Importance of Using Molecular Characterization of Fungal Species Identified in Superficial Mycoses in Togo

Aims: This study aims to measure the accuracy of routine techniques for identifying fungi in mycology laboratories in Lomé, Togo. Study Design: It was a descriptive-analytical study. Place and Duration of Study: The study was carried out at the Mycology Laboratories of the Sylvanus Olympio and Campus University Hospitals in Lomé-Togo and at the Parasitology-Mycology Laboratory of the Pitié Salpêtrière Hospital in Paris, France, from March 2023 to April 2024. Methodology: Fungal isolates were initially identified using routine laboratory techniques. All isolates were then reanalyzed using Matrix-Assisted Laser Desorption/Ionization Time-of-Flight Mass Spectrometry (MALDI-TOF MS), and the results were compared to assess concordance and improvements in species identification. Results: Among the 249 isolates analyzed, MALDI-TOF MS showed a 51.81% concordance with conventional methods. Additionally, 26.10% of isolates initially identified only at the genus level were further classified at the species level using MALDI-TOF MS. The technique also corrected the identification of 17.27% of strains previously misidentified by conventional methods and successfully characterized 3.61% of isolates that could not be identified using routine techniques. Although 1.20% of isolates remained unidentified by MALDI-TOF MS, the method significantly enhanced fungal identification rates by 46.98%, increasing overall identification accuracy from 51.81% to 98.79%. Conclusion: These findings highlight the need to upgrade mycology laboratories with advanced diagnostic tools like MALDI-TOF MS, expand fungal diagnostic capabilities, and provide continuous training for laboratory personnel. Strengthening these capacities will improve the accuracy of fungal identification and enhance the therapeutic management of patients with mycoses.