A large-scale North American study of fungal isolates from nails: the frequency of onychomycosis, fungal distribution, and antifungal susceptibility patterns |
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Authors: | Ghannoum M A Hajjeh R A Scher R Konnikov N Gupta A K Summerbell R Sullivan S Daniel R Krusinski P Fleckman P Rich P Odom R Aly R Pariser D Zaiac M Rebell G Lesher J Gerlach B Ponce-De-Leon G F Ghannoum A Warner J Isham N Elewski B |
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Institution: | Department of Dermatology, University Center for Medical Mycology, Cleveland, OH 44106-5028, USA. |
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Abstract: | BACKGROUND: Onychomycosis, a fungal infection of the nail bed, is responsible for up to 50% of nail disorders. Although several surveys have been conducted in different parts of the world, there have been no multicenter epidemiologic surveys of onychomycosis in North America. OBJECTIVE: A 12-center study was undertaken to (1) determine the frequency of onychomycosis, (2) identify organisms recovered from the nails, and (3) determine the antifungal susceptibility of isolates. METHODS: A total of 1832 subjects participated in this study and completed a comprehensive questionnaire, and nail clippings were collected for potassium hydroxide examination and culturing. RESULTS: The frequency of onychomycosis, as defined by the presence of septate hyphae on direct microscopy and/or the recovery of a dermatophyte, was found to be 13.8%. In general, the dermatophyte isolates were susceptible to the antifungals tested. CONCLUSION: Because of the limited number of large-scale studies, the baseline incidence is not firmly established. However, the higher frequency of onychomycosis in this study may confirm the suspected increase in incidence of disease in North America. |
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