Department of Pediatric Nephrology and Hypertension, Indiana University School of Medicine, Indianapolis, USA.
West Virginia School of Medicine, Department of Pathology, Anatomy, and Laboratory Medicine, Morgantown, USA.
Perit Dial Int. 2020 Jan;40(1):96-99. doi: 10.1177/0896860819879874.
Fungal peritonitis in the peritoneal dialysis population is difficult to diagnose promptly due to the inherently slow cultivation-based methods currently required for identification of peritonitis pathogens. Because of the moderate risk for severe complications, the need for rapid diagnostics is considerable. One possible solution to this unmet need is the T2Candida Panel, a new technology designed to detect the most common pathogenic spp. directly from whole blood specimens in as little as a few hours. We hypothesized that this technology could be applied to the detection of Candida in peritoneal dialysate, a matrix not currently approved by the Food and Drug Administration for testing by this system. Remnant dialysate samples from three healthy (noninfected) pediatric peritoneal dialysis patients were spiked with , serially diluted, and tested in triplicate with unaltered dialysate specimens. The assay detected in 100% of spiked dialysate samples across the full spectrum of dilutions tested, and no assay inhibition or cross-reactivity was noted. These findings suggest one of possibly more applications of this technology. The positive clinical implications of this test will continue to be realized as its use is validated in peritoneal dialysate and other patient specimen types.
真菌性腹膜炎在腹膜透析人群中难以迅速诊断，因为目前鉴定腹膜炎病原体需要基于培养的固有缓慢方法。由于存在严重并发症的中度风险，因此对快速诊断的需求相当大。解决这一未满足需求的一种可能方法是 T2Candida 检测试剂盒，这是一种新技术，旨在直接从全血标本中检测最常见的致病性 spp.，只需数小时。我们假设该技术可应用于腹膜透析液中真菌的检测，而目前该系统尚未批准该基质进行检测。从 3 名健康（未感染）儿科腹膜透析患者的残余透析液样本中加入 ，连续稀释，并与未经处理的透析液样本一式三份重复检测。该检测试剂盒在检测的整个稀释范围内 100%检测到了，且未观察到检测抑制或交叉反应。这些发现提示了该技术的一种可能的更多应用。随着该检测在腹膜透析液和其他患者标本类型中的验证，其阳性临床意义将不断得到体现。
