Fungal Diagnostics: Review of Commercially Available Methods

Abstract

Fungi and yeasts are critical causes of acute infection. As such, the detection and identification of these organisms are crucial in the diagnosis of affected patient populations. There is a vast array of commercial tests currently available for diagnostic purposes. These vary from traditional culture and biochemical methods to advanced multiparameter molecular tests. Recent technological advances have driven the development of rapid tests which are complementing and in some cases replacing the more traditional methods of detection. Irrespective of the method used the ultimate goal is timely detection of the infectious agent allowing appropriate treatment and improved outcome for the patient.

Multicenter Study Evaluating the Vitek MS System for Identification of Medically Important Yeasts

“…The results of the multicenter study indicate that, independent of the laboratory and the geographical origin of the isolates, the Vitek MS demonstrated an overall species identification rate comparable or superior to those for both traditional biochemical and nucleic acid-based yeast identification systems (11,12) but with a significant reduction in the time to identification. This method is technically facile and, once the laboratory has recovered the capital investment for the instrument purchase, the ongoing cost of consumables is low.…”

“…While fewer studies evaluating MALDI-TOF MS identification of yeasts than bacteria have been published to date, the theme of the existing literature is that the performance of MALDI-TOF MS in identifying fungi, both yeasts and molds, is comparable or su-perior to that of conventional and nucleic acid-based identification methods (11,12,19,(22)(23)(24)(25)(26)(27)(28)(29). The major advantages of MALDI-TOF MS identification of yeasts, compared with conventional methods, are the marked decreases in cost and time to identification (30).…”

“…The methods for identification of yeasts in the diagnostic clinical microbiology laboratory have improved significantly over the past several decades (11,12), with methods ranging from simple manual biochemical assays to automated biochemical methods to sophisticated nucleic acid-based assays (11,12). While these advancements in methodology have greatly enhanced our ability to identify yeasts, the limitations of these methods include cost, turnaround time, and, in some instances, the need for considerable expertise.…”

Evolution of Cryptococcal Antigen Testing: What Is New?

“…However, new innovative technologies that use molecular and immunoassay point-of-care platforms have the potential to meet the needs of both resource-rich and resource-limited clinical environments [4] • . In this review, we describe the evolution of diagnostic techniques for cryptococcal infection focusing on CrAg testing and outline the current need and gaps in the area of cryptococcal infection testing.…”

MALDI-TOF Mass Spectrometry for Microorganism Identification

“…High inter-laboratory accuracy was observed for the identification of medically relevant yeasts collected at distinct sites across North America (Westblade et al, 2013). In summary, MALDI-TOF MS performs as well as and often exceeds conventional methods for the identification of medically relevant yeast and can delivers results days to weeks earlier than conventional methods (Marcos & Pincus, 2013).…”