ArticlePloS one2020
High prevalence of mixed infections in global onychomycosis.
Article in PloS one, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 28 papers.
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Who cites it
28 citing papers in PubMed, 56 citations in OpenAlex.
- Comparative study of safety and efficacy of combination therapy of fractional COLasers in medical science · 2023Trial
- Determination of the susceptibility of onychomycosis agents isolated in Sakarya to octenidine dihydrochloride and hypochlorous acid.European journal of clinical microbiology & infectious diseases : official publication of the European Society of Clinical Microbiology · 2026Article
- Comparative evaluation of conventional and nanopore approaches in onychomycosis diagnosis.Diagnostic microbiology and infectious disease · 2026Article
- Multifunctional Activity ofPlants (Basel, Switzerland) · 2026Article
- Onychomycosis prevalence etiology and associated factors in women using nail cosmetics attending Mbarara regional referral hospital dermatology clinic Uganda.Scientific reports · 2025Article
- [Scopulariopsis brevicaulis : The "arsenic fungus"-a difficult-to-treat pathogen].Dermatologie (Heidelberg, Germany) · 2025Review
- An Assessment of the Antifungal Efficacy of a Novel Topical Onychomycosis Treatment Using Human Nail and Skin Infection Models.Journal of fungi (Basel, Switzerland) · 2025Article
- The Dual PathogenJournal of fungi (Basel, Switzerland) · 2025Review
- Clinical and Onychoscopy Patterns In Fingernail Onychomycosis - A Study By The International Dermoscopy Society "Trichoscopy and Onychoscopy" Task Force.Dermatology practical & conceptual · 2025Article
- Addressing filamentous fungi-related onychomycosis in the era of antifungal resistance: assessment ofCurrent medical mycology · 2025Article
- Dermoscopy-guided sampling improves the diagnostic yield of fungal culture for onychomycosis: a comparative study.Frontiers in medicine · 2025Article
- Onychomycosis in Foot and Toe Malformations.Journal of fungi (Basel, Switzerland) · 2024Article
- Species distribution and antifungal susceptibility profiles of yeasts isolated from onychomycosis: a cross-sectional study with insights into emerging species.Antonie van Leeuwenhoek · 2023Article
- Clinical and epidemiological study of onychomycosis among patients of the national institute of hygiene in rabat, Morocco (2016-2020).Current medical mycology · 2023Article
- In Vitro and Ex Vivo Biofilm-Forming Ability ofJournal of fungi (Basel, Switzerland) · 2023Article
- Single-Point Nail Sampling to Diagnose Onychomycosis Caused by Non-Dermatophyte Molds: Utility of Polymerase Chain Reaction (PCR) and Histopathology.Journal of fungi (Basel, Switzerland) · 2023Article
- Case of Mixed Infection of Toenail Caused byJournal of fungi (Basel, Switzerland) · 2023Article
- Membranolytic Activity Profile of Nonyl 3,4-Dihydroxybenzoate: A New Anti-Biofilm Compound for the Treatment of Dermatophytosis.Pharmaceutics · 2023Article
- Metagenomics of Toenail Onychomycosis in Three Victorian Regions of Australia.Journal of fungi (Basel, Switzerland) · 2022Article
- Onychomycosis in Two Populations with Different Socioeconomic Resources in an Urban Nucleus: A Cross-Sectional Study.Journal of fungi (Basel, Switzerland) · 2022Article
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Authors and funding
6 authors at 3 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Onychomycosis is estimated at a prevalence of 10% worldwide with the infecting organism most commonly Trichophyton rubrum (T. rubrum). Traditional culture identification of causative organisms has inherent risks of overestimating dermatophytes, like T. rubrum, by inhibiting the growth of possible nondermatophyte mould (NDM) environmental contaminants which could be causative agents. Recently, molecular methods have revealed that a proportion of onychomycosis cases in North America may be caused by mixed infections of T. rubrum as an agent co-infecting with one or more NDM. Determining the global burden of mixed infections is a necessary step to evaluating the best therapies for this difficult-to-treat disease. To determine the prevalence of mixed infections in a global population, nail samples from onychomycosis patients in Brazil, Canada, and Israel (n = 216) were analyzed by molecular methods for the presence of dermatophytes and five NDMs. If an NDM was detected, repeat sampling was performed to confirm the NDM. T. rubrum was detected in 98% (211/216) of infections with 39% mixed (84/216). The infection type was more likely to be mixed in samples from Brazil, but more likely to be a dermatophyte in samples from Canada and Israel (Χ2 = 16.92, df = 2, P<0.001). The most common cause of onychomycosis was T. rubrum. In all countries (Brazil, Canada and Israel combined) the prevalence of dermatophyte (Χ2 = 211.15, df = 3, P<0.001) and mixed (dermatophyte and NDM; Χ2 = 166.38, df = 3, P<0.001) infection increased with patient age. Our data suggest that mixed infection onychomycosis is more prevalent than previously reported with the aging population being at increased risk for mixed infections.
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