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J. Fungi 2019, 5(1), 9; https://doi.org/10.3390/jof5010009

New Concepts in Diagnostics for Invasive Mycoses: Non-Culture-Based Methodologies

Division 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
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Received: 11 December 2018 / Revised: 14 January 2019 / Accepted: 15 January 2019 / Published: 17 January 2019
(This article belongs to the Special Issue Fungal Infections in Immunocompromised Hosts)
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PDF [259 KB, uploaded 28 January 2019]

Abstract

Non-culture-based diagnostics have been developed to help establish an early diagnosis of invasive fungal infection. Studies have shown that these tests can significantly impact the diagnosis of infection in high risk patients. Aspergillus galactomannan EIA testing is well-recognized as an important adjunct to the diagnosis of invasive aspergillosis and can be detected in serum, bronchoalveolar lavage and other fluids. Galactomannan testing used along with PCR testing has been shown to be effective when integrated into care paths for high risk patients for both diagnoses and as a surrogate marker for outcome when used in serial testing. Beta-d-glucan assays are non-specific for several fungal genera including Aspergillus and Candida and in high risk patients have been an important tool to augment the diagnosis. Lateral flow technology using monoclonal antibodies to Aspergillus are available that allow rapid testing of clinical samples. While standard PCR for Candida remains investigational, T2 magnetic resonance allows for the rapid diagnosis of Candida species from blood cultures. Aspergillus PCR has been extensively validated with standardized approaches established for these methods and will be included in the diagnostic criteria in the revised European Organization for Research and Treatment of Cancer/Mycoses Study Group (EORTC-MSG) definitions. Finally, these non-culture-based tests can be used in combination to significantly increase the detection of invasive mycoses with the ultimate aim of establishing an early diagnosis of infection. View Full-Text
Keywords: invasive fungal infection; non-culture-based diagnostics; aspergillosis; candidiasis; Aspergillus PCR; galactomannan; lateral flow; beta-d-glucan; T2 Candida invasive fungal infection; non-culture-based diagnostics; aspergillosis; candidiasis; Aspergillus PCR; galactomannan; lateral flow; beta-d-glucan; T2 Candida
This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited (CC BY 4.0).
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Patterson, T.F.; Donnelly, J.P. New Concepts in Diagnostics for Invasive Mycoses: Non-Culture-Based Methodologies. J. Fungi 2019, 5, 9.

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