PCR-Based Methods for the Diagnosis of Invasive Candidiasis: Are They Ready for Use in the Clinic?

AbstractPurpose of ReviewWe review the performance of Candida PCR and the T2Candida panel (T2Biosystems, Lexington, MA) in diagnosing invasive candidiasis, consider how these tests may be incorporated into patient care, and determine if they are ready to be used in the clinic.Recent FindingsPCR and T2Candida sensitivity/specificity for diagnosing candidemia are ~  90%/90% and ~ 90%/98%, respectively. Limited data for intra-abdominal candidiasis suggest PCR sensitivity of ~ 85–90%, but specificity has varied from 33 to 97%. T2Candida data are lacking for infections other than candidemia.SummaryPCR and T2Candida will have the greatest value if their use is restricted to cases in which positive and negative predictive values differ in a clinically meaningful way from the pre-test likelihood. Studies are needed to establish that patient care and stewardship strategies incorporating Candida PCR or T2Candida improve patients ’ outcomes, reduce unnecessary antifungal usage, limit emergence of resistance, and are cost-effective. The development and validation of standardized PCR assays is a top priority.
Source: Current Fungal Infection Reports - Category: Infectious Diseases Source Type: research