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Updated: Feb 13, 2026

Isolation of Culturable Yeasts and Molds from Soils to Investigate Fungal Population Structure
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Fungal diagnostic stewardship in immunocompromised populations: a focus on molds and dimorphic fungi

Julie M Steinbrink1, Daniel Z Friedman2, George R Thompson3,4

  • 1Division of Infectious Diseases, Department of Internal Medicine, Duke University Medical Center, Durham, North Carolina, USA.

Clinical Microbiology Reviews
|February 12, 2026
PubMed

Insights

Fungal diagnostic stewardship improves care for immunocompromised patients by optimizing antifungal use and diagnostic testing. This approach reduces errors and unnecessary tests, leading to better patient outcomes.

Area of Science:

  • Medical Mycology
  • Infectious Diseases
  • Clinical Diagnostics

Background:

  • Invasive fungal diseases (IFDs) pose a significant threat to immunocompromised patients.
  • Antifungal use and diagnostic testing are increasing but lack traditional stewardship.
  • Current practices may lead to suboptimal patient care and resource utilization.

Purpose of the Study:

  • To review current fungal diagnostic assays for molds and dimorphic fungi.
  • To evaluate the diagnostic performance of these assays in immunocompromised hosts.
  • To propose strategies for effective fungal diagnostic stewardship.

Main Methods:

  • Literature review of fungal diagnostic assays.
  • Analysis of diagnostic performance data in immunocompromised populations.
  • Discussion of stewardship principles applied to fungal diagnostics.

Main Results:

  • Fungal diagnostic stewardship can decrease unnecessary testing and improve appropriate test utilization.
  • Optimized testing strategies can reduce diagnostic errors in immunocompromised patients.
  • Improved stewardship enhances patient outcomes and resource management.

Conclusions:

  • Implementing fungal diagnostic stewardship is crucial for managing IFDs.
  • Stewardship enhances the appropriate use of diagnostic assays and antifungal therapies.
  • This approach is vital for improving the care of vulnerable patient populations.
Keywords:
diagnostic stewardshipdimorphic fungifungal diagnosticsimmunocompromised hostsmolds

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