Fungal Molecular Diagnostics

Potential Advantages of Direct Detection

February 2011

Direct detection of Candida species from blood is obviously advantageous for the patient. Rapid identification of the 5 commonly encountered species should lead to improved patient safety by permitting the physician to select the most effective drug (for example, fluconazole versus an echinocandin) and to begin appropriate treatment as rapidly as possible, thus potentially decreasing the hospital length of stay. Decreasing the length of stay has an obvious impact on cost, but so does selecting the best drug even before traditional drug susceptibility results become available because the daily cost of fluconazole is much less than that of an echinocandin. Therefore, knowing that fluconazole should be effective within 2 to 3 hours of a positive blood culture can contribute to reduced healthcare costs.

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Potential Advantages of Direct Detection

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Jump to section:

• Introduction
• Objectives
• Traditional Methods of Fungal Diagnostics
• Traditional Methods
• Potential Advantages of Fungal Molecular Diagnostics
• Currently Available Molecular Diagnostics for Fungi
• Nucleic Acid Hybridization Probes³
• Nucleic Acid Hybridization Probes
• Nucleic Acid Hybridization Probes for Fungi
• Nucleic Acid Hybridization Probes
• DNA Sequencing for Fungi
• Ribosomal Structure: Fungi
• Traditional Sequencing Workflow
• Sequence Analysis
• Current Applications of D2 Fungal Sequencing at the Mayo Clinic
• Rapid, Direct Identification of Yeast from Blood Cultures
• PNA-FISH Basics
• PNA FISH for Candida spp—Direct Detection from Blood
• Yeast Identification Timeline from Positive Blood Bottle
• Potential Advantages of Direct Detection
• Fungal PCR Assays at Mayo Clinic
• Real-time PCR Workflow
• Pneumocystis PCR
• Pneumocystis LC-PCR Melt Curves
• Concordance of the Pneumocystis LightCycler PCR Assay and Calcofluor White Stain for BAL Fluid
• Coccidioides species Real-time PCR
• Melt-curve Analysis of Coccidioides spp Grown in Culture
• Utility of Coccidioides PCR Testing in the Clinical Setting⁴
• Meningeal Coccidioidomycosis Diagnosed by Real-Time PCR Analysis of Cerebrospinal Fluid⁵
• Histoplasma capsulatum/Blastomyces dermatitidis Real-Time PCR
• What lies in the future for fungal molecular diagnostics?
• Mass Spectrometric Identification Of Fungi
• Summary
• References
• Questions?
• Disclosure