Prevalence and Risk Factors Predicting Onychomycosis in Patients with and Without Diabetes Mellitus in Spain: A Cross-Sectional Study.

IF 4.2 2区 生物学 Q2 MICROBIOLOGY
David Navarro-Pérez, José Luis Lázaro-Martínez, Sara García-Oreja, Teresa Pérez-Pérez, Francisco Javier Álvaro-Afonso, Aroa Tardáguila-García
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Abstract

Background: A cross-sectional study was conducted to investigate the prevalence of onychomycosis (ONM) and its causative pathogens in populations with and without diabetes in Spain. The association between the presence of ONM, different risk factors, and comorbidities was also examined.

Methodology: A total of 160 patients with diabetes and 160 individuals without diabetes were recruited consecutively. A single investigator recorded the relative data of each patient and sampled nail dust and detritus for microbiological culture and polymerase chain reaction (PCR) analyses of patients who showed clinical signs of fungal infection.

Results: The prevalence of ONM was 36.88% (59/160) in the population with diabetes, 17.5% (28/160) in the population without diabetes, and 34.35% (45/131) in the population with diabetic foot. Dermatophyte fungi were most frequently identified, although the proportion was higher among those without diabetes than those with diabetes (19/28 and 28/59, respectively). However, the rate of mixed infections was higher in the population with diabetes compared to those without diabetes (13/59 and 2/28, respectively). A statistically significant association was found between the presence of diabetes and the risk of ONM (p < 0.001; odds ratio (OR) = 2.754; 95% confidence interval (CI) 1.652-4.679). The risk factors associated with ONM among the patients with diabetes were a history of minor amputation, revascularisation, or cardiovascular disease, a low educational level, HbA1c values > 7%, hyperkeratosis, and subungual detritus. Among the patients without diabetes, nail thickening and chromonychia were associated with ONM.

Conclusion: The results of this study suggest that the early diagnosis of ONM and knowledge of risk factors among patients with diabetes could enable the prevention of ONM, complications, and serious injuries through education for professionals and patients.

西班牙糖尿病患者和非糖尿病患者中甲癣菌病的患病率和风险预测因素:一项横断面研究。
背景:我们进行了一项横断面研究,调查西班牙糖尿病患者和非糖尿病患者的甲癣(ONM)患病率及其致病病原体。研究还探讨了甲癣的存在与不同风险因素和合并症之间的关系:方法:连续招募了 160 名糖尿病患者和 160 名非糖尿病患者。由一名研究人员记录每位患者的相关数据,并对出现真菌感染临床症状的患者采集指甲灰尘和碎屑样本进行微生物培养和聚合酶链反应(PCR)分析:结果:在糖尿病患者中,ONM的发病率为36.88%(59/160);在非糖尿病患者中,ONM的发病率为17.5%(28/160);在糖尿病足患者中,ONM的发病率为34.35%(45/131)。皮癣真菌是最常发现的真菌,但非糖尿病患者的比例高于糖尿病患者(分别为19/28和28/59)。不过,与非糖尿病患者相比,糖尿病患者的混合感染率更高(分别为 13/59 和 2/28)。研究发现,糖尿病与ONM风险之间存在明显的统计学关联(p < 0.001;几率比(OR)= 2.754;95% 置信区间(CI)1.652-4.679)。在糖尿病患者中,与甲沟炎相关的风险因素包括:轻微截肢、血管再通或心血管疾病史、教育程度低、HbA1c 值大于 7%、过度角化和甲下脱屑。在无糖尿病的患者中,指甲增厚和色斑与 ONM 有关:本研究结果表明,通过对专业人员和患者进行教育,糖尿病患者如能及早诊断甲沟炎并了解风险因素,就能预防甲沟炎、并发症和严重损伤。
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来源期刊
Journal of Fungi
Journal of Fungi Medicine-Microbiology (medical)
CiteScore
6.70
自引率
14.90%
发文量
1151
审稿时长
11 weeks
期刊介绍: Journal of Fungi (ISSN 2309-608X) is an international, peer-reviewed scientific open access journal that provides an advanced forum for studies related to pathogenic fungi, fungal biology, and all other aspects of fungal research. The journal publishes reviews, regular research papers, and communications in quarterly issues. Our aim is to encourage scientists to publish their experimental and theoretical results in as much detail as possible. Therefore, there is no restriction on paper length. Full experimental details must be provided so that the results can be reproduced.
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