Division of Microbiology, Department of Laboratory Medicine, National University Health System, Singapore, Singapore.
Division of Infectious Diseases, University Medicine Cluster, National University Health System, NUHS Tower Block, 1E Kent Ridge Road, Singapore, 119228, Singapore.
Mycopathologia. 2021 Oct;186(5):575-582. doi: 10.1007/s11046-021-00549-x. Epub 2021 Jul 2.
Diagnostic tests for fungi provide the mycological evidence to strengthen diagnosis of invasive fungal disease. Conventional microbiology and histopathology have their limitations. Recognizing this, there have been attempts at developing new methods to improve yield of diagnosing invasive fungal disease (IFD). The recent focus has been on non-culture-based antigen detection and molecular methods. The use of antigen detection of IFD through 1,3-β-D-glucan and galactomannan assay have been expanded, followed by development of lateral flow assays, and in combination with other diagnostic modalities to further increase diagnostic yield. The molecular diagnostic front has seen initiatives to standardize polymerase chain reaction methodologies to detect fungi and anti-fungal resistance, new platforms such as the T2Candida Biosystems and foray into fungal metagenomics. As these newer assays undergo stringent validation before incorporation into the diagnostic algorithm, the clinician needs to be mindful of their bedside utility as well as their limitation.
真菌诊断检测为侵袭性真菌感染的诊断提供了微生物学依据。传统的微生物学和组织病理学有其局限性。为了克服这些局限性，人们一直在尝试开发新的方法来提高侵袭性真菌感染（IFD）的诊断率。最近的研究重点是基于非培养的抗原检测和分子方法。通过 1,3-β-D-葡聚糖和半乳甘露聚糖检测来检测 IFD 的抗原检测方法已经得到了扩展，随后开发了侧流检测法，并与其他诊断方式相结合，以进一步提高诊断率。在分子诊断领域，人们已经采取措施来标准化聚合酶链反应方法，以检测真菌和抗真菌药物的耐药性，同时也出现了新的平台，如 T2Candida Biosystems，以及真菌宏基因组学的探索。在将这些新的检测方法纳入诊断算法之前，需要进行严格的验证，因此临床医生需要了解它们的床边实用性及其局限性。
