Thank you for visiting nature. You are using a browser version with limited support for CSS. To obtain the best experience, we recommend you use a more up to date browser or turn off compatibility mode in Internet Explorer. In the meantime, to ensure continued support, we are displaying the site without styles and JavaScript.
Onychomycosis OM is a common fungal nail infection. Based on the rich mycobial diversity in healthy toenails, we speculated that this is lost in OM due to the predominance of a single pathogen. We used next generation sequencing to obtain insights into the biodiversity of fungal communities in both healthy individuals and OM patients. By sequencing, a total of operational-taxonomic units were found in OM patients and healthy controls.
Interestingly, a classifier distinguished three distinct subsets: healthy controls and two groups within OM patients with either a low or high abundance of Trichophyton. Diversity per sample was decreased in controls compared to cases with low Trichophyton abundance LTA , while cases with a high Trichophyton abundance HTA showed a lower diversity.
Variation of mycobial communities between the samples showed shifts in the community structure between cases and controls—mainly driven by HTA cases. Collectively, our data provides an in-depth characterization of fungal diversity in health and OM. Our findings also suggest that onychomycosis develops either through pathogen-driven mechanisms, i. Patients exhibit symptoms such as white or yellow nail discoloration, thickening, roughness, and separation of the nail from the nail bed.
The current understanding of OM, as a mostly single pathogen-driven infection is based on its current clinical diagnostics, specifically microscopy and culture of clinical samples.
