A comparison of conventional rapid methods in diagnosis of superficial and cutaneous mycoses based on KOH, Chicago sky blue 6B and calcofluor white stains
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Abstract
Background and Objectives: Rapid confirmation of dermatomycoses is desirable, as it allows the clinicians to initiate appropriate therapy immediately. In this study, the utility of a novel contrast stain, Chicago sky blue stain, was compared with potassium hydroxide mount and calcofluor white stain to determine the causative fungal elements in the rapid detection method.
Materials and Methods: In this survey, 189 samples of suspected dermatomycosis infections were assessed in 3 incubation times of 30 minutes, 2 hours, and > 6 hours.
Results: Positive cases were shown in Chicago sky blue 6B (55%), calcofluor white (53.4%), and potassium hydroxide (36%), with 30-minute incubation. Positive results increased in other incubation times. Sensitivity, specificity, PPV, NPV and accuracy of Chicago sky blue 6B were 97%, 100%, 100%, 96% and 98% and, for potassium hydroxide, they were 66%, 98%, 97%, 98%, 80% versus CFW, respectively.
Conclusion: This study provides evidence that the Chicago sky blue 6B stain is a simple, fast and cost-effective method.
Faure-Cognet O, Fricker-Hidalgo H, Pelloux H, Leccia M. Superficial fungal infections in a French teaching hospital in Grenoble area: retrospective study on 5470 samples from 2001 to 2011. Mycopathologia. 2016;181(1-2):59.
Prakash R, Prashanth HV, Ragunatha S, Kapoor M, Anitha T, Krishnamurthy V. Comparative study of efficacy, rapidity of detection, and cost‐effectiveness of potassium hydroxide, calcofluor white, and Chicago sky blue stains in the diagnosis of dermatophytoses. International journal of dermatology. 2016;55(4).
Havlickova B, Czaika VA, Friedrich M. Epidemiological trends in skin mycoses worldwide. Mycoses. 2008;51(s4):2-15.
Hawkins DM, Smidt AC. Superficial fungal infections in children. Pediatric clinics of North America. 2014;61(2):443-55.
Kumar RS, Ganvir S, Hazarey V. Candida and calcofluor white: Study in precancer and cancer. Journal of oral and maxillofacial pathology: JOMFP. 2009;13(1):2.
Hay R. Superficial fungal infections. Medicine. 2013;41(12):716-8.
Gupta M, Chandra A, Prakash P, Maurya O, Tilak R. Fungal keratitis in north India; Spectrum and diagnosis by Calcofluor white stain. 2015.
Afshar P, Shokrzadeh M, Kalhori S, Babaee Z, Saeedi Saravi SS. Occurrence of Ochratoxin A and Aflatoxin M1 in human breast milk in Sari, Iran. Food Control. 2013 2013/06/01/;31(2):525-9.
Afshar P, Khodavaisy S, Kalhori S, Ghasemi M, Razavyoon T. Onychomycosis in north-East of iran. Iranian journal of microbiology. 2014;6(2):98.
Afshar P, Vahedi L, Ghasemi M, Mardanshahi A. Epidemiology of tinea capitis in northeast Iran: a retrospective analysis from 1998 to 2012. International journal of dermatology. 2016;55(6):640-4.
Hedayati MT, Afshar P, Shokohi T, Aghili R. A study on tinea gladiatorum in young wrestlers and dermatophyte contamination of wrestling mats from Sari, Iran. Br J Sports Med. 2007;41:332-4.
Afshar P, Hedayati MT, Aslani N, Khodavaisy S, Babamahmoodi F, Mahdavi MR, et al. First Autochthonous Coinfected Anthrax in an Immunocompetent Patient. Case Reports in Medicine. 2015;2015.
Liesche J, Marek M, Günther-Pomorski T. Cell wall staining with Trypan blue enables quantitative analysis of morphological changes in yeast cells. Frontiers in microbiology. 2015;6.
Munro CA. Chitin and glucan, the yin and yang of the fungal cell wall, implications for antifungal drug discovery and therapy. Adv Appl Microbiol. 2013;83:145-72.
Li S, Calvo AM, Yuen GY, Du L, Harris SD. Induction of cell wall thickening by the antifungal compound dihydromaltophilin disrupts fungal growth and is mediated by sphingolipid biosynthesis. Journal of eukaryotic microbiology. 2009;56(2):182-7.
Suyoso S, Noviandini A, Astari L. Parker ink-KOH stain, Chicago Sky Blue (CSB) stain, and Fungi Culture, for The Diagnosis of Superficial Dermatomycoses. Berkala Ilmu Kesehatan Kulit dan Kelamin. 2017;29(1):21-9.
Kumar RS, Ganvir SM, Hazarey VK. Candida and calcofluor white: Study in precancer and cancer. Journal of Oral and Maxillofacial Pathology : JOMFP. 2009 Jan-Jun;13(1):2-8. PubMed PMID: PMC3162850.
Rasconi S, Jobard M, Jouve L, Sime-Ngando T. Use of Calcofluor White for Detection, Identification, and Quantification of Phytoplanktonic Fungal Parasites. Applied and Environmental Microbiology. 2009 Apr;75(8):2545-53. PubMed PMID: 19233954.
Dass SM, Vinayaraj E, Pavavni K, Pallam A, Rao MS. Comparison of KOH, Calcofluor White and Fungal Culture for Diagnosing Fungal Onychomycosis in an Urban Teaching Hospital, Hyderabad. Indian Journal of Microbiology Research. 2015;2(3):148-53.
