Prevalence and Risk Factors Predicting Onychomycosis in Patients with and Without Diabetes Mellitus in Spain: A Cross-Sectional Study
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:...
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MDPI AG
2024-11-01
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| Series: | Journal of Fungi |
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| author | David Navarro-Pérez José Luis Lázaro-Martínez Sara García-Oreja Teresa Pérez-Pérez Francisco Javier Álvaro-Afonso Aroa Tardáguila-García |
| author_facet | David Navarro-Pérez José Luis Lázaro-Martínez Sara García-Oreja Teresa Pérez-Pérez Francisco Javier Álvaro-Afonso Aroa Tardáguila-García |
| author_sort | David Navarro-Pérez |
| collection | DOAJ |
| description | 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 (<i>p</i> < 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. |
| format | Article |
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| institution | OA Journals |
| issn | 2309-608X |
| language | English |
| publishDate | 2024-11-01 |
| publisher | MDPI AG |
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| series | Journal of Fungi |
| spelling | doaj-art-e9a65022a335452db325513f927553ab2025-08-20T02:04:58ZengMDPI AGJournal of Fungi2309-608X2024-11-01101179010.3390/jof10110790Prevalence and Risk Factors Predicting Onychomycosis in Patients with and Without Diabetes Mellitus in Spain: A Cross-Sectional StudyDavid Navarro-Pérez0José Luis Lázaro-Martínez1Sara García-Oreja2Teresa Pérez-Pérez3Francisco Javier Álvaro-Afonso4Aroa Tardáguila-García5Diabetic Foot Unit, University Podiatric Clinic, Faculty of Nursing, Physiotherapy and Podiatry, Complutense University of Madrid, 28040 Madrid, SpainDiabetic Foot Unit, University Podiatric Clinic, Faculty of Nursing, Physiotherapy and Podiatry, Complutense University of Madrid, 28040 Madrid, SpainDiabetic Foot Unit, University Podiatric Clinic, Faculty of Nursing, Physiotherapy and Podiatry, Complutense University of Madrid, 28040 Madrid, SpainDepartment of Statistics and Data Science, Complutense University of Madrid, 28040 Madrid, SpainDiabetic Foot Unit, University Podiatric Clinic, Faculty of Nursing, Physiotherapy and Podiatry, Complutense University of Madrid, 28040 Madrid, SpainDiabetic Foot Unit, University Podiatric Clinic, Faculty of Nursing, Physiotherapy and Podiatry, Complutense University of Madrid, 28040 Madrid, SpainBackground: 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 (<i>p</i> < 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.https://www.mdpi.com/2309-608X/10/11/790onychomycosisdiabetes mellitusdiabetic footrisk factorsdiagnosisprevalence |
| spellingShingle | David Navarro-Pérez José Luis Lázaro-Martínez Sara García-Oreja Teresa Pérez-Pérez Francisco Javier Álvaro-Afonso Aroa Tardáguila-García Prevalence and Risk Factors Predicting Onychomycosis in Patients with and Without Diabetes Mellitus in Spain: A Cross-Sectional Study Journal of Fungi onychomycosis diabetes mellitus diabetic foot risk factors diagnosis prevalence |
| title | Prevalence and Risk Factors Predicting Onychomycosis in Patients with and Without Diabetes Mellitus in Spain: A Cross-Sectional Study |
| title_full | Prevalence and Risk Factors Predicting Onychomycosis in Patients with and Without Diabetes Mellitus in Spain: A Cross-Sectional Study |
| title_fullStr | Prevalence and Risk Factors Predicting Onychomycosis in Patients with and Without Diabetes Mellitus in Spain: A Cross-Sectional Study |
| title_full_unstemmed | Prevalence and Risk Factors Predicting Onychomycosis in Patients with and Without Diabetes Mellitus in Spain: A Cross-Sectional Study |
| title_short | Prevalence and Risk Factors Predicting Onychomycosis in Patients with and Without Diabetes Mellitus in Spain: A Cross-Sectional Study |
| title_sort | prevalence and risk factors predicting onychomycosis in patients with and without diabetes mellitus in spain a cross sectional study |
| topic | onychomycosis diabetes mellitus diabetic foot risk factors diagnosis prevalence |
| url | https://www.mdpi.com/2309-608X/10/11/790 |
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