ISSN: 2689-7822
Authors: Natesan SK*
Invasive candidiasis (IC) is an important cause of nosocomial blood stream infections and deep tissue infections, not only in immunocompromised patients but also in immunocompetent patients admitted to intensive care units. Despite the advent of novel azoles and echinocandins over the last few years, IC continues to be associated with an unacceptable mortality rate of ~30%. The critical factors that will have a favorable impact on morbidity and mortality of IC, include early diagnosis and timely initiation of appropriate antifungal therapy. Blood culture is currently the gold standard for diagnosis of candidemia. Currently available blood culture systems detect a dismal 50% of IC and therefore unreliable. Hence it is imperative that non -culture based diagnostic tests are developed, validated and standardized to enhance the diagnostic sensitivity of invasive candidiasis. The last three decades have witnessed the intermittent flow of several diagnostic tests, most of which failed to stand the test of time as they lacked sensitivity and specificity. This article provides an overview of various non -culture methods that have been unsuccessfully tried in the past, details the currently available advanced novel diagnostics and helps understand their strengths and limitations. It also provides a guide for physicians to interpret test results from a clinical perspective that will translate into judicious use of antifungal agents. Such a strategic approach will enhance patient care and decrease mortality associated with IC.
Keywords: Candidemia; Invasive Candidiasis; Mortality; Diagnosis; Echinocandins
