Medicine

Fugitive Fungi No More

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Science  26 Apr 2013:
Vol. 340, Issue 6131, pp. 409
DOI: 10.1126/science.340.6131.409-c
CREDIT: CDC/WILLIAM KAPLAN

Systemic fungal infections of the bloodstream or major organs, such as those caused by some species of Candida, can lead to fatalities, particularly in immunocompromised patients. The standard technique for detection requires culturing whole blood followed by morphological assessment, a process that can take several days. Neely et al. developed a wholeblood–compatible procedure that can detect certain strains down to one colony-forming unit per milliliter. After blood cell lysis and concentration of the Candida cells, polymerase chain reaction was used to selectively amplify the Candida DNA. This DNA was then captured with specific probes targeted toward one of five Candida species, which would then agglomerate, giving clusters that could be detected with T2 magnetic resonance, using a custom-made bedside detector. For spiked samples, detection could be achieved within 3 hours, in contrast to the 1 to 2 days needed for the C. krusei and C. albicans species, respectively. Testing was also done on fully blinded specimens from patients who showed symptoms of septicemia, with excellent identification of both the Candida-positive and -negative cases. Three patients were also tracked in time, and in contrast to culture methods, which require viable fungal cells, the method could also detect nonviable cells after the treatment of patients with antifungal agents.

Sci. Transl. Med. 5, 182ra54 (2013).

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