Invasive candidiasis: future directions in non-culture based diagnosis

Expert Rev Anti Infect Ther. 2017 Sep;15(9):829-838. doi: 10.1080/14787210.2017.1370373. Epub 2017 Sep 7.

Abstract

Delayed initial antifungal therapy is associated with high mortality rates caused by invasive candida infections, since accurate detection of the opportunistic pathogenic yeast and its identification display a diagnostic challenge. diagnosis of candida infections relies on time-consuming methods such as blood cultures, serologic and histopathologic examination. to allow for fast detection and characterization of invasive candidiasis, there is a need to improve diagnostic tools. trends in diagnostics switch to non-culture-based methods, which allow specified diagnosis within significantly shorter periods of time in order to provide early and appropriate antifungal treatment. Areas covered: within this review comprise novel pathogen- and host-related testing methods, e.g. multiplex-PCR analyses, T2 magnetic resonance, fungus-specific DNA microarrays, microRNA characterization or analyses of IL-17 as biomarker for early detection of invasive candidiasis. Expert commentary: Early recognition and diagnosis of fungal infections is a key issue for improved patient management. As shown in this review, a broad range of novel molecular based tests for the detection and identification of Candida species is available. However, several assays are in-house assays and lack standardization, clinical validation as well as data on sensitivity and specificity. This underscores the need for the development of faster and more accurate diagnostic tests.

Keywords: Candida; PCR; candidiasis; diagnosis; molecular-based tools.

Publication types

  • Review

MeSH terms

  • Antifungal Agents / therapeutic use
  • Biomarkers / blood
  • Blood Culture
  • Candida / classification*
  • Candida / drug effects
  • Candida / genetics
  • Candida / isolation & purification*
  • Candidiasis, Invasive / diagnosis*
  • Candidiasis, Invasive / drug therapy*
  • Candidiasis, Invasive / microbiology
  • Candidiasis, Invasive / mortality
  • Delayed Diagnosis
  • Humans
  • Interleukin-17 / blood
  • Magnetic Resonance Spectroscopy / standards
  • Microbial Sensitivity Tests
  • Multiplex Polymerase Chain Reaction / standards
  • Mycological Typing Techniques / instrumentation
  • Mycological Typing Techniques / methods
  • Mycological Typing Techniques / standards*
  • Oligonucleotide Array Sequence Analysis / standards
  • Survival Analysis

Substances

  • Antifungal Agents
  • Biomarkers
  • Interleukin-17