Commercial Multiplex Polymerase Chain Reaction versus Periodic Acid-Schiff Testing for the Diagnosis of Onychomycosis
| Autor: | Karen Uchmanowicz, Stephanie Petrofski, Jill S. Kawalec, Bryan D. Caldwell, Carl Kurzel |
|---|---|
| Rok vydání: | 2020 |
| Předmět: |
Antifungal
medicine.medical_specialty Insufficient Sample medicine.drug_class Periodic acid–Schiff stain Sensitivity and Specificity law.invention 030207 dermatology & venereal diseases 03 medical and health sciences 0302 clinical medicine 030502 gerontology law Biopsy Multiplex polymerase chain reaction Onychomycosis medicine Species identification Humans Toenail infection Polymerase chain reaction medicine.diagnostic_test business.industry Periodic Acid General Medicine Periodic Acid-Schiff Reaction Dermatology Nails 0305 other medical science business Multiplex Polymerase Chain Reaction |
| Zdroj: | Journal of the American Podiatric Medical Association. 110(6) |
| ISSN: | 1930-8264 |
| Popis: | BackgroundDiagnosis of onychomycosis using the periodic acid–Schiff (PAS) test for sensitive identification of hyphae and fungal culture for identification of species has become the mainstay for many clinical practices. With the advent of polymerase chain reaction (PCR) testing, physicians can identify a fungal toenail infection quickly with the added benefit of species identification. We compared PAS testing with multiplex PCR testing from a clinical perspective.MethodsA total of 209 patients with clinically diagnosed onychomycosis were recruited. A high-resolution picture was taken of the affected hallux nail, and the nail was graded using the Onychomycosis Severity Index. A proximal sample of the affected toenail and subungual debris were obtained and split into two equal samples. One sample was sent for multiplex PCR testing and the other for PAS testing. The results were analyzed and compared.ResultsSix patients were excluded due to insufficient sample size for PCR testing. Of the remaining 203 patients, 109 (53.7%) tested positive with PAS, 77 (37.9%) tested positive with PCR. Forty-one patients tested positive with PAS but negative with PCR, and nine tested positive with PCR but negative with PAS.ConclusionsPhysicians should continue the practice of using PAS biopsy staining for confirmation of a fungal toenail infection before using oral antifungal therapy. Because multiplex PCR allows species identification, some physicians may elect to perform both tests. |
| Databáze: | OpenAIRE |
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