Cargando…

Performance of Multiplex PCR and β-1,3-D-Glucan Testing for the Diagnosis of Candidemia

Bloodstream infections caused by Candida yeasts (candidemia) are associated with high morbidity and mortality. Diagnosis remains challenging, with the current gold standard—isolation from blood culture (BC)—being limited by low sensitivity and long turnaround time. This study evaluated the performan...

Descripción completa

Detalles Bibliográficos
Autores principales: Koc, Özlem, Kessler, Harald H., Hoenigl, Martin, Wagener, Johannes, Suerbaum, Sebastian, Schubert, Sören, Dichtl, Karl
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9504845/
https://www.ncbi.nlm.nih.gov/pubmed/36135696
http://dx.doi.org/10.3390/jof8090972
_version_ 1784796319736397824
author Koc, Özlem
Kessler, Harald H.
Hoenigl, Martin
Wagener, Johannes
Suerbaum, Sebastian
Schubert, Sören
Dichtl, Karl
author_facet Koc, Özlem
Kessler, Harald H.
Hoenigl, Martin
Wagener, Johannes
Suerbaum, Sebastian
Schubert, Sören
Dichtl, Karl
author_sort Koc, Özlem
collection PubMed
description Bloodstream infections caused by Candida yeasts (candidemia) are associated with high morbidity and mortality. Diagnosis remains challenging, with the current gold standard—isolation from blood culture (BC)—being limited by low sensitivity and long turnaround time. This study evaluated the performance of two nonculture methods: PCR and β-1,3-D-glucan (BDG) testing. The sera of 103 patients with BC-proven candidemia and of 46 controls were analyzed with the Fungiplex Candida Real-Time PCR and the Wako β-Glucan Test. The BDG assay demonstrated higher sensitivity than the multiplex PCR (58% vs. 33%). This was particularly evident in ICU patients (60% vs. 28%) and in C. albicans candidemia (57% vs. 37%). The earlier prior to BC sampling the sera were obtained, the more the PCR sensitivity decreased (46% to 18% in the periods of 0–2 and 3–5 days before BC, respectively), while BDG testing was independent of the sampling date. No positive PCR results were obtained in sera sampled more than five days before BC. Specificities were 89% for BDG and 93% for PCR testing. In conclusion, BDG testing demonstrated several advantages over PCR testing for the diagnosis of candidemia, including higher sensitivity and earlier diagnosis. However, BC remains essential, as BDG does not allow for species differentiation.
format Online
Article
Text
id pubmed-9504845
institution National Center for Biotechnology Information
language English
publishDate 2022
publisher MDPI
record_format MEDLINE/PubMed
spelling pubmed-95048452022-09-24 Performance of Multiplex PCR and β-1,3-D-Glucan Testing for the Diagnosis of Candidemia Koc, Özlem Kessler, Harald H. Hoenigl, Martin Wagener, Johannes Suerbaum, Sebastian Schubert, Sören Dichtl, Karl J Fungi (Basel) Article Bloodstream infections caused by Candida yeasts (candidemia) are associated with high morbidity and mortality. Diagnosis remains challenging, with the current gold standard—isolation from blood culture (BC)—being limited by low sensitivity and long turnaround time. This study evaluated the performance of two nonculture methods: PCR and β-1,3-D-glucan (BDG) testing. The sera of 103 patients with BC-proven candidemia and of 46 controls were analyzed with the Fungiplex Candida Real-Time PCR and the Wako β-Glucan Test. The BDG assay demonstrated higher sensitivity than the multiplex PCR (58% vs. 33%). This was particularly evident in ICU patients (60% vs. 28%) and in C. albicans candidemia (57% vs. 37%). The earlier prior to BC sampling the sera were obtained, the more the PCR sensitivity decreased (46% to 18% in the periods of 0–2 and 3–5 days before BC, respectively), while BDG testing was independent of the sampling date. No positive PCR results were obtained in sera sampled more than five days before BC. Specificities were 89% for BDG and 93% for PCR testing. In conclusion, BDG testing demonstrated several advantages over PCR testing for the diagnosis of candidemia, including higher sensitivity and earlier diagnosis. However, BC remains essential, as BDG does not allow for species differentiation. MDPI 2022-09-17 /pmc/articles/PMC9504845/ /pubmed/36135696 http://dx.doi.org/10.3390/jof8090972 Text en © 2022 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Koc, Özlem
Kessler, Harald H.
Hoenigl, Martin
Wagener, Johannes
Suerbaum, Sebastian
Schubert, Sören
Dichtl, Karl
Performance of Multiplex PCR and β-1,3-D-Glucan Testing for the Diagnosis of Candidemia
title Performance of Multiplex PCR and β-1,3-D-Glucan Testing for the Diagnosis of Candidemia
title_full Performance of Multiplex PCR and β-1,3-D-Glucan Testing for the Diagnosis of Candidemia
title_fullStr Performance of Multiplex PCR and β-1,3-D-Glucan Testing for the Diagnosis of Candidemia
title_full_unstemmed Performance of Multiplex PCR and β-1,3-D-Glucan Testing for the Diagnosis of Candidemia
title_short Performance of Multiplex PCR and β-1,3-D-Glucan Testing for the Diagnosis of Candidemia
title_sort performance of multiplex pcr and β-1,3-d-glucan testing for the diagnosis of candidemia
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9504845/
https://www.ncbi.nlm.nih.gov/pubmed/36135696
http://dx.doi.org/10.3390/jof8090972
work_keys_str_mv AT kocozlem performanceofmultiplexpcrandb13dglucantestingforthediagnosisofcandidemia
AT kesslerharaldh performanceofmultiplexpcrandb13dglucantestingforthediagnosisofcandidemia
AT hoeniglmartin performanceofmultiplexpcrandb13dglucantestingforthediagnosisofcandidemia
AT wagenerjohannes performanceofmultiplexpcrandb13dglucantestingforthediagnosisofcandidemia
AT suerbaumsebastian performanceofmultiplexpcrandb13dglucantestingforthediagnosisofcandidemia
AT schubertsoren performanceofmultiplexpcrandb13dglucantestingforthediagnosisofcandidemia
AT dichtlkarl performanceofmultiplexpcrandb13dglucantestingforthediagnosisofcandidemia