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KMID : 0670820170220020062
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Korean Journal of Medical Mycology
2017 Volume.22 No. 2 p.62 ~ p.72
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Clinical Usefulness of PCR-REBA for Diagnosis of Onychomycosis
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Kim Joon-Goon
Shin Dong-Hoon
Choi Jong-Soo
Lee Chae-Hoon
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Abstract
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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.
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KEYWORD
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Molecular based method, Onychomycosis, PCR-REBA, Polymerase chain reaction, Reverse blot hybridization assay
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