Interdigital and Plantar Foot Infections: A Retrospective Analysis of Molecularly Diagnosed Specimens in the United States and a Literature Review
Up to one-quarter of the United States population is affected by tinea pedis (athlete’s foot). Tinea pedis of the web space (interdigital tinea pedis) is a common clinical presentation causing skin macerations and fissures. A “dermatophytosis complex” (i.e., concomitant bacterial colonization) furth...
Saved in:
| Main Authors: | , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
MDPI AG
2025-01-01
|
| Series: | Microorganisms |
| Subjects: | |
| Online Access: | https://www.mdpi.com/2076-2607/13/1/184 |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1832587880531230720 |
|---|---|
| author | Aditya K. Gupta Tong Wang Sara A. Lincoln Wayne L. Bakotic |
| author_facet | Aditya K. Gupta Tong Wang Sara A. Lincoln Wayne L. Bakotic |
| author_sort | Aditya K. Gupta |
| collection | DOAJ |
| description | Up to one-quarter of the United States population is affected by tinea pedis (athlete’s foot). Tinea pedis of the web space (interdigital tinea pedis) is a common clinical presentation causing skin macerations and fissures. A “dermatophytosis complex” (i.e., concomitant bacterial colonization) further complicates treatment. Here, we examined records of 14,429 skin specimens taken from the feet of dermatology and podiatry outpatients over a 4.6-year period; all specimens were subjected to multiplex qPCR diagnosis for the detection of dermatophytes, <i>Candida</i>, <i>Corynebacterium minutissimum</i>, <i>Pseudomonas</i> and <i>Staphylococcus aureus</i>. A literature search was conducted to review the reported prevalence of fungal and bacterial agents. In both interdigital and plantar foot specimens, dermatophytes (33.3–33.8%) and <i>S. aureus</i> (24.3–25%) were found to be the predominate pathogens. In the interdigital space, a higher prevalence of <i>C. minutissimum</i> (15.7% vs. 7.9%) and <i>Pseudomonas</i> (23.5% vs. 9.6%) was found. The detection of <i>Pseudomonas</i> was more likely to be observed in the presence of <i>Candida</i>, reflecting a higher risk of mixed infection. In dermatophyte-positive specimens, the “dermatophytosis complex” variant was observed at 45.5% (SD: 2.3). An analysis of patient characteristics showed male patients exhibiting higher likelihoods for dermatophyte, <i>C. minutissimum</i>, <i>Pseudomonas</i> and <i>S. aureus</i> detections. The elderly were disproportionately infected with <i>Candida</i>. In children, an <i>S. aureus</i> detection was more common, which could be attributed to impetigo. The recent literature lacks reporting on concomitant bacterial colonization in tinea pedis patients, likely due to the reliance on fungal culture supplemented with antibiotics. Geographical variation has been identified in the detection of the <i>Trichophyton mentagrophytes</i> complex. In conclusion, PCR diagnosis serves as a valuable tool for the management of tinea pedis. An accurate and timely detection of fungal pathogens and concomitant bacterial colonization can better inform healthcare providers of appropriate treatment selection. |
| format | Article |
| id | doaj-art-c09134c250154164b2c78e36415373a5 |
| institution | Kabale University |
| issn | 2076-2607 |
| language | English |
| publishDate | 2025-01-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Microorganisms |
| spelling | doaj-art-c09134c250154164b2c78e36415373a52025-01-24T13:42:58ZengMDPI AGMicroorganisms2076-26072025-01-0113118410.3390/microorganisms13010184Interdigital and Plantar Foot Infections: A Retrospective Analysis of Molecularly Diagnosed Specimens in the United States and a Literature ReviewAditya K. Gupta0Tong Wang1Sara A. Lincoln2Wayne L. Bakotic3Division of Dermatology, Department of Medicine, Temerty Faculty of Medicine, University of Toronto, Toronto, ON M5S 3H2, CanadaMediprobe Research Inc., London, ON N5X 2P1, CanadaBako Diagnostics, Alpharetta, GA 30005, USABako Diagnostics, Alpharetta, GA 30005, USAUp to one-quarter of the United States population is affected by tinea pedis (athlete’s foot). Tinea pedis of the web space (interdigital