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Concordance analysis between different methodologies used for identification of oral isolates of Candida  species
Zuluaga, Alejandra; Arango-Bustamante, Karen; Caceres, Diego H.; Sánchez-Quitian, Zilpa A.; Velásquez, Verónica; Gómez, Beatriz L.; Parra-Giraldo, Claudia M.; Maldonado, Natalia; Cano, Luz E.; de Bedout, Catalina & Rivera, Raúl E.
Abstract
Background: The yeasts species determination is fundamental not
only for an accurate diagnosis but also for establishing a suitable patient
treatment. We performed a concordance study of five methodologies
for the species identification of oral isolates of Candida in Colombia.
Methods: Sixty-seven Candida isolates were tested by; API® 20C-AUX,
Vitek®2 Compact, Vitek®MS, Microflex® and a molecular test (panfungal
PCR and sequencing). The commercial cost and processing time of the
samples was done by graphical analysis.
Results: Panfungal PCR differentiated 12 species of Candida, Vitek®MS
and Microflex® methods identified 9 species, and API® 20C-AUX and
Vitek®2 Compact methods identified 8 species each. Weighted Kappa
(wK) showed a high agreement between Panfungal PCR, Vitek®MS,
Microflex® and API® 20C-AUX (wK 0.62-0.93). The wK that involved the
Vitek®2 Compact method presented moderate or good concordances
compared with the other methods (wK 0.56-0.73). Methodologies
based on MALDI TOF MS required 4 minutes to generate results and
the Microflex® method had the lowest selling price.
Conclusion: The methods evaluated showed high concordance in their
results, being higher for the molecular methods and the methodologies
based on MALDI TOF. The latter are faster and cheaper, presenting as
promising alternatives for the routine identification of yeast species of
the genus Candida.
Keywords
Candida; mouth mucosa; diagnosis; Polymerase Chain Reaction; Spectrometry; Mass; Matrix-Assisted Laser Desorption-Ionization; Colombia
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