Nail Testing

Nail infections are commonly identified in both fingernails and toenails and are frequently difficult to treat. Infected nails can result in thickened, brittle, or discolored fingernails due to either fungal (onychomycosis) or bacterial (paronychia) pathogens in the nail bed, nail plate or the surrounding tissue. An injury or irritation can cause these infections to the nail or surrounding area and are frequently seen in patients with weakened immune systems, diabetes, or poor circulation.

Both fungal and bacterial nail infections rely on accurate clinical diagnosis to identify the pathogens present and will determine the success of the patient treatment plan. Conventional detection methods, such as culture and direct microscopy, are time-consuming, and many visual identification techniques often cannot identify nail pathogens in specimens. Nail culturing techniques are considered less sensitive than other detection methods and often depend on the amount of viable pathogen present in the sample and the success of growth in a culture environment. Direct microscopy of a sample is also considered less specific than other detection as it relies on a visual examination (potassium hydroxide (KOH)) of pathogens present. The accuracy of test results using both nail culture and direct microscopy detection also may be impacted by the current antibiotic or antifungal use of the patient.

Molecular diagnostics can help bring precision-targeted diagnostics to nail infections, identifying a broad group of fungal and bacterial pathogens and including any antibiotic resistance. With a simple nail clipping, Innovative Gx Laboratories (IGx) performs multiplex polymerase chain reaction (PCR) technology to identify pathogens present in the nail, as well as antibiotic resistance contained in the pathogens. Among the pathogens identified in the IGx Nail Pathogen test are:

Bacteria/Fungus

  • Alternaria spp
  • Aspergillus fumigatus, Aspergillus flavus
  • Candida group 1 (Candida albicans, C. tropicalis, C. parapsilosis, C. dubliniensis)
  • Curvularia lunata
  • Epidermophyton floccosum
  • Fusarium keratoplasticum (solani)
  • Geotrichum candidum
  • Malassezia furfur
  • Microsporum ferrugineum, Microsporum audouinii, Microsporum canis
  • Nocardia asteroides
  • Pseudomonas aeruginosa
  • Scopulariopsis brevicaulis
  • Scytalidium dimidiatum
  • Trichophyton Group (T. rubrum, T. interdigitale, T. tonsurans)

Molecular antibiotic resistance

  • Carbapenemase and Matallo-Betalactamase Resistance
  • Class A and C Beta-lactams Resistance
  • Class A and Plasmid ESBL Resistance
  • Class C Beta-lactams Resistance
  • Class D Betalactamase Resistance
  • Dihydrofolate and Sulfonamide Resistance
  • Quinolone Resistance

The IGx Nail Test delivers results within 24-48 hours upon receipt to our laboratory with the highest levels of accuracy, sensitivity, and specificity to help diagnose and correctly treat the pathogens in infected nails. For more information on the IGx Nail Pathogen test, please contact our office or a member of the IGx sales staff.

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