title: Trichosporon isolation from human ungueal infections: is there a pathogenic role?
abstract: BACKGROUND
  Although dermatophytes are considered the major cause of onychomycosis, many reports have incriminated non-dermatophyte moulds and yeasts in the disease's etiology. Successive Trichosporon isolation from onychomycosis has led to the genus being suspected as a nail primary pathogen.
  
  
  OBJECTIVE
  To determine the prevalence of Trichosporon isolation in onychomycosis patients who attended a mycology diagnostic service in Rio de Janeiro, Brazil, between January 2003 and December 2006. The study also includes a worldwide review on Trichosporon isolation prevalence in ungueal disease, emphasizing T. ovoides.
  
  
  METHODS
  This retrospective study was conducted with the support of staff from the Mycology Laboratory at the Dermatological Service of Rio de Janeiro's Santa Casa da Misericórdia (MLDS).
  
  
  RESULTS
  Mycological analysis provided positive results equaling 47/5036 (0.93%) for Trichosporon spp.; obtained mainly as a single agent (72.35%), and from mixed cultures (27.65%; X2= 6.397; p= 0.018). The great majority belongs to the T. ovoides species (91.5%; n=43), obtained as a single isolate (74.41%; n= 32/43; X2 = 7.023; p= 0.014).
  
  
  CONCLUSIONS
  Although T. ovoides is classically associated as an etiologic agent of white piedra, this study highlights its potential as a human nail disease pathogen. Our study opens doors for future epidemiologic and virulence factors aimed at determining whether T. ovoides is an important causative agent of onychomycosis in Brazil.
authors.affiliation: Universidade Federal Fluminense, Niterói, RJ, Brazil.
authors.forename: Alba Regina de
authors.initials: AR
authors.lastname: Magalhães
authors.affiliation: Fundação Oswaldo Cruz, Rio de Janeiro, RJ, Brazil.
authors.forename: Marília Martins
authors.initials: MM
authors.lastname: Nishikawa
authors.affiliation: Universidade Federal Fluminense, Niterói, RJ, Brazil.
authors.forename: Silvia Suzana Bona de
authors.initials: SS
authors.lastname: Mondino
authors.affiliation: Universidade Federal Fluminense, Niterói, RJ, Brazil.
authors.forename: Heloisa Werneck de
authors.initials: HW
authors.lastname: Macedo
authors.affiliation: Universidade Federal Fluminense, Niterói, RJ, Brazil.
authors.forename: Elisabeth Martins da Silva da
authors.initials: EM
authors.lastname: Rocha
authors.affiliation: Universidade Federal Fluminense, Niterói, RJ, Brazil.
authors.forename: Andrea Regina de Souza
authors.initials: AR
authors.lastname: Baptista
mesh_terms: D000368:Aged; D001938:Brazil / Q000453:epidemiology; D015169:Colony Count, Microbial; D005260:Female; D005533:Foot Dermatoses / Q000382:microbiology; D006229:Hand Dermatoses / Q000382:microbiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D014009:Onychomycosis / Q000453:epidemiology* / Q000382:microbiology*; D015995:Prevalence; D012189:Retrospective Studies; D014250:Trichosporon / Q000302:isolation & purification* / Q000472:pathogenicity*