Gupta Aditya K, Wang Tong, Lincoln Sara A, Bakotic Wayne L
Division of Dermatology, Department of Medicine, Temerty Faculty of Medicine, University of Toronto, Toronto, ON M5S 3H2, Canada.
Mediprobe Research Inc., London, ON N5X 2P1, Canada.
Microorganisms. 2025 Jan 16;13(1):184. doi: 10.3390/microorganisms13010184.
Up to one-quarter of the United States population is affected by tinea pedis (athlete's foot). Tinea pedis of the web space (interdigital tinea pedis) is a common clinical presentation causing skin macerations and fissures. A "dermatophytosis complex" (i.e., concomitant bacterial colonization) further complicates treatment. Here, we examined records of 14,429 skin specimens taken from the feet of dermatology and podiatry outpatients over a 4.6-year period; all specimens were subjected to multiplex qPCR diagnosis for the detection of dermatophytes, , , and . A literature search was conducted to review the reported prevalence of fungal and bacterial agents. In both interdigital and plantar foot specimens, dermatophytes (33.3-33.8%) and (24.3-25%) were found to be the predominate pathogens. In the interdigital space, a higher prevalence of (15.7% vs. 7.9%) and (23.5% vs. 9.6%) was found. The detection of was more likely to be observed in the presence of , reflecting a higher risk of mixed infection. In dermatophyte-positive specimens, the "dermatophytosis complex" variant was observed at 45.5% (SD: 2.3). An analysis of patient characteristics showed male patients exhibiting higher likelihoods for dermatophyte, , and detections. The elderly were disproportionately infected with . In children, an detection was more common, which could be attributed to impetigo. The recent literature lacks reporting on concomitant bacterial colonization in tinea pedis patients, likely due to the reliance on fungal culture supplemented with antibiotics. Geographical variation has been identified in the detection of the complex. In conclusion, PCR diagnosis serves as a valuable tool for the management of tinea pedis. An accurate and timely detection of fungal pathogens and concomitant bacterial colonization can better inform healthcare providers of appropriate treatment selection.
高达四分之一的美国人口受到足癣（脚气）的影响。趾间足癣是一种常见的临床表现，会导致皮肤浸渍和皲裂。“皮肤癣菌病复合体”（即伴随细菌定植）会使治疗更加复杂。在此，我们检查了4.6年期间从皮肤科和足病科门诊患者足部采集的14429份皮肤标本记录；所有标本都进行了多重定量聚合酶链反应诊断，以检测皮肤癣菌、 、 和 。进行了文献检索以回顾已报道的真菌和细菌病原体的患病率。在趾间和足底标本中，皮肤癣菌（33.3% - 33.8%）和 （24.3% - 25%）被发现是主要病原体。在趾间空间， （15.7%对7.9%）和 （23.5%对9.6%）的患病率更高。在存在 的情况下更有可能检测到 ，这反映了混合感染的风险更高。在皮肤癣菌阳性标本中，观察到“皮肤癣菌病复合体”变体的比例为45.5%（标准差：2.3）。对患者特征的分析表明，男性患者检测到皮肤癣菌、 、 和 的可能性更高。老年人感染 的比例过高。在儿童中， 检测更为常见，这可能归因于脓疱病。最近的文献缺乏关于足癣患者伴随细菌定植的报道，可能是由于依赖补充抗生素的真菌培养。在 复合体的检测中已发现地理差异。总之，聚合酶链反应诊断是管理足癣的有价值工具。准确及时地检测真菌病原体和伴随的细菌定植可以更好地为医疗保健提供者提供适当治疗选择的信息。
