Ye Xin, Tian Jun, Liao Wanqing, Pan Weihua, Liu Zhe, Zhang Jiaming, Yang Li, Zhang Lei
Department of Laboratory Medicine, The First Affiliated Hospital of Xi'an Jiao Tong University, Xi'an, China.
Department of Dermatology, Shaanxi Provincial People's Hospital, The Third Affiliated Hospital of Xi'an Jiao Tong University, Xi'an, China.
Front Microbiol. 2025 May 1;16:1582147. doi: 10.3389/fmicb.2025.1582147. eCollection 2025.
Onychomycosis, a common nail disease, is caused by a diverse range of pathogens worldwide. However, the epidemiology and pathogen profile of onychomycosis in China remain insufficiently characterized. This study aimed to investigate these aspects in a large Chinese hospital.
A six-year retrospective analysis was conducted at a tertiary hospital in China, where nail samples from 298 patients who were clinically suspected of onychomycosis were cultured and analyzed to identify causative agents and clinical features.
Of the 298 samples, 51.00% (152) were positive for fungal infection. Young adults (18-30 years) comprised the majority of the patients, with a man-to-woman ratio of 1:1.45. Dermatophytes were the most prevalent causative agents (36.18%), followed by yeasts (28.29%) and non-dermatophyte molds (NDMs) (28.29%). Among dermatophytes, species (34.9%) were the most frequently identified, followed by (21.7%) and dematiaceous fungi (8.6%). Dermatophytes were the predominant pathogens in the patients aged 18-50 years. The toenails (63.04%) were more commonly affected than the fingernails (36.96%), with bilateral toenail involvement (34.07%) being the most frequent.
While dermatophytes remain the leading cause of onychomycosis in China, non-dermatophyte molds, particularly dematiaceous fungi, are emerging as significant pathogens. These organisms present unique treatment challenges and warrant increased clinical attention.
甲癣是一种常见的指甲疾病，在全球范围内由多种病原体引起。然而，中国甲癣的流行病学和病原体特征仍未得到充分描述。本研究旨在对一家大型中国医院的这些方面进行调查。
在中国一家三级医院进行了为期六年的回顾性分析，对298例临床怀疑患有甲癣的患者的指甲样本进行培养和分析，以确定病原体和临床特征。
在298份样本中，51.00%（152份）真菌感染呈阳性。年轻成年人（18 - 30岁）占患者大多数，男女比例为1:1.45。皮肤癣菌是最常见的病原体（36.18%），其次是酵母菌（28.29%）和非皮肤癣菌霉菌（NDMs）（28.29%）。在皮肤癣菌中， 种（34.9%）是最常鉴定出的，其次是 （21.7%）和暗色真菌（8.6%）。皮肤癣菌是18 - 50岁患者中的主要病原体。趾甲（63.04%）比指甲（36.96%）更常受累，双侧趾甲受累（34.07%）最为常见。
虽然皮肤癣菌仍然是中国甲癣的主要病因，但非皮肤癣菌霉菌，特别是暗色真菌，正成为重要的病原体。这些病原体带来了独特的治疗挑战，值得临床更多关注。
