ORIGINAL RESEARCH article
Front. Microbiol.
Sec. Infectious Agents and Disease
Volume 16 - 2025 | doi: 10.3389/fmicb.2025.1582147
This article is part of the Research TopicPathogenic microorganisms and biosafetyView all articles
A six-year retrospective study on the causative agent of onychomycosis in China: Emerging dematiaceous fungi
Provisionally accepted
- 1The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
- 2Shaanxi Provincial People's Hospital, Xi'an, Shaanxi Province, China
- 3Shanghai Changzheng Hospital, Huangpu, Shanghai Municipality, China
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Onychomycosis, a prevalent nail disease, is caused by a diverse spectrum of pathogens worldwide. However, the epidemiology and pathogen profile of onychomycosis in China remain insufficiently characterized. This study aims 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 clinically suspected onychomycosis patients were cultured and analyzed for 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 patients, with a male-to-female ratio of 1:1.45. Dermatophytes were the most prevalent causative agents (36.18%), followed by yeasts (28.29%) and non-dermatophyte molds (28.29%). Among dermatophytes, Trichophyton species (34.9%) were the most frequently identified, followed by Candida (21.7%) and dematiaceous fungi (8.6%). Dermatophytes were the predominant pathogens in patients aged 18-50 years. Toenails (63.04%) were more commonly affected than 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 pathogens that present unique treatment challenges and warrant increased clinical attention.
Keywords: Onychomycosis, Epidemiology, Trichophyton, Dematiaceous, Dermatophytes
Received: 24 Feb 2025; Accepted: 11 Apr 2025.
Copyright: © 2025 Ye, Tian, Liao, Pan, Liu, Zhang, Yang and Zhang. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Lei Zhang, Shaanxi Provincial People's Hospital, Xi'an, 710068, Shaanxi Province, China
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