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Journal of Clinical Microbiology, May 2005, p. 2141-2147, Vol. 43, No. 5
0095-1137/05/$08.00+0 doi:10.1128/JCM.43.5.2141-2147.2005
Copyright © 2005, American Society for Microbiology. All Rights Reserved.
ARUP Institute for Clinical and Experimental Pathology, Salt Lake City, Utah,1 ARUP Infectious Diseases Laboratory, Salt Lake City, Utah,2 Spectral Genomics, Inc., Houston, Texas,3 Department of Pathology, University of Utah Medical School, Salt Lake City, Utah4
Received 1 December 2004/ Returned for modification 28 December 2004/ Accepted 19 January 2005
The performance of repetitive-sequence-based PCR (rep-PCR) using the DiversiLab system for identification of dermatophytes commonly isolated in a clinical laboratory was assessed by comparing results to those of conventional tests (colony morphology, microscopic examination of slide cultures, and, for suspected Trichophyton species, use of additional media). Sixty-one cultures were tested in phase 1, the feasibility portion of the study; 64 additional cultures were tested in phase 2, the validation portion conducted to assess reproducibility and confirm accuracy. Discrepancies were resolved by repeating rep-PCR and conventional tests and, in phase 2, sequencing the internal transcribed spacers. After initial testing of the cultures in phase 1 (excluding one contaminated culture), agreement between conventional tests and rep-PCR was 90% (54 of 60). Agreement was 98.3% after resolution of discrepancies, and in all but one case the initial rep-PCR result was correct. After initial testing of cultures in phase 2 (excluding one discarded and one contaminated culture), agreement between rep-PCR and conventional testing was 88.7% (55 of 62). After discrepancies were resolved, agreement was 100%. Initial rep-PCR results were correct, except for one Microsporum canis culture containing two colony variants, which could not be initially identified by rep-PCR. The performance of the DiversiLab system for identification of the dermatophytes commonly encountered in a clinical mycology laboratoryTrichophyton mentagrophytes, Trichophyton rubrum, Trichophyton tonsurans, and M. caniswas excellent. Moreover, the DiversiLab system is technically simple and provides results in <24 h once a pure culture is available for testing, which is considerably more rapid than conventional identification tests.
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