Candida identification: a journey from conventional to molecular methods in medical mycology

Area of Science:

• Clinical Microbiology
• Infectious Diseases
• Molecular Diagnostics

Background:

• Increasing incidence of Candida infections, particularly candidemia, linked to immunosuppression and intensive care unit practices.
• Candida albicans is a major cause of morbidity and mortality, exacerbated by antimicrobial resistance and limited antifungal options.
• Accurate and early detection of candidemia and species identification are critical for effective therapeutic intervention.

Purpose of the Study:

• To review conventional and molecular techniques for Candida species identification.
• To discuss the advantages and limitations of various diagnostic methods.
• To highlight promising molecular approaches for rapid and accurate Candida identification.

Main Methods:

• Review of existing diagnostic techniques, including conventional methods (e.g., blood culture) and molecular approaches.
• Focus on molecular methods targeting the internal transcribed spacer (ITS) regions (ITS1 and ITS2) of the rRNA gene.
• Specific mention of ITS sequencing and PCR-restriction fragment length polymorphism (PCR-RFLP) analysis.

Main Results:

• Conventional methods like blood culture lack sensitivity and conventional species identification is time-consuming and prone to misdiagnosis.
• Molecular methods offer improved accuracy and speed for Candida species identification.
• ITS sequencing and PCR-RFLP analysis of the ITS region show promise as rapid, easy, and cost-effective identification tools.

Conclusions:

• Molecular methods, especially those targeting ITS regions, are valuable alternatives for accurate and rapid identification of Candida species.
• These methods can overcome limitations of conventional techniques, aiding in timely and appropriate patient management.
• Further evaluation of discriminatory power, reproducibility, and ease of performance is essential for widespread adoption.