Rapid differentiation of Candida albicans from non-C. albicans directly in a variety of clinical specimens using fluorescent in situ hybridisation

Abstract

Rapid differentiation of Candida albicans from non-C. albicans species in direct clinical samples is crucial to optimise empirical antifungal therapy at an early stage, which can lead to the reduction in caspofungin usage with an overall cost saving. Traditional phenotypic methods are time-consuming and difficult to accurately differentiate Candida albicans from non-C. albicans species. There is an urgent clinical need for a rapid, sensitive and specific method for the differentiation of Candida albicans from non-C. albicans species in clinical specimens. In this study, we established a protocol for the application of a fluorescent in situ hybridisation (FISH) assay on different clinical samples, and analysed the effectiveness of this protocol for discriminating these organisms without prior cultivation. The FISH protocol for differentiating C. albicans from non-C. albicans species showed 95% sensitivity and 100% specificity. The positive predictive value was 100% and the negative predictive value was 94% compared with results obtained using traditional methods. Three clinical samples were FISH negative and culture positive, the percentage of false negatives with FISH was 4.0%. The results indicate that the FISH protocol is effective and reliable for the rapid differentiation of C. albicans from non-C. albicans species directly in clinical samples.

Rapid and Selective Detection of Pathogenic Bacteria in Bloodstream Infections with Aptamer-Based Recognition

“…However, the inability to diagnose pathogenic bacteria rapidly in the early stage of infection is one of the main causes of high mortality. − As the consensus has been reached that every hour of delay in administration of effective antibiotic therapy results in a 7.6% mean decrease in survival rate, , it is an urgent demand to develop new diagnostic methods for selective and rapid pathogen detection directly from blood samples. Nowadays, amplification-based molecular diagnostic methods such as fluorescent in situ hybridization − and real-time polymerase chain reactions − have been used to effectively shorten the time for bacterial identification following blood culture positivity. Nonetheless, these methods also involve long-term blood culture.…”

Treatment and prophylaxis of invasive candidiasis with anidulafungin, caspofungin and micafungin and its impact on use and costs - review of the literature

“…However, since methods for rapid species differentiations are available and save early detection of the fungus strain and its resistance patterns is enormously important. Fluorescent in situ hybridisation (FISH) assay is a proven method for the differentiation Candida strains [ 39 ]. Forrest et al and Alexander et al investigated the potential economical benefit of early detection of the causative Candida strain.…”