Division of Clinical Microbiology, Department of Laboratory Medicine, The First People's Hospital of Jingmen, Hubei, China.
Mycoses. 2011 Jul;54(4):331-6. doi: 10.1111/j.1439-0507.2009.01851.x. Epub 2010 Jan 13.
Rapid differentiation of Candida albicans from non-C. albicans species in direct clinical samples is crucial to optimise empirical antifungal therapy at an early stage, which can lead to the reduction in caspofungin usage with an overall cost saving. Traditional phenotypic methods are time-consuming and difficult to accurately differentiate Candida albicans from non-C. albicans species. There is an urgent clinical need for a rapid, sensitive and specific method for the differentiation of Candida albicans from non-C. albicans species in clinical specimens. In this study, we established a protocol for the application of a fluorescent in situ hybridisation (FISH) assay on different clinical samples, and analysed the effectiveness of this protocol for discriminating these organisms without prior cultivation. The FISH protocol for differentiating C. albicans from non-C. albicans species showed 95% sensitivity and 100% specificity. The positive predictive value was 100% and the negative predictive value was 94% compared with results obtained using traditional methods. Three clinical samples were FISH negative and culture positive, the percentage of false negatives with FISH was 4.0%. The results indicate that the FISH protocol is effective and reliable for the rapid differentiation of C. albicans from non-C. albicans species directly in clinical samples.
快速区分临床直接样本中的白色念珠菌与非白色念珠菌物种对于优化早期经验性抗真菌治疗至关重要，这可以减少卡泊芬净的使用并节省总体成本。传统的表型方法既耗时又难以准确地区分白色念珠菌与非白色念珠菌物种。临床迫切需要一种快速、敏感和特异的方法来区分临床标本中的白色念珠菌与非白色念珠菌物种。在本研究中，我们建立了一种荧光原位杂交（FISH）检测不同临床样本的应用方案，并分析了该方案在无需预先培养的情况下区分这些生物体的有效性。区分白色念珠菌与非白色念珠菌物种的 FISH 方案显示出 95%的敏感性和 100%的特异性。与传统方法相比，阳性预测值为 100%，阴性预测值为 94%。三个临床样本 FISH 为阴性而培养为阳性，FISH 的假阴性率为 4.0%。结果表明，FISH 方案可有效可靠地直接在临床样本中快速区分白色念珠菌与非白色念珠菌物种。
