VA Pittsburgh Healthcare System, Pittsburgh, Pennsylvania, USA
University of Pittsburgh, Department of Medicine, Pittsburgh, Pennsylvania, USA.
J Clin Microbiol. 2018 Apr 25;56(5). doi: 10.1128/JCM.01909-17. Print 2018 May.
Cultures are negative in ∼50% of invasive candidiasis. Data are emerging for the performance of nonculture tests such as mannan/antimannan, germ tube antibody, 1,3-β-d-glucan, PCR, and the T2Candida panel in diagnosing both candidemia and deep-seated candidiasis. In most settings, positive predictive values of nonculture test are low, and negative predictive values are high. For tests to be useful, clinicians must understand the pretest likelihood of invasive candidiasis and test performance for the most common disease manifestation in a given patient. This paper reviews nonculture diagnostics and discusses how they might be used effectively in patient care.
培养物在侵袭性念珠菌病中的阳性率约为 50%。目前正在出现一些非培养检测方法的数据，如甘露聚糖/抗甘露聚糖、芽管抗体、1,3-β-D-葡聚糖、PCR 和 T2 念珠菌检测板，用于诊断菌血症和深部念珠菌病。在大多数情况下，非培养检测的阳性预测值较低，阴性预测值较高。为了使这些检测具有实用性，临床医生必须了解侵袭性念珠菌病的术前可能性以及特定患者最常见临床表现的检测性能。本文综述了非培养诊断方法，并讨论了它们如何在患者护理中有效使用。
