Universiti Malaya, 50603 Kuala Lumpur, Malaysia. Electronic address: limailian@um.edu.my.

PMID: 40532696
PMCID: PMC12335371 (available on 2026-06-17)
DOI: 10.1016/j.cell.2025.05.034

Abstract

Recent outbreaks of multidrug-resistant fungi infecting human skin emphasize the importance of understanding fungal pathophysiology and spread. In efforts to address health concerns with various Indigenous Peninsular Malaysians (Orang Asli [OA]), tinea imbricata-a Trichophyton concentricum fungal skin infection-emerged as a particular concern. We investigated the etiology and transmission of tinea imbricata by culturing, testing antifungal sensitivities, and sequencing T. concentricum isolates in remote OA villages. Among regionally conserved isolates, we identified the emergence of terbinafine-resistant T. concentricum microbiologically and genomically. Investigating the skin microbiomes of 82 Indigenous OA, we found unique microbiota and lower relative abundances of bacterial commensals (Cutibacterium acnes, Staphylococcus epidermidis) among OA versus Malaysian and US urban populations, emphasizing how understudied populations provide unprecedented knowledge on host-microbiome co-evolution. These findings provide valuable insights into clinical, microbiological, and genomic features of chronic fungal skin infections, offering the potential to inform strategies to address drug resistance and effective therapy.

Keywords: Indigenous; Trichophyton; fungi; metagenome-assembled genomes; skin microbiome; strain sharing; terbinafine resistance; tinea; urbanization.

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Conflict of interest statement

Declaration of interests The authors declare no competing interests.

References

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Trichophyton concentricum fungal infections and skin microbiomes of Indigenous Peninsular Malaysians

Affiliations

Trichophyton concentricum fungal infections and skin microbiomes of Indigenous Peninsular Malaysians

Authors

Affiliations

Abstract

Conflict of interest statement

References

MeSH terms

Substances

Supplementary concepts

Grants and funding

LinkOut - more resources

Full Text Sources

Medical