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Updates in Laboratory Diagnostics for Invasive Fungal Infections
David Terrero-Salcedo1, Margaret V Powers-Fletcher2
1Department of Internal Medicine, University of Cincinnati College of Medicine, Cincinnati, Ohio, USA.
Abstract:
Appropriate diagnosis of invasive fungal infections (IFIs) is critical due to the high rates of morbidity and mortality, as well as the substantial economic burden, associated with the management of these diseases. The recognition of IFI and differentiation from other infections with similar clinical presentations can be challenging, which can lead to diagnostic error that not only has an impact on individual patient health outcomes but also on antimicrobial drug usage and the growing threat of antimicrobial resistance in bacteria. Therefore, there is a significant need for improved stewardship related to diagnostic testing for and treatment of IFIs. The purpose of this review is to highlight recent advances related to current fungal diagnostics, as well as explore some of the most innovative technology that has emerged with the potential to shift the paradigm of clinical mycology. In general, this review will discuss research related to enhanced fungal culture utilization and identification techniques, expanded applications of fungal antigen testing, and recently developed molecular assays and other novel nonculture fungal diagnostic approaches. Specifically, the application of mass spectrometry, novel glycobiomarker detection, and detection of fungal-specific volatile organic compounds will be reviewed, along with other key updates, to provide the reader with an updated review that extends beyond the basics of IFI laboratory diagnostics. Where appropriate, the reader will be directed to more comprehensive reviews of certain aspects of clinical mycology laboratory testing to provide a broader context for the critical consideration of these updates.
Insights
Accurate diagnosis of invasive fungal infections (IFIs) is vital. This review explores advanced fungal diagnostics, including mass spectrometry and molecular assays, to improve patient outcomes and combat antimicrobial resistance.
Area of Science:
- Clinical Mycology
- Infectious Diseases
- Diagnostic Microbiology
Background:
- Invasive fungal infections (IFIs) present significant morbidity, mortality, and economic burdens.
- Diagnostic challenges in IFIs can lead to errors, impacting patient health and antimicrobial stewardship.
- There is a critical need for improved diagnostic testing and treatment strategies for IFIs.
Purpose of the Study:
- To review recent advancements in fungal diagnostics.
- To explore innovative technologies with the potential to transform clinical mycology.
- To provide an updated overview of laboratory diagnostics for IFIs.
Main Methods:
- Review of research on enhanced fungal culture techniques and identification.
- Discussion of expanded applications of fungal antigen testing.
- Exploration of novel molecular assays and non-culture diagnostic approaches, including mass spectrometry, glycobiomarker detection, and volatile organic compound analysis.
Main Results:
- Recent advances include improved culture methods, expanded antigen tests, and novel molecular assays.
- Innovative technologies like mass spectrometry offer new diagnostic possibilities.
- Non-culture methods, such as biomarker and volatile organic compound detection, show promise for early IFI diagnosis.
Conclusions:
- Advancements in fungal diagnostics are crucial for timely and accurate IFI detection.
- Innovative technologies have the potential to significantly improve clinical mycology.
- Enhanced diagnostic stewardship for IFIs is essential to improve patient care and combat antimicrobial resistance.
