Molecular Identification of Candida Species Isolated from Onychomycosis in Shanghai, China
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Candida is a common cause of onychomycosis, especially for fingernail onychomycosis. In this study, two simple PCR-based assays combined with the internal transcribed spacers sequencing were performed to reveal the prevalence of Candida species including emerging species in onychomycosis, and triazole antifungal susceptibility profiles for Candida species were also evaluated. Among 210 Candida strains isolated from onychomycosis, Candida parapsilosis was the most common species (54.3 %), followed by C. albicans (23.3 %) and C. metapsilosis (9.5 %). However, C. metapsilosis became the second leading species in toenail onychomycosis and accounted for 19.5 % of Candida isolates from toenail samples. C. nivariensis, an emerging species, was firstly recovered from a toenail sample. Other emerging species such as C. orthopsilosis, C. pararugosa and C. fabryi were also identified by molecular tools. C. metapsilosis isolates exhibited significantly higher fluconazole minimum inhibitory concentrations than those exhibited by C. parapsilosis and C. albicans (P < 0.001). This study provides insight into the prevalence, distribution and susceptibility profiles of Candida species including emerging Candida species in onychomycosis.
KeywordsCandida Onychomycosis Molecular typing Polymerase chain reaction
We thank Orazio Romeo (University of Messina, Messina, Italy), Jozef Nosek (Comenius University, Bratislava, Slovak Republic) and David C. Coleman (Dublin Dental University Hospital, University of Dublin, Dublin, Republic of Ireland) for generously contributing reference strains for this study. This work was supported by grants from National Key Basic Research Program of China (2013CB531601 and 2013CB531606), Major Infectious Disease Fund (2013ZX10004612) and the Shanghai Key Laboratory of Molecular Medical Mycology Fund (14DZ2272900).
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