Abstract
Invasive candidiasis is a common healthcare-associated infection with high mortality and is difficult to diagnose due to nonspecific symptoms and limitations of culture based diagnostic methods. T2Candida, based on T2 magnetic resonance technology, is FDA approved for the diagnosis of candidemia and can rapidly detect the five most commonly isolated Candida sp. in approximately 5 h directly from whole blood. We discuss the preclinical and clinical studies of T2Candida for the diagnosis of candidemia and review the current literature on its use in deep-seated candidiasis, its role in patient management and prognosis, clinical utility in unique populations and non-blood specimens, and as an antifungal stewardship tool. Lastly, we summarize the strengths and limitations of this promising nonculture-based diagnostic test.
Highlights
Candida is the most common cause of invasive fungal infections and associated mortality in the United States [1]
These diagnostic limitations leave clinicians struggling to balance the benefits of early empiric antifungal therapy (EAT) with the risks of antifungal resistance and healthcare costs associated with unnecessary antifungal use
We examine the role of T2Candida for the diagnosis of deep-seated candidiasis, its potential as a prognostic and management tool for invasive candidiasis, and its use as a stewardship resource to de-escalate antifungal therapy
Summary
Candida is the most common cause of invasive fungal infections and associated mortality in the United States [1]. Invasive candidiasis includes both candidemia and deep-seated. Blood cultures will not identify deep-seated invasive candidiasis unless it is associated with candidemia. These diagnostic limitations leave clinicians struggling to balance the benefits of early empiric antifungal therapy (EAT) with the risks of antifungal resistance and healthcare costs associated with unnecessary antifungal use. Rapid and sensitive non-culture based diagnostic methods for detecting invasive candidiasis are needed to improve outcomes through early initiation of targeted antifungal therapy [5,6,7]. We discuss the clinical utility of this test in unique patient populations and testing of non-blood clinical specimens
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