{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,17]],"date-time":"2025-10-17T14:31:45Z","timestamp":1760711505313,"version":"3.41.2"},"reference-count":33,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2025,5,1]],"date-time":"2025-05-01T00:00:00Z","timestamp":1746057600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Microbiol."],"abstract":"<jats:sec><jats:title>Introduction<\/jats:title><jats:p>Onychomycosis, a common nail disease, is caused by a diverse range of pathogens worldwide. However, the epidemiology and pathogen profile of onychomycosis in China remain insufficiently characterized. This study aimed to investigate these aspects in a large Chinese hospital.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A six-year retrospective analysis was conducted at a tertiary hospital in China, where nail samples from 298 patients who were clinically suspected of onychomycosis were cultured and analyzed to identify causative agents and clinical features.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Of the 298 samples, 51.00% (152) were positive for fungal infection. Young adults (18\u201330 years) comprised the majority of the patients, with a man-to-woman ratio of 1:1.45. Dermatophytes were the most prevalent causative agents (36.18%), followed by yeasts (28.29%) and non-dermatophyte molds (NDMs) (28.29%). Among dermatophytes, <jats:italic>Trichophyton<\/jats:italic> species (34.9%) were the most frequently identified, followed by <jats:italic>Candida<\/jats:italic> (21.7%) and dematiaceous fungi (8.6%). Dermatophytes were the predominant pathogens in the patients aged 18\u201350 years. The toenails (63.04%) were more commonly affected than the fingernails (36.96%), with bilateral toenail involvement (34.07%) being the most frequent.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>While dermatophytes remain the leading cause of onychomycosis in China, non-dermatophyte molds, particularly dematiaceous fungi, are emerging as significant pathogens. These organisms present unique treatment challenges and warrant increased clinical attention.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fmicb.2025.1582147","type":"journal-article","created":{"date-parts":[[2025,5,1]],"date-time":"2025-05-01T05:38:38Z","timestamp":1746077918000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":1,"title":["A six-year retrospective study on the causative agents of onychomycosis in China: the emergence of dematiaceous fungi"],"prefix":"10.3389","volume":"16","author":[{"given":"Xin","family":"Ye","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jun","family":"Tian","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Wanqing","family":"Liao","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Weihua","family":"Pan","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Zhe","family":"Liu","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jiaming","family":"Zhang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Li","family":"Yang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lei","family":"Zhang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2025,5,1]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"712","DOI":"10.3390\/jof9070712","article-title":"Risk factors and treatment trends for onychomycosis: a case\u2013control study of onychomycosis patients in the all of us research program","volume":"9","author":"Albucker","year":"2023","journal-title":"J. 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