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Cited by 290Antifungal resistance and susceptibilityBacterial Identification and Susceptibility TestingFungal Infections and Studies

Performance of Candida Real-time Polymerase Chain Reaction, -D-Glucan Assay, and Blood Cultures in the Diagnosis of Invasive Candidiasis

Nguyen, M. H., Wissel, M. C., Shields, R. K., Salomoni, M. A., Hao, B., Press, E. G., Shields, R. M., Cheng, S. +5 more·2012·Clinical Infectious Diseases
DOI 10.1093/cid/cis200
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Abstract

BACKGROUND: The sensitivity of blood cultures for diagnosing invasive candidiasis (IC) is poor. METHODS: We performed a validated Candida real-time polymerase chain reaction (PCR) and the Fungitell 1,3-β-D-glucan (BDG) assay on blood samples collected from prospectively identified patients with IC (n = 55) and hospitalized controls (n = 73). Patients with IC had candidemia (n = 17), deep-seated candidiasis (n = 33), or both (n = 5). Controls had mucosal candidiasis (n = 5), Candida colonization (n = 48), or no known Candida colonization (n = 20). RESULTS: PCR using plasma or sera was more sensitive than whole blood for diagnosing IC (P = .008). Plasma or sera PCR was more sensitive than BDG in diagnosing IC (80% vs 56%; P = .03), with comparable specificity (70% vs 73%; P = .31). The tests were similar in diagnosing candidemia (59% vs 68%; P = .77), but PCR was more sensitive for deep-seated candidiasis (89% vs 53%; P = .004). PCR and BDG were more sensitive than blood cultures among patients with deep-seated candidiasis (88% and 62% vs 17%; P = .0005 and .003, respectively). PCR and culture identified the same Candida species in 82% of patients. The sensitivity of blood cultures combined with PCR or BDG among patients with IC was 98% and 79%, respectively. CONCLUSIONS: Candida PCR and, to a lesser extent, BDG testing significantly enhanced the ability of blood cultures to diagnose IC.

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Crossref · 10.1093/cid/cis200

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  • Standard diagnostic approaches require blood cultures, which are slow and can have low sensitivity, with some studies reporting sensitivities as low as 17% or 45%.

    “standard diagnostic approaches require blood cultures, which are slow and can have a low sensitivity. For instance, some studies reported sensitivities as low as 17% [7] or 45% [8].”

    From Evolutionary Emergence of Drug Resistance in Candida Opportunistic Pathogens (2018) · cites this paper as [7]

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Authors
Nguyen, M. H., Wissel, M. C., Shields, R. K., Salomoni, M. A., Hao, B., Press, E. G., Shields, R. M., Cheng, S., Mitsani, D., Vadnerkar, A., Silveira, F. P., Kleiboeker, S. B., & Clancy, C. J.
Affiliations
University of Pittsburgh (US)
ORCID
Venue
Clinical Infectious Diseases
Publisher
Oxford University Press (OUP)
Published
2012-03-19
Volume
54
Issue
9
Pages
1240-1248
ISSN
  • 1058-4838 (ISSN-L)
  • 1537-6591
DOI
10.1093/cid/cis200
OpenAlex
W2141171649
Cited by
290
References
32
Citations by year
2026: 9 · 2025: 15 · 2024: 14 · 2023: 17 · 2022: 12 · 2021: 16 · 2020: 18 · 2019: 20 · 2018: 15 · 2017: 30 · 2016: 27 · 2015: 36 · 2014: 28 · 2013: 21 · 2012: 9
FWCI
20.85
Type
journal article
Language
en
Open access
closed
Locations
  • Clinical Infectious Diseases (publishedVersion)
  • PubMed (publishedVersion)
Funders
  • Pfizer
  • AstraZeneca
  • CSL Behring
Topics
  • Health Sciences › Medicine › Infectious Diseases › Antifungal resistance and susceptibility
  • Life Sciences › Biochemistry, Genetics and Molecular Biology › Clinical Biochemistry › Bacterial Identification and Susceptibility Testing
  • Health Sciences › Medicine › Epidemiology › Fungal Infections and Studies
Keywords
invasive candidiasis, 1,3-β-D-glucan assay, blood culture, candidemia, diagnostic sensitivity, Candida colonization, mucosal candidiasis
MeSH terms
Candida, Candidiasis, DNA, Fungal, Humans, Prospective Studies, Proteoglycans, Reagent Kits, Diagnostic, Sensitivity and Specificity, beta-Glucans, Candidiasis, Invasive, Candidemia, Real-Time Polymerase Chain Reaction

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