Molecular diagnosis of Candida infection in the immunocompromised host: Current status and future prospects

Recent trends in molecular diagnosis have shown great promise, particularly for the rapid identification of fungal infections. The development of the polymerase chain reaction (PCR) technology has led to renewed efforts to bring molecular diagnostics to clinical mycology. Not only can PCR technology identify Candida DNA but the product can be analyzed for determination of species and drug susceptibility pattern. All of this analysis can be performed within hours of receiving a specimen, thus giving the clinicians information sooner on which to base therapeutic decisions. Prior to widespread use in diagnosis of Candida infection, high throughput technology will have to pass a stringent set of tests, guaranteeing an acceptable sensitivity and specificity. Large prospective studies that correlate isolation techniques with PCR-based studies are needed to establish the diagnostic usefulness of PCR. Analyzing clinical isolates for unique genetic fingerprints could lead to better understanding of the modes of transmission for Candida infection and, in the process, illuminate new aspects of pathogenesis. Over the coming decade, studies will address these issues and ultimately determine the clinical usefulness of PCR technology.