title: Comparison of real-time PCR with conventional methods to detect dermatophytes in samples from patients with suspected dermatophytosis.
abstract: A PCR detecting dermatophytes within a short turnaround time would significantly enhance the management of patients with suspected dermatophytosis. This study aimed at comparing the results of a real-time PCR assay with those of the conventional diagnostic (direct microscopy and culture) performed by a dermatologist working in a medical mycology laboratory for the detection of dermatophytes in nail and skin samples. A total of 112 specimens (54 nail and 58 skin) were collected from 52 patients with one to four suspected dermatophytosis lesions. The PCR diagnostic indices were calculated for either sample- or patient-based dermatophytosis diagnosis. The sample-based diagnostic efficacy yielded 79% sensitivity and 73% specificity. The patient-based diagnostic efficacy was higher with 100% sensitivity and 82% specificity. Interestingly, PCR yielded significantly (p < 0.004) lesser false negative results and performed overall better (diagnostic odds ratio = 24.0 vs. 5.5) in nail than in skin samples. In conclusion, this real-time PCR assay performance was consistent with those of the conventional methods in the hands of a skilled expert and particularly efficacious in diagnosing dermatophyte onychomycosis. This PCR is suited to high throughput batch processing; if used instead of direct microscopy, it could reduce hands-on time in the routine clinical laboratory workflow.
authors.affiliation: Parasitology & Mycology, Hôpital Cochin, Université Paris-Descartes, Assistance Publique-Hôpitaux de Paris, 75014 Paris, France.
authors.forename: A
authors.initials: A
authors.lastname: Paugam
authors.forename: C
authors.initials: C
authors.lastname: L'ollivier
authors.forename: C
authors.initials: C
authors.lastname: Viguié
authors.forename: L
authors.initials: L
authors.lastname: Anaya
authors.forename: C
authors.initials: C
authors.lastname: Mary
authors.forename: G
authors.initials: G
authors.lastname: de Ponfilly
authors.forename: S
authors.initials: S
authors.lastname: Ranque
mesh_terms: D003883:Arthrodermataceae / Q000302:isolation & purification*; D004271:DNA, Fungal / Q000302:isolation & purification*; D006801:Humans; D009262:Nails / Q000382:microbiology; D012337:RNA, Ribosomal, 18S / Q000302:isolation & purification*; D060888:Real-Time Polymerase Chain Reaction / Q000379:methods*; D012680:Sensitivity and Specificity; D012867:Skin / Q000382:microbiology; D014005:Tinea / Q000175:diagnosis* / Q000382:microbiology
chemical_list: D004271:DNA, Fungal; D012337:RNA, Ribosomal, 18S
keywords: Dermatophytes; Dermatophytosis; Diagnosis; Real-time PCR