Use of Multiplex Tandem PCR (MT-PCR) in the Diagnosis of Dermatomycosis

Dermatophytes are the leading cause of cutaneous fungal infection worldwide, followed by non-dermatophyte molds and Candida spp. Microbiological diagnosis is essential to identify the etiological agent and to guide targeted therapy. Conventional methods, including direct microscopy and fungal culture, are fundamental tools in the diagnostic workflow. This study aimed to assess quantitative Multiplex Tandem PCR performance in comparison with microscopy and culture for rapid and accurate identification in real clinical practice. A total of 50 clinical specimens were collected and analyzed with conventional methods. Direct microscopic examination yielded positive results in 45 out of 50 samples (90%), while fungal culture identified clinically significant fungi in 29 out of 50 cases (58%). The same 50 specimens were retrospectively analyzed using Multiplex MT-PCR, which detects major dermatophytes, Scopulariopsis, Aspergillus and Candida species. MT-PCR identified fungal DNA in 84% of samples. Compared to standard reference methods, the assay demonstrated a sensitivity of 84% and a specificity of 60%. Notably, MT-PCR identified fungal pathogens that were missed by conventional techniques in 32% of cases, significantly reducing the turnaround time. Conversely, 6% of samples were PCR-negative but culture-positive, likely reflecting pre-analytical variability and sample heterogeneity. Although the sample size was limited, MT-PCR proved to be a rapid and highly sensitive complementary diagnostic tool, warranting further investigation in larger-scale studies.