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Published on: April 19, 2017
Update on the diagnosis of invasive fungal infection
E Ibáñez-Martínez, A Ruiz-Gaitán, J Pemán-García1
1Javier Pemán-García, Servicio de Microbiología, Hospital Universitari i Politècnic La Fe, Valencia, Spain. peman_jav@gva.es.
Abstract:
The number of patients at risk of suffering invasive fungal infection (IFI) is increasing. Because of its high mortality, new rapid and accurate diagnostic tools are needed. Last advances in invasive candidiasis diagnosis comprise Peptide Nucleic Acid Fluorescent In-Situ Hybridization (PNA-FISH), direct MALDI-TOF or multiplex acid nucleic testing. While all of them rely in positive blood cultures, T2Candida uses PCR coupled with T2Magnetic resonance detection directly in whole blood, allowing detection of 1-3 UFC/mL of Candida in about four hours. Beyond galactomannan (GM), novelties in IFI caused by molds include the international standardization of PCR techniques, with several commercial kits available. A combination of GM and PCR appears to be a good diagnostic strategy for invasive aspergillosis. PCR coupled to electrospray ionization/mass spectrometry and detection of volatile organic compounds in exhaled air by gas chromatography/mass spectrometry are other promising approaches to IFI diagnostic that still need to be validated.
Insights
New diagnostic tools are crucial for invasive fungal infections (IFI) due to increasing patient risk and high mortality. Advances include rapid molecular tests like T2Candida and standardized PCR for molds, improving early detection and patient outcomes.
Area of Science:
- Medical Mycology
- Infectious Diseases
- Diagnostic Microbiology
Background:
- Invasive fungal infections (IFI) pose a significant threat with high mortality rates.
- The increasing number of at-risk patients necessitates rapid and accurate diagnostic methods.
- Current diagnostic tools for invasive candidiasis often rely on positive blood cultures.
Purpose of the Study:
- To review recent advancements in the diagnosis of invasive fungal infections.
- To highlight novel diagnostic strategies for invasive candidiasis and invasive aspergillosis.
- To discuss emerging technologies for faster and more sensitive IFI detection.
Main Methods:
- Review of recent diagnostic technologies for invasive fungal infections.
- Comparison of methods for invasive candidiasis diagnosis, including T2Candida (PCR and T2Magnetic resonance).
- Evaluation of diagnostic approaches for invasive aspergillosis, such as galactomannan (GM) and PCR.
Main Results:
- T2Candida offers rapid detection of Candida directly from whole blood in approximately four hours.
- Standardized PCR techniques and commercial kits are now available for mold-related IFIs.
- A combination of GM and PCR shows promise for diagnosing invasive aspergillosis.
Conclusions:
- Novel diagnostic tools are essential for improving outcomes in patients with invasive fungal infections.
- Emerging technologies like T2Candida and standardized PCR represent significant progress in IFI diagnostics.
- Further validation is needed for promising techniques such as PCR-MS and volatile organic compound detection.
