Scherer William P, Scherer Michael D
Private practice, PO Box 272207, Boca Raton, FL 33427, USA.
J Am Podiatr Med Assoc. 2004 Nov-Dec;94(6):528-34. doi: 10.7547/0940528.
An investigative study was performed to compare the results from two mycology laboratories for the diagnosis of onychomycosis in a geriatric population and to determine the possible pharmacologic treatments based on the two laboratories' results. In this study, 85 cases of suspected onychomycosis involving men and women 65 years and older from a nursing home setting in South Florida were used. Samples were taken from the hallux toenail and sent to two different mycology laboratories for fluorescent potassium hydroxide preparation and microscopic examination of a fungal culture. Of the 85 cases studied, the two mycology laboratories reported similar potassium hydroxide preparation results for 58.8% of the patients and similar fungal culture results for genus and species identification for 37.6% of the patients. When the potassium hydroxide preparation and fungal culture results were combined, the two mycology laboratories reported similar results for only 27.1% of the patients. As a result of the two mycology laboratories' findings, the possible US Food and Drug Administration-approved pharmacologic treatments may differ for 43.5% of the patients studied. The discrepancy between the two independent laboratories leaves physicians to question the reproducibility of fluorescent potassium hydroxide preparation and fungal culture analysis in a geriatric patient population for the diagnosis of onychomycosis.
进行了一项调查研究，以比较两个真菌学实验室对老年人群甲癣诊断的结果，并根据两个实验室的结果确定可能的药物治疗方法。在这项研究中，使用了来自南佛罗里达州一家养老院的85例疑似甲癣病例，涉及65岁及以上的男性和女性。样本取自拇趾趾甲，送至两个不同的真菌学实验室进行荧光氢氧化钾制备和真菌培养的显微镜检查。在研究的85例病例中，两个真菌学实验室报告58.8%的患者氢氧化钾制备结果相似，37.6%的患者真菌培养的属和种鉴定结果相似。当将氢氧化钾制备和真菌培养结果相结合时，两个真菌学实验室仅报告27.1%的患者结果相似。由于两个真菌学实验室的发现，对于43.5%的研究患者，美国食品药品监督管理局批准的可能药物治疗方法可能不同。两个独立实验室之间的差异让医生质疑荧光氢氧化钾制备和真菌培养分析在老年患者群体中诊断甲癣的可重复性。
