| RRC ID |
85186
|
| 著者 |
Ohara S, Noguchi H, Matsumoto T, Kubo M, Hayashi D, Kashiwada-Nakamura K, Yaguchi T, Kano R.
|
| タイトル |
Emerging Antifungal-Resistant Onychomycosis in a Dermatology Clinic in Kumamoto, Japan.
|
| ジャーナル |
Med Mycol J
|
| Abstract |
We examined 477 patients with culture-positive onychomycosis at the Noguchi Dermatology Clinic between July 2015 and June 2024. Toenail onychomycosis (n = 422) was caused by Trichophyton rubrum (78.0%), Trichophyton interdigitale (19.0%), non-dermatophyte mould (2.8%) and Candida species (0.2%). Fingernail onychomycosis (n = 69) was caused by Candida species (46.4%), T. rubrum (43.5%), T. interdigitale (2.9%), non-dermatophyte mould (4.3%), and Trichosporon species (2.9%). Terbinafine-resistant dermatophyte onychomycosis (n = 17) was caused by T. rubrum (94.1%) and T. interdigitale (5.9%). The prevalence was higher than in the Japanese survey (2.3%), accounting for 6.0% of cases since 2020. Ten mutant strains (58.8%) also showed reduced sensitivity to itraconazole (0.125-0.5 mg/L). These strains were highly sensitive to ravuconazole, efinaconazole, and luliconazole. Fosravuconazole (n = 13) and topical efinaconazole (n = 4) could cure the disease. Non-dermatophyte mould onychomycosis (n = 15) was caused by Aspergillus species (40.0%), Fusarium species (33.3%), Penicillium citrinum, Talaromyces muroii, Botryosphaeria dothidea, and Scopulariopsis brevicaulis (6.7%). When the breakpoint was set to 0.5 mg/L, these strains frequently exhibited resistance to terbinafine (71.4%) and itraconazole (92.9%). Efinaconazole (n = 7) and fosravuconazole (n = 5) were effective in treating these patients. Yeast onychomycosis (n = 35) mainly affected the fingernails (34/35) and was mainly caused by Candida albicans (88.6%). We identified non-albicans Candida species (n = 2), including Candida guilliermondii and Candida parapsilosis. Non-albicans Candida isolates showed low sensitivity to itraconazole and fluconazole. Trichosporon species (n = 2) were isolated from fingernail onychomycosis.
|
| 巻・号 |
66(2)
|
| ページ |
61-67
|
| 公開日 |
2025-1-1
|
| DOI |
10.3314/mmj.24-00028
|
| PMID |
40451890
|
| MeSH |
Adolescent
Adult
Aged
Aged, 80 and over
Antifungal Agents* / pharmacology
Antifungal Agents* / therapeutic use
Arthrodermataceae / drug effects
Candida / drug effects
Child
Drug Resistance, Fungal*
Female
Humans
Itraconazole / pharmacology
Japan / epidemiology
Male
Microbial Sensitivity Tests
Middle Aged
Onychomycosis* / drug therapy
Onychomycosis* / epidemiology
Onychomycosis* / microbiology
Prevalence
Terbinafine / pharmacology
Trichophyton / drug effects
Young Adult
|
| リソース情報 |
| 病原真核微生物 |
Trichophyton rubrumIFM 63288, IFM 66684, IFM 66728, IFM 66729, IFM 66867, IFM 66868, IFM 66870, IFM 66730, IFM 67657, T. interdigitale IFM 67632, Fusarium solani IFM 67840, Penicillium citrinum IFM 65759, Talaromyces muroii IFM 68200, Scopulariopsis brevicaulis IFM 65758 |
