Wei Huamei, Thammasit Patcharin, Amsri Artid, Pruksaphon Kritsada, Deng Fenglian, Nosanchuk Joshua D, Youngchim Sirida
Department of Microbiology, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand.
Department of Pathology, The Affiliated Hospital of Youjiang Medical University for Nationalities, Baise, China.
Front Cell Infect Microbiol. 2025 May 23;15:1591429. doi: 10.3389/fcimb.2025.1591429. eCollection 2025.
() is a temperature-dependent biphasic deep opportunistic infectious fungus that primarily affects individuals with advanced HIV disease and other immunocompromised populations. Traditional diagnostic methods rely on fungal culture, but this process, although sensitive, is time-consuming and susceptible to contamination. Therefore, non-culture techniques serve as important complementary and alternative methods for diagnosing talaromycosis. They enable faster and more convenient pathogen identification, improving diagnostic efficiency and facilitating earlier initiation of treatment. Patients with talaromycosis can present with a wide range of clinical symptoms, and different clinical samples require different detection techniques. Blood samples are the most versatile, as laboratory technologists can utilize a wide range of diagnostic methods to obtain accurate results, particularly in the setting of a suspected disseminated infection. In contrast, urine diagnosis relies primarily on immunological methods that detect an antigen abundantly secreted during an infection. Moreover, for invasive samples like bronchoalveolar lavage fluid or cerebrospinal fluid, metagenomic next-generation sequencing is likely to be of significant importance for the early diagnosis due to its high sensitivity and specificity, though this approach is not yet standardized or widely available. For tissue samples, histopathology for light microscopy analysis is a well-established basic method, but it relies on experienced laboratory personnel, is time-consuming, and the histological appearance of other fungi can overlap with . Recent advances in rapid non-culture-based methods diagnostics underscore the growing importance of these tools in clinical settings, particularly for resource-limited areas where culture facilities are inadequate or unavailable. These methods improve diagnostic turnaround time and may lead to better clinical outcomes, especially for vulnerable patient populations. This review emphasizes the need for ongoing development and validation of non-culture diagnostics, with a focus on standardization, accessibility, and integration of rapid molecular and immunological tools to improve early detection and patient management in endemic regions.
()是一种温度依赖性双相深部机会性感染真菌,主要影响晚期HIV疾病患者和其他免疫功能低下人群。传统的诊断方法依赖于真菌培养,但这个过程虽然灵敏,但耗时且易受污染。因此,非培养技术作为诊断土曲霉病的重要补充和替代方法。它们能够更快、更方便地鉴定病原体,提高诊断效率并促进更早开始治疗。土曲霉病患者可表现出广泛的临床症状,不同的临床样本需要不同的检测技术。血液样本用途最广泛,因为实验室技术人员可以利用多种诊断方法获得准确结果,特别是在疑似播散性感染的情况下。相比之下,尿液诊断主要依赖于检测感染期间大量分泌的抗原的免疫学方法。此外,对于支气管肺泡灌洗液或脑脊液等侵入性样本,宏基因组下一代测序由于其高灵敏度和特异性,可能对早期诊断具有重要意义,尽管这种方法尚未标准化或广泛应用。对于组织样本,用于光学显微镜分析的组织病理学是一种成熟的基本方法,但它依赖于经验丰富的实验室人员,耗时且其他真菌的组织学表现可能与之重叠。基于非培养的快速诊断方法的最新进展凸显了这些工具在临床环境中的重要性日益增加,特别是对于培养设施不足或不可用的资源有限地区。这些方法缩短了诊断周转时间,可能带来更好的临床结果,特别是对于脆弱的患者群体。本综述强调需要持续开发和验证非培养诊断方法,重点是标准化、可及性以及快速分子和免疫工具的整合,以改善流行地区的早期检测和患者管理。