Nascimento Teresa, Inácio João, Guerreiro Daniela, Patrício Patrícia, Proença Luís, Toscano Cristina, Barroso Helena
Egas Moniz Center for Interdisciplinary Research (CiiEM); Egas Moniz School of Health & Science, Caparica, Almada, 2829-511, Portugal.
Instituto Higiene e Medicina Tropical Universidade Nova de Lisboa, Lisboa, Portugal.
BMC Microbiol. 2025 Sep 29;25(1):589. doi: 10.1186/s12866-025-04288-7.
The skin mycobiome is a largely unexplored component of the human microbiome, especially in critically ill patients. Fungal colonisation in the Intensive Care Unit (ICU) may be influenced by underlying comorbidities and hospital-related risk factors, potentially impacting patient outcomes. This pilot study aimed to characterize the diversity and abundance of skin fungi in ICU patients during their first week of hospitalization. A total of 35 ICU patients were recruited and divided into two groups: Group 1 (patients with 1-2 comorbidities and ICU risk factors) and Group 2 (patients with more than 2 comorbidities and ICU risk factors). Bilateral axillary-groin swabs were collected on admission day (D1) and after one week of ICU stay (D8) for fungal identification. Culture-based methods and MALDI-TOF MS were initially used, followed by Internal Transcribed Spacer 2 (ITS2) sequencing via the Illumina MiSeq platform for in-depth analysis of fungal communities. Fungal diversity and relative abundance were assessed using standard alpha and beta diversity metrics. Culture and MALDI-TOF MS identified only Candida spp., suggesting limited diversity. ITS2 sequencing revealed that Candida (69.3%) was the most prevalent genus, followed by Penicillium (10.3%) and Cladosporium (4.0%), with Malassezia being rare (0.7%). Diversity analysis indicated a relatively stable fungal community throughout the first week (ANOSIM, p = 0.499), with no significant changes in species richness or community structure. By Day 8, Candida spp. represented 79.9% and 78.9% of the mycobiome in Groups 1 and 2, respectively. Preliminary data suggest that the ICU skin mycobiome is dominated by Candida spp. and exhibits low fungal diversity. These findings provide foundational insight into the skin mycobiome of critically ill patients and underscore the need for further research to elucidate its clinical significance and potential role in patient management.
皮肤真菌微生物群是人类微生物群中一个很大程度上未被探索的组成部分，尤其是在重症患者中。重症监护病房（ICU）中的真菌定植可能受到潜在合并症和医院相关风险因素的影响，这可能会影响患者的预后。这项前瞻性研究旨在描述ICU患者住院第一周皮肤真菌的多样性和丰度。总共招募了35名ICU患者，并将其分为两组：第1组（有1-2种合并症和ICU风险因素的患者）和第2组（有2种以上合并症和ICU风险因素的患者）。在入院当天（D1）和ICU住院一周后（D8）采集双侧腋窝-腹股沟拭子进行真菌鉴定。最初使用基于培养的方法和基质辅助激光解吸电离飞行时间质谱（MALDI-TOF MS），随后通过Illumina MiSeq平台进行内转录间隔区2（ITS2）测序，以深入分析真菌群落。使用标准的α和β多样性指标评估真菌多样性和相对丰度。培养和MALDI-TOF MS仅鉴定出念珠菌属，表明多样性有限。ITS2测序显示，念珠菌（69.3%）是最常见的属，其次是青霉属（10.3%）和枝孢属（4.0%），马拉色菌属较少见（0.7%）。多样性分析表明，在第一周内真菌群落相对稳定（相似性分析，p = 0.499），物种丰富度或群落结构没有显著变化。到第8天，念珠菌属分别占第1组和第2组真菌微生物群的79.9%和78.9%。初步数据表明，ICU皮肤真菌微生物群以念珠菌属为主，真菌多样性较低。这些发现为重症患者的皮肤真菌微生物群提供了基础性见解，并强调需要进一步研究以阐明其临床意义以及在患者管理中的潜在作用。
