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New Concepts in Diagnostics for Invasive Mycoses: Non-Culture-Based Methodologies
Thomas F Patterson1, J Peter Donnelly2
1Division of Infectious Diseases, San Antonio Center for Medical Mycology, The University of Texas Health Science Center at San Antonio and the South Texas Veterans Health Care System, 7703 Floyd Curl Drive-MSC 7881, San Antonio, TX 78229-3900, USA. patterson@uthscsa.edu.
Journal of Fungi (Basel, Switzerland)
|January 20, 2019
Summary
Non-culture-based diagnostics, including galactomannan and beta-d-glucan assays, aid early detection of invasive fungal infections in high-risk patients. Combining these methods improves diagnostic accuracy for better patient outcomes.
Area of Science:
- Medical Diagnostics
- Mycology
- Infectious Diseases
Background:
- Early diagnosis of invasive fungal infections is crucial for high-risk patients.
- Traditional culture-based methods have limitations in speed and sensitivity.
- Non-culture-based diagnostics offer promising alternatives for timely detection.
Purpose of the Study:
- To review the role and advancements of non-culture-based diagnostic methods for invasive fungal infections.
- To highlight the utility of galactomannan, beta-d-glucan, PCR, and T2 magnetic resonance assays.
- To emphasize the benefits of integrating these tests into patient care pathways.
Main Methods:
- Review of studies on non-culture-based diagnostic tests for invasive fungal infections.
- Analysis of galactomannan EIA, beta-d-glucan assays, PCR, and T2 magnetic resonance technologies.
- Evaluation of their application in serum, bronchoalveolar lavage, and blood cultures.
Main Results:
- Galactomannan testing is valuable for diagnosing invasive aspergillosis.
- Beta-d-glucan assays aid in diagnosing infections caused by Aspergillus and Candida.
- Combined testing strategies significantly increase the detection rate of invasive mycoses.
Conclusions:
- Non-culture-based diagnostics significantly impact early diagnosis and management of invasive fungal infections.
- These advanced tests, especially when used serially, serve as surrogate markers for treatment outcomes.
- Integration of these methods into diagnostic criteria, like the revised EORTC-MSG definitions, enhances patient care.
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