Emerging Role of PCR-based surveillance in the Diagnosis of invasive candidiasis
DOI:
https://doi.org/10.5281/zenodo.22811733Keywords:
invasive candidiasis, polymerase chain reaction, beta-D-glucan, T2Candida, candidemiaAbstract
Background: Blood culture, the reference standard for invasive candidiasis, takes two to three days to turn positive and misses roughly half of patients with deep-seated disease, a delay tied to the disease's high attributable mortality [1,2].
Objective: This review synthesizes the accuracy of PCR-based detection of Candida DNA in blood relative to blood culture, beta-D-glucan, and the T2Candida panel, and its role in specific high-risk populations.
Methods: We reviewed meta-analyses and comparative diagnostic-accuracy studies of Candida PCR, beta-D-glucan, and T2Candida, together with population-specific studies and current IDSA and ESCMID guideline positions.
Findings: Pooled PCR sensitivity reaches approximately 95% with specificity around 92% [10], comparing favorably with beta-D-glucan (77-80% sensitivity) [15,16] and complementing T2Candida, which returns a result in 4.4 hours against more than two days for culture [18]; combined PCR/beta-D-glucan strategies outperform either alone in neonatal and intra-abdominal cohorts [12,22].
Conclusions: PCR-based surveillance offers a substantial sensitivity and turnaround advantage over blood culture and is best deployed alongside beta-D-glucan or T2Candida; the principal barrier to guideline endorsement remains assay standardization rather than accuracy [24,25].
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