Improving the Diagnosis of Candidiasis and Antifungal Resistance Detection

Improved molecular diagnostics are urgently needed to optimal treat invasive fungal infections. The Westerdijk Fungal Biodiversity Institute and CBMR Scientific Nanoscience b.v. collaborate on this to setup a new molecular diagnostic tool that targets clusters of fungal species according to their antifungal susceptibility profiles.   

Fungal infections are a serious health concern at a global scale. Invasive fungal infections affect over 1.5 million individuals annually and have a very high mortality rate of 50-75%. Candida species are a major cause of nosocomial infections. Invasive candidiasis (IC) has a high crude average mortality rate of 40%, but differ according to Candida species involved. IC can be treated with a few antifungal agents, but inherently less susceptible isolates and acquired resistance complicates treatment. The gold standard diagnostic approach is blood culture that is an insensitive and time-consuming approach. There is a need for rapid detection and accurate species identification as this is of utmost importance for optimal IC treatment.

The molecular diagnostic tool that has been setup by ID‐CARD targets clusters of Candida species according to their antifungal susceptibility profiles. The large ribosomal DNA fragment has been sequenced for >120 Candida yeasts which forms the basis for the multiplex qPCR design. Antifungal susceptibility testing with fluconazole and anidulafungin was carried out to screen for antifungal resistance. Those yeasts that showed antifungal resistance were again tested but now also in the presence of the antimicrobial lactoferrin‐based peptide hLF(1‐11) that offers a new promising possibility to combat resistance as all yeasts were susceptible for hLF(1‐11) treatment.

The ID‐CARD multiplex qPCR will be tested using routine diagnostic clinical materials that were Candida positive by using conventional methods. ID‐CARD will contribute to a fast and reliable molecular detection and identification of yeasts involved in IC.