Title：Diversity of phenotypically non-dermatophyte, non-Aspergillus filamentous fungi causing nail infections: importance of accurate identification and antifungal susceptibility testing

标题：引起指甲感染的非皮肤癣菌、非青霉菌丝状真菌的多样性：准确鉴定和抗真菌敏感性测试

Authors: Tsang C.C., Tang J.Y.M., Chan K.F., et al.

Journal: Emerging Microbes & Infections, 2019, Volume 8, Issue 1, Pages 531-541

DOI: 10.1080/22221751.2019.1598781

Abstract

This study investigates the species and antifungal susceptibility of non-dermatophyte, non-Aspergillus filamentous fungi isolated from patients' nails in Hong Kong. Over a 10-year period, 24 non-repetitive strains were isolated from the nails of 24 patients. Using polyphasic analysis, 17 of these strains were identified as 13 known species belonging to 11 genera and at least 9 families. The remaining 7 strains could not be identified to species level by multi-locus sequencing and may represent 7 novel species in 4 known genera and 3 novel genera. 33.3%, 41.7%, and 95.8% of the strains had minimum inhibitory concentrations (MICs) greater than 1 µg/mL for terbinafine, itraconazole, and fluconazole, respectively. The results indicate that onychomycosis is associated with a highly diverse array of molds, and a significant proportion of these strains may represent novel species. Molecular identification and antifungal susceptibility testing of these rare fungi are warranted to guide appropriate therapy.

摘要

本研究调查了在香港的患者指甲中分离出的非皮肤癣菌和非曲霉菌丝真菌的种类和抗真菌药物敏感性。研究覆盖了10年期间从24位患者指甲中分离出的24株非重复菌株。使用多相分析方法，确定了其中17株为13种已知真菌，分别属于11个属和至少9个科。其余7株通过多位点测序未能确定具体种类，可能为4个已知属和3个新属的7个新种。33.3%、41.7%和95.8%的菌株对特比萘芬、伊曲康唑和氟康唑的最低抑菌浓度（MIC）大于1 µg/mL。结果显示甲真菌病与高度多样化的霉菌相关，且其中相当一部分菌株可能为新种。为了指导合理治疗，应对这些罕见真菌进行分子鉴定和抗真菌药物敏感性测试。

Antifungal Compounds and CAS Numbers

1. **Terbinafine (特比萘芬)**

   - CAS Number: 91161-71-6

2. **Itraconazole (伊曲康唑)**

   - CAS Number: 84625-61-6

3. **Fluconazole (氟康唑)**

   - CAS Number: 86386-73-4