Abstract
Invasive candidiasis (IC) is associated with high morbidity and mortality. Candida species have significant roles in invasive candidiasis andthe emergence of clinical strains that are difficult to treat due tovirulent and resistant properties. Expansion of fungal pathogen diversity necessitates the development and adoption of new methods for prompt diagnosis and management. The review aimed to highlight the relevance of different Candida diagnostic methods for prompt management of Candida infections. The conventional gold standard diagnostic phenotypic-based (culture)method is time-consuming, associated withlow specificity and subjective interpretation.The specificity and sensitivity performances for candidaemia or deep-seated candidiasis of biochemical-based methods, including VITEK, API 20C AUX, and latex agglutination, have higher resolution than the culture. Nucleic acid-basedpolymerase chain reaction diagnostic techniques have been rapidly evolving. PCR will improve the diagnostic performance and patient outcome. The PCR technique uses different ribosomal DNA gene complexes, including D1/D2, ITS1/ITS4, or IGS1/IGS2, ashelpful markersto delineate the main pathogenic fungal species belonging to different genera. Sensitive and specific diagnostic methods for Candida speciesare significant for clinical decision and effective clinical outcome.
Highlights
Candida species are common pathogenic yeasts associated with and threatening invasive infections
Candida dubliniensis is a closely related organism to C. albicans with many phenotypic similarities
These techniques have shown low TAT within four hours and had long been validated for application in antifungal susceptibility testing (AFST) within 68 hours (She and Bender, 2019). These available commercial phenotypic methods (e.g.,VITEK2 and API 20C) for identifying C. glabrata from each member of the Nakaseomyces clade are helpful for preliminary identification
Summary
Candida species are common pathogenic yeasts associated with and threatening invasive infections. The milk promotes C. albicans growth and chlamydospore formation This method's limitation includes the high TAT of approximately 48 h, laborious, requires specific skills to speciate the isolates, and depends on primary culture before CMA analysis (Bharathi, 2018). Candida dubliniensis is a closely related organism to C. albicans with many phenotypic similarities Both species produce germ tubes, chlamydospores on cornmeal or RiceTween agars, and green colour on ChromAgar media. This method's limitation is the dependence on a pure culture that takes a minimum of 24 h before the germ tube test When it is negative, the decision requires the addition of approximately 48 h to check for chlamydospore formation using cornmeal agar (Mirhendi et al, 2011). Deorukhkar (2018) recent report indicated Candida africana as a germ tube producer, so the method is inadequate and needs further analysis for decision
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