tinea pedis) is a common clinical presentation causing skin macerations and fissures. A “dermatophytosis complex” (i.e., concomitant bacterial colonization) further complicates treatment. Here, we examined records of 14,429 skin specimens taken from the feet of dermatology and podiatry outpatients over a 4.6-year period; all specimens were subjected to multiplex qPCR diagnosis for the detection of dermatophytes, <i>Candida</i>, <i>Corynebacterium minutissimum</i>, <i>Pseudomonas</i> and <i>Staphylococcus aureus</i>. A literature search was conducted to review the reported prevalence of fungal and bacterial agents. In both interdigital and plantar foot specimens, dermatophytes (33.3–33.8%) and <i>S. aureus</i> (24.3–25%) were found to be the predominate pathogens. In the interdigital space, a higher prevalence of <i>C. minutissimum</i> (15.7% vs. 7.9%) and <i>Pseudomonas</i> (23.5% vs. 9.6%) was found. The detection of <i>Pseudomonas</i> was more likely to be observed in the presence of <i>Candida</i>, reflecting a higher risk of mixed infection. In dermatophyte-positive specimens, the “dermatophytosis complex” variant was observed at 45.5% (SD: 2.3). An analysis of patient characteristics showed male patients exhibiting higher likelihoods for dermatophyte, <i>C. minutissimum</i>, <i>Pseudomonas</i> and <i>S. aureus</i> detections. The elderly were disproportionately infected with <i>Candida</i>. In children, an <i>S. aureus</i> detection was more common, which could be attributed to impetigo. The recent literature lacks reporting on concomitant bacterial colonization in tinea pedis patients, likely due to the reliance on fungal culture supplemented with antibiotics. Geographical variation has been identified in the detection of the <i>Trichophyton mentagrophytes</i> complex. In conclusion, PCR diagnosis serves as a valuable tool for the management of tinea pedis. An accurate and timely detection of fungal pathogens and concomitant bacterial colonization can better inform healthcare providers of appropriate treatment selection.https://www.mdpi.com/2076-2607/13/1/184erythrasmaintertrigotinea pedisinterdigital tinea pedis |
| spellingShingle | Aditya K. Gupta Tong Wang Sara A. Lincoln Wayne L. Bakotic Interdigital and Plantar Foot Infections: A Retrospective Analysis of Molecularly Diagnosed Specimens in the United States and a Literature Review Microorganisms erythrasma intertrigo tinea pedis interdigital tinea pedis |
| title | Interdigital and Plantar Foot Infections: A Retrospective Analysis of Molecularly Diagnosed Specimens in the United States and a Literature Review |
| title_full | Interdigital and Plantar Foot Infections: A Retrospective Analysis of Molecularly Diagnosed Specimens in the United States and a Literature Review |
| title_fullStr | Interdigital and Plantar Foot Infections: A Retrospective Analysis of Molecularly Diagnosed Specimens in the United States and a Literature Review |
| title_full_unstemmed | Interdigital and Plantar Foot Infections: A Retrospective Analysis of Molecularly Diagnosed Specimens in the United States and a Literature Review |
| title_short | Interdigital and Plantar Foot Infections: A Retrospective Analysis of Molecularly Diagnosed Specimens in the United States and a Literature Review |
| title_sort | interdigital and plantar foot infections a retrospective analysis of molecularly diagnosed specimens in the united states and a literature review |
| topic | erythrasma intertrigo tinea pedis interdigital tinea pedis |
| url | https://www.mdpi.com/2076-2607/13/1/184 |
| work_keys_str_mv | AT adityakgupta interdigitalandplantarfootinfectionsaretrospectiveanalysisofmolecularlydiagnosedspecimensintheunitedstatesandaliteraturereview AT tongwang interdigitalandplantarfootinfectionsaretrospectiveanalysisofmolecularlydiagnosedspecimensintheunitedstatesandaliteraturereview AT saraalincoln interdigitalandplantarfootinfectionsaretrospectiveanalysisofmolecularlydiagnosedspecimensintheunitedstatesandaliteraturereview AT waynelbakotic interdigitalandplantarfootinfectionsaretrospectiveanalysisofmolecularlydiagnosedspecimensintheunitedstatesandaliteraturereview |