Detection of dermatophytes, Candida spp., and molds by the EuroArray Dermatomycosis® microarray versus fungal culture in patients with suspected dermatomycosis

Highly sensitive molecular assays have become standard in most microbiology laboratories for the detection of a large variety of pathogens. For dermatophytes, however, fungal culture is often still pursued as the routine method although it requires weeks before results are available. We were interested in whether dermatology patients might benefit from the performance of a commercially available microarray that detects 23 dermatophytes, three yeasts, and three molds.We consecutively examined 49 skin specimens and 52 nail samples from 99 outpatients by both microarray and culture for the detection of fungi. The array detected dermatophytes and yeasts in skin and nail samples significantly more often than culture, and most culture-negative, array-positive patients returning after antifungal therapy showed clinical improvement. Three cultures yielded growth of environmental fungi not included in the array. In order to explain these discrepancies, fluorescence intensities of the microarray spots were analyzed. Fluorescence intensities for dermatophytes were significantly higher than those for molds; data were comparable, however, for culture-positive and culture-negative samples.In conclusion, the microarray investigated constitutes a valuable and sensitive tool in the laboratory diagnosis of dermatomycoses. Rapid, molecular assays for the detection of dermatophytes should be introduced in routine laboratory procedures.