Standard TP 39. Staining Procedures. UK Standards Unit. Microbiology Services. Public Health England 2015.
Perry JL, Miller GR. Quality control slide for potassium hydroxide and cellufluor fungal preparations. J Clin Microbiol. 1989 Jun;27(6):1411-2. PubMed PMID: 2754012.
Baratloo A, Elfil M, Negida A. Part 3: Positive and Negative Likelihood Ratios of Diagnostic Tests. Emergency. 2015;3(4):170-1.
Baratloo A, Hosseini M, Negida A, El Ashal G. Part 1: simple definition and calculation of accuracy, sensitivity and specificity. Emergency. 2015;3(2):48-9.
Safari S, Baratloo A, Elfil M, Negida AS. Part 2: Positive and negative predictive values of diagnostic tests. Emergency. 2015;3(3):87-8.
Pihet M, Le Govic Y. Reappraisal of Conventional Diagnosis for Dermatophytes. Mycopathologia. 2017;182(1-2):169-80.
Fonseka S, Lim CSH, Bandara UN, Dissanayake M. New Contrast Stain for the Rapid Diagnosis of Dermatophytosis and Pityriasis Versicolor. Laboratory Medicine. 2011;42(11):649-52.
Lim CS-H, Lim S-L. Practical tip: Chicago Sky Blue (CSB) stain can be added to the routine potassium hydroxide (KOH) wet-mount to provide a color contrast and facilitate the diagnosis of dermatomycoses. Dermatology Online Journal. 2011;17(8).
Unemo M, Ballard R, Ison C, Lewis D, Ndowa F, Peeling R, et al. Laboratory diagnosis of sexually transmitted infections, including human immunodeficiency virus. 2013.
Hamer E, Moore C, Denning D. Comparison of two fluorescent whiteners, Calcofluor and Blankophor, for the detection of fungal elements in clinical specimens in the diagnostic laboratory. Clinical microbiology and infection. 2006;12(2):181-4.
Haghani I, Shokohi T, Hajheidari Z, Khalilian A, Aghili SR. Comparison of diagnostic methods in the evaluation of onychomycosis. Mycopathologia. 2013;175(3-4):315-21.
Liu Z, Sheng P, Yang Y-P, Li W, Huang W-M, Wang J-D, et al. Comparison of modified Chicago sky blue stain and potassium hydroxide mount for the diagnosis of dermatomycoses and onychomycoses. Journal of microbiological methods. 2015;112:21-3.
Fonseka S, Lim CS, Bandara UN, Dissanayake M. New contrast stain for the rapid diagnosis of dermatophytosis and pityriasis versicolor. Laboratory Medicine. 2011;42(11):649-52.
Lim CS-H, Lim S-L. New contrast stain for the rapid diagnosis of dermatophytic and candidal dermatomycoses. Archives of dermatology. 2008;144(9):1228-9.
Tambosis E, Lim C. A comparison of the contrast stains, Chicago blue, chlorazole black, and Parker ink, for the rapid diagnosis of skin and nail infections. International journal of dermatology. 2012;51(8):935-8.
Lodha N, Poojary SA. A novel contrast stain for the rapid diagnosis of pityriasis versicolor: A comparison of Chicago Sky Blue 6B stain, potassium hydroxide mount and culture. Indian journal of dermatology. 2015;60(4):340.
Priyanka B, Patil RK, Dwarakanath S. A review on detection methods used for foodborne pathogens. The Indian journal of medical research. 2016;144(3):327.
Law JW-F, Ab Mutalib N-S, Chan K-G, Lee L-H. Rapid methods for the detection of foodborne bacterial pathogens: principles, applications, advantages and limitations. Frontiers in microbiology. 2015;5:770.
Jahandeh N, Saberi F, Fesahat M, Mirnejad R. Different Methods for Diagnosis of Brucella and Legionella spp. in Various Samples. Journal of Applied Biotechnology Reports. 2015;2(1):187-90.
Costa‐de‐Oliveira S, Silva AP, Miranda IM, Salvador A, Azevedo MM, Munro CA, et al. Determination of chitin content in fungal cell wall: an alternative flow cytometric method. Cytometry Part A. 2013;83(3):324-8.
Jacobson LS, McIntyre L, Mykusz J. Comparison of real-time PCR with fungal culture for the diagnosis of Microsporum canis dermatophytosis in shelter cats: a field study. Journal of feline medicine and surgery. 2018;20(2):103-7.
Jacobson LS, McIntyre L, Mykusz J. Comparison of real-time PCR with fungal culture for the diagnosis of Microsporum canis dermatophytosis in shelter cats: a field study. Journal of Feline Medicine and Surgery. 2017:1098612X17695899.
Ohst T, Kupsch C, Gräser Y. Detection of common dermatophytes in clinical specimens using a simple quantitative real‐time TaqMan polymerase chain reaction assay. British Journal of Dermatology. 2016;174(3):602-9.
Haghani I, Amirinia F, Nowroozpoor-Dailami K, Shokohi T. Detection of fungi by conventional methods and semi-nested PCR in patients with presumed fungal keratitis. Current medical mycology. 2015;1(2):31.
| Files | ||
| Issue | Vol 10 No 6 (2018) | |
| Section | Original Article(s) | |
| Keywords | ||
| Rapid diagnosis Dermatomycosis Potassium hydroxide Chicago sky blue 6B Calcofluor white | ||
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