Clinical Usefulness of PCR-REBA for Diagnosis of Onychomycosis.
10.17966/KJMM.2017.22.2.62
- Author:
Joon Goon KIM
1
;
Dong Hoon SHIN
;
Jong Soo CHOI
;
Chae Hoon LEE
Author Information
1. Department of Dermatology, College of Medicine, Yeungnam University, Daegu, Korea. jschoi@med.yu.ac.kr
- Publication Type:Original Article
- Keywords:
Molecular based method;
Onychomycosis;
PCR-REBA;
Polymerase chain reaction;
Reverse blot hybridization assay
- MeSH:
Base Sequence;
Cladosporium;
Coinfection;
Diagnosis*;
Fungi;
Humans;
Onychomycosis*;
Penicillium;
Polymerase Chain Reaction;
Rhodotorula;
Sensitivity and Specificity;
Trichophyton
- From:Korean Journal of Medical Mycology
2017;22(2):62-72
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
BACKGROUND: PCR-based reverse blot hybridization assay (PCR-REBA) has high sensitivity and specificity, can be performed directly on nail samples, is relatively cheaper than other molecular biologic methods, and is useful for diagnosing onychomycosis. OBJECTIVE: This study aims to compare the diagnostic efficacy of fungal culture and REBA Fungus-ID® which is a commercial PCR-REBA-based kit used for onychomycosis diagnosis. METHODS: Fifty nail samples were collected from 50 patients diagnosed with onychomycosis via direct microscopic examination using KOH preparation, and subjected to fungal culture and REBA Fungus-ID® test. RESULTS: The sensitivity of conventional fungal culture and REBA Fungus-ID® was 56% and 100%, respectively. In REBA Fungus-ID®, 43 of 50 samples were found to be infected with Trichophyton rubrum. Four of the remaining 7 samples were identified as infected with Trichophyton spp., one with Trichophyton mentagrophytes, and two revealed a panfungal DNA sequence. In fungal culture, 28 of 50 samples showed growth, of which 18 samples were identified as T. rubrum, 3 as Rhodotorula mucilaginosa, 3 as Cladosporium spp., 1 as Cyphellophora europaea, 1 as Penicillium cvjetkovicii, 1 as Lachnum soppittii, and 1 as non-dermatophytic mold. REBA Fungus-ID® and fungal culture were identical in 20 cases (40%). The non-dermatophytic fungi identified in fungal culture were considered contaminants. CONCLUSION: Nail specimens can be used directly for REBA Fungus-ID®, which has a high sensitivity for onychomycosis diagnosis. Therefore, it can be considered useful for diagnosis and identification of the causative organism in mixed infections like onychomycosis.
