The evolving role of direct amplification tests in diagnosing osteoarticular infections caused by mycobacteria and fungi.

Polymerase chain reaction-based direct amplification tests have been developed for many species of mycobacteria and fungi. Their applications in clinical medicine are evolving rapidly but are still not fully defined. Uncritical use of direct amplification tests for individual patients without a clear understanding of their limitations and how to integrate their results with other clinical and laboratory data may lead to incorrect patient management. Although presently available tests seem to be clinically useful when properly applied, further technical development and clinical studies are needed before these powerful diagnostic tools achieve their full value.