A retrospective analysis of the concordance of in‐house fungal culture and a commercial quantitative PCR from 16 dermatology referral practices across the USA (2018–2019)
2022
Frost, Katrina | Schick, Anthea | Mount, Rebecca
BACKGROUND: Commercial quantitative (q)PCR and fungal culture can be used concurrently or individually to test for dermatophytosis with a reported high sensitivity and specificity. HYPOTHESIS/OBJECTIVES: The aims of this retrospective study were: (i) to evaluate the concordance of a commercial qPCR with in‐house fungal culture for the initial diagnosis of dermatophytosis and for monitoring for mycological cure during treatment in dermatology private practice; and (ii) determine the sensitivity and specificity of qPCR overall, (iii) for initial diagnosis and (iv) for treatment monitoring in dogs and cats. ANIMALS: Four‐hundred and twenty‐seven client‐owned dogs and 188 client‐owned cats. MATERIALS AND METHODS: Retrospective evaluation of electronic medical records from 615 client‐owned dogs and cats presented to 16 dermatology referral practices across the USA from 2018 to 2019. Concordance of qPCR with in‐house fungal culture and sensitivity and specificity were determined from 667 paired samples. RESULTS: qPCR agreed with in‐house fungal culture in 63 of 85 positive tests and 571 of 582 negative tests, with an overall sensitivity and specificity of 74.1% [95% confidence interval (CI) 63.5–83.0] and 98.1% (95%CI 96.6–99.0), respectively. qPCR sensitivity and specificity for the initial diagnosis of dermatophytosis and for treatment monitoring were 72.4% (95%CI 59.1–83.3) and 98.7% (95%CI 97.3–99.5), and 77.8% (95%CI 57.7–91.4) and 92.0% (95%CI 80.1–97.8), respectively. CONCLUSIONS AND CLINICAL RELEVANCE: Compared to in‐house fungal culture, qPCR was less sensitive and more specific than reported previously. These findings suggest that a diagnosis of dermatophytosis and determining mycological cure should continue to be based on a combination of complementary diagnostic tests.
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