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Review
. 2021;15(3):67-80.
doi: 10.1007/s12281-021-00421-x. Epub 2021 Jun 18.

Molecular Diagnosis of Yeast Infections

P Lewis White  1 , Jessica S Price  1 , Alan Cordey  1 , Matthijs Backx  1
Affiliations
Review

Molecular Diagnosis of Yeast Infections

P Lewis White et al. Curr Fungal Infect Rep. 2021.

Abstract

Purpose of review: The use of molecular tests to aid the diagnosis of invasive yeast infection, in particular invasive candidosis, has been described for over two decades, yet widespread application is limited, and diagnosis remains heavily dependent on classical microbiology. This article will review developments from the past decade in attempt to build on existing knowledge. It will highlight clinical performance and limitations while reviewing developments on recognized procedures; it will also provide insight into novel approaches incorporated in response to clinical demand (e.g. C. auris and antifungal resistance) or technological advances (e.g. next-generation sequencing).

Recent findings: Limited methodological standardization and, until recently, unavailability of commercial options have hindered the integration of molecular diagnostics for yeasts. The development of certain, novel commercial methods has received considerable evaluation allowing a greater understanding of individual assay performance, but widespread multicentre evaluation of most commercial kits is lacking. The detection of emerging pathogens (e.g. C. auris) has been enhanced by the development of molecular tests. Molecular methods are providing a better understanding of the mycobiome, mechanisms of resistance and epidemiology/phylogeny.

Summary: Despite over two decades of use, the incorporation of molecular methods to enhance the diagnosis of yeast infections remains limited to certain specialist centres. While the development of commercial tests will provide stimulus for broader application, further validation and reduced costs are required. Over the same period of time, Aspergillus PCR has become more widely accepted driven by international efforts to standardize methodology; it is critical that yeast PCR follows suit. Next-generation sequencing will provide significant information on the mycobiome, antifungal resistance mechanism and even broad-range detection directly from the specimen, which may be critical for the molecular detection of yeasts other than Candida species, which is currently limited.

Keywords: Candida; Molecular diagnosis; PCR; Yeast.

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Conflict of interest statement

Conflict of InterestP. Lewis White: Performed diagnostic evaluations and received meeting sponsorship from Associates of Cape Cod, Bruker, Dynamiker and Launch Diagnostics; speakers’ fees, expert advice fees and meeting sponsorship from Gilead; and speaker and expert advice fees from F2G and speaker fees from IMMY, MSD and Pfizer. Is a founding member of the European Aspergillus PCR Initiative.Matthijs Backx: Speakers’ fees, expert advice fees and meeting sponsorship from Gilead. Meeting sponsorship from AbbVie. Jessica S. Price and Alan Cordey declare that they have no conflict of interest.

References

    1. Ullmann AJ, Cornely OA, Donnelly JP, Akova M, Arendrup MC, Arikan-Akdagli S, Bassetti M, Bille J, Calandra T, Castagnola E, Garbino J, Groll AH, Herbrecht R, Hope WW, Jensen HE, Kullberg BJ, Lass-Flörl C, Lortholary O, Meersseman W, Petrikkos G, Richardson MD, Roilides E, Verweij PE, Viscoli C, Cuenca-Estrella M, ESCMID Fungal Infection Study Group ESCMID guideline for the diagnosis and management of Candida diseases 2012: developing European guidelines in clinical microbiology and infectious diseases. Clin Microbiol Infect. 2012;18(SUPPL.7):1–8. doi: 10.1111/1469-0691.12037. - DOI - PubMed
    1. Cuenca-Estrella M, Verweij PE, Arendrup MC, Arikan-Akdagli S, Bille J, Donnelly JP, Jensen HE, Lass-Flörl C, Richardson MD, Akova M, Bassetti M, Calandra T, Castagnola E, Cornely OA, Garbino J, Groll AH, Herbrecht R, Hope WW, Kullberg BJ, Lortholary O, Meersseman W, Petrikkos G, Roilides E, Viscoli C, Ullmann AJ, ESCMID Fungal Infection Study Group ESCMID guideline for the diagnosis and management of Candida diseases 2012: diagnostic procedures. Clin Microbiol Infect. 2012;18(SUPPL.7):9–18. doi: 10.1111/1469-0691.12038. - DOI - PubMed
    1. Avni T, Leibovici L, Paul M. PCR diagnosis of invasive candidiasis: systematic review and meta-analysis. J Clin Microbiol. 2011;49(2):665–670. doi: 10.1128/JCM.01602-10. - DOI - PMC - PubMed
    1. Pfaller MA, Diekema DJ. Epidemiology of invasive mycoses in North America. Crit Rev Microbiol. 2010;36(1):1–53. doi: 10.3109/10408410903241444. - DOI - PubMed
    1. Tumbarello M, Posteraro B, Trecarichi EM, Fiori B, Rossi M, Porta R, de Gaetano Donati K, la Sorda M, Spanu T, Fadda G, Cauda R, Sanguinetti M. Biofilm production by Candida species and inadequate antifungal therapy as predictors of mortality for patients with candidemia. J Clin Microbiol. 2007;45(6):1843–1850. doi: 10.1128/JCM.00131-07. - DOI - PMC - PubMed

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