Clinical validation of a multiplex real-time PCR assay for detection of invasive candidiasis in intensive care unit patients

Abstract

MRT-PCR appears to be a useful test for confirming a diagnosis of IC in critically ill patients, especially in those with deep-seated disease. Its high sensitivity and positive predictive value make it a much more efficient tool for the management of IC than other diagnostic procedures and clinical scores.

Molecular diagnostic methods for invasive fungal disease: the horizon draws nearer?

“…[30][31][32] McMullan et al 30 prospectively evaluated the performance of three real-time PCR assays to detect Candida species in 157 critically ill patients (assay 1 targeted C. albicans, C. tropicalis, C. parapsilosis and C. dubliniensis; assay 2 targeted C. glabrata; and assay 3 targeted C. krusei). These results were supported by another study 25 comparing a multiplex real-time PCR assay with blood culture and BDG. 30 More recently, Nguyen et al 32 reported that a Candida realtime PCR was more sensitive than the Fungitell 1,3-b-D-glucan (BDG) assay (Associates of Cape Cod, USA) for diagnosing IC (80% versus 56%) and deep-seated (blood culture negative) candidiasis (89% versus 53%), with comparable specificity (70% versus 73%).…”

“…Lau et al 34 developed an MT-PCR assay to simultaneously detect 11 fungal pathogens (7 Candida species, C. neoformans complex, Fusarium solani, Fusarium species and S. prolificans) from blood culture. Recently, Fortún et al 25 found whole blood and serum yielded similar results for the detection of IC in ICU patients by multiplex RT-PCR. 34 Drawbacks of PCR-based methods for Candida, which limit their routine use, include: the propensity for false positive results (inability to distinguish colonisation or even contamination, from real infection), lack of method standardisation and high costs.…”

“…Whilst there is strength in evaluating a range of methodologies, comparison between methods is problematic. Negative predictive values (NPVs) were higher (88-100%), suggesting that PCR-based assays are more useful in excluding, rather than establishing, the diagnosis of IC, 24,25 and may provide justification for stopping antifungal therapy. Arvanitis et al 1 reported that although the ranges of sensitivity and specificity are wide (56-100% and 54-100%, respectively) most studies report higher sensitivity and specificity values (in the range of 80-100%, and 90-100%, respectively).…”

A New Age in Molecular Diagnostics for Invasive Fungal Disease: Are We Ready?

“…Most Candida PCR data have been sourced using WB or blood fractions with reported high sensitivities (80-100%), specificities (90-100%), and NPVs (88-100%) for those species targeted. This suggests that PCR-based assays may be more useful in excluding, rather than establishing, the diagnosis of IC (Arvanitis et al, 2014;Fortún et al, 2014). However, the clinical utility of these assays is uncertain due to their limited validation in real-life prospective settings.…”

Candidemia-induced pediatric sepsis and its association with free radicals, nitric oxide, and cytokine level in host

“…The increase in the candidemia case in tertiary hospital is because of improvement in detection techniques. The current uses of PCR have increased the detection of Candida-induced infection in hospitals [29]. The increase in candidemia cases in our study was probably due to good quality of detection techniques using PCR and species identification by DNA sequencing.…”