Teaching about dermatophytosis in the era of antifungal resistance: design, implementation, and evaluation of a multidisciplinary workshop in Honduras.

backgroundThe global increase in fungal infections and the emergence of antifungal-resistant species, particularly Trichophyton indotineae, have exposed critical gaps in medical mycology training and diagnostic capacity, especially in low- and middle-income countries. Despite their high prevalence, dermatophytoses are underrepresented in health sciences curricula and continuing professional education, contributing to misdiagnosis, delayed treatment, and inappropriate antifungal use.

methodsWe designed, implemented, and evaluated a multidisciplinary educational workshop entitled “Medical Mycology: Dermatophytoses, New Challenges in the Era of Antifungal Resistance”, conducted in Honduras in September 2025. The 24-hour in-person intervention combined 16 h of theoretical instruction with 8 h of hands-on laboratory training and targeted healthcare professionals and laboratory personnel nationwide. Educational impact was assessed using pre- and post-intervention questionnaires evaluating knowledge on dermatophyte taxonomy, identification methods, epidemiology, and antifungal resistance. Additionally, a structured survey was applied to characterize participants’ institutional diagnostic capacities. Descriptive analyses were performed to compare pre- and post-workshop responses.

resultsAmong the 36 participants who completed both assessments, post-workshop results demonstrated substantial learning gains across all evaluated domains. The largest improvements were observed in recognition of recently revised dermatophyte genera and in understanding the transmission, clinical relevance, and terbinafine resistance mechanisms of T. indotineae. Correct response rates increased to near 100% for most items. The diagnostic capacity survey revealed that diagnostic practices in participating institutions are predominantly based on phenotypic methods, characterized by reliance on direct microscopy and culture, the exclusive use of morphological identification, and the absence of molecular methods, antifungal susceptibility testing, and MALDI-TOF mass spectrometry. The workshop also facilitated the development of standardized didactic materials and the establishment of a preliminary national network for future molecular surveillance.

conclusionsThis experience demonstrates that a structured, evidence-based educational intervention can significantly strengthen knowledge and practical skills in medical mycology. Such initiatives represent a scalable model to improve dermatophyte diagnosis and antifungal resistance awareness in resource-limited settings.