Abstract：
Onychomycosis, a fungal nail infection, is primarily caused by dermatophytes, yeasts, and non-dermatophyte moulds (NDMs). The incidence of this disease and the predominance of specific pathogens vary across different regions and evolve. This study aimed to elucidate the epidemiology of onychomycosis and the pattern of causative pathogens in Beijing, and to ascertain the in vitro antifungal susceptibility profiles of Trichophyton rubrum against itraconazole (ITR), terbinafine (TER), and fluconazole (FLU). Involving 245 patients of onychomycosis with positive fungal culture results, the study implemented internal transcribed spacer (ITS) sequencing of ribosomal DNA (rDNA) on all collected samples. The mean age of the participants was 37.93 ± 13.73 years, with a male-to-female ratio of 1.53:1. The prevalence of toenail infections was significantly higher than that of fingernails. Distal and lateral subungual onychomycosis (DLSO) were the most frequent clinical classifications. PCR results indicated that dermatophytes were the most prevalent pathogens, followed by yeasts and NDMs, among which T. rubrum was the most dominant dermatophyte. TER demonstrated high sensitivity to T. rubrum. However, in clinical settings, some patients with onychomycosis exhibit a poor response to TER treatment. The relationship between in vitro antifungal sensitivity and clinical effectiveness is complex, and understanding the link between in vitro MIC values and clinical efficacy requires further investigation.
摘要：
甲癣,真菌指甲感染,主要是由皮肤癣菌引起的，酵母,和非皮肤癣菌霉菌（NDMs）。这种疾病的发病率和特定病原体的优势在不同地区变化并进化。本研究旨在阐明北京地区甲真菌病的流行病学和病原谱。并确定红色毛癣菌对伊曲康唑（ITR）的体外抗真菌药敏谱，特比萘芬（TER），和氟康唑（FLU）。涉及245例真菌培养阳性的甲癣患者，这项研究对所有收集的样本进行了核糖体DNA(rDNA)的内部转录间隔区(ITS)测序.参与者的平均年龄为37.93±13.73岁，男女比例为1.53:1。脚趾甲感染的患病率明显高于手指甲。远端和外侧甲癣（DLSO）是最常见的临床分类。PCR结果表明皮肤癣菌是最常见的病原菌,其次是酵母和NDM，其中红斑苔藓是最主要的皮肤癣菌。TER对红花毛虫表现出很高的敏感性。然而,在临床环境中，一些甲癣患者对TER治疗的反应较差.体外抗真菌药物敏感性和临床疗效之间的关系是复杂的，了解体外MIC值与临床疗效之间的联系需要进一步研究。
