Abstract
We recently reported the development of a 5-hour multiplex PCR test for the detection of tinea unguium and the optimization of this test by the inclusion of an inhibition control. Here we report the performance of this procedure as used in a routine clinical laboratory as compared to conventional microscopy and culture-based techniques performed in a mycology reference laboratory. We found in processing 109 samples that 22 (20.2%) yielded fungi in culture while the suspected etiologic agents were noted microscopically in 15 (13.8%) that were negative in culture. Fungi were detected by PCR in 37 (33.9%) samples, of which only three were positive in culture. Since the majority of PCR positive but culture negative samples were positive in microscopic examinations, the increased sensitivity was not due to contamination. PCR inhibitors were present in 5% of the samples, but this was overcome by re-running the samples with a 50% reduction of sample DNA. In conclusion, the PCR test performance in the routine setting was excellent and provided a markedly reduced time to diagnosis with a higher sensitivity.
Declaration of interest: Anna Brillowska-Dabrowska, Sanne Søgaard Nielsen, Henrik Vedel Nielsen: No confict of interest.
Maiken Cavling Arendrup has received honoraries for speaking, consultancy, advisory board membership, or reimbursement of travel expenses from Merck Sharp and Dohme, Pfzer, Scheering Plough, Swedish Orphan, Astellas, Mycognostica, and SpePharm. Maiken Cavling Arendrup has received research funding although not for this project from Merck, Astellas and Pfzer. Maiken Cavling Arendrup holds no stocks or shares, and owns no patents.
This paper was first published online on Early Online on 27 January 2010.