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Fungitell

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Dr Suzy Budavari - MBBCh, DTM&H, FCPath (SA)

PATHCHAT NO 13: FUNGITELL OPTION 2 

Introduction

Fungitell is a new test offered to detect the presence of certain invasive fungi in the blood. It indicates the presence of these fungi well before they are cultured in clinical specimens, and thus has utility in the EARLY detection of invasive fungal infections.

Candida species are now the 4th most commonly isolated organism in nosocomial bloodstream infections. They are associated with significant morbidity and mortality; attributable mortality has been shown to be as high as 47%. Invasive candidiasis has a non-specific presentation; clinical and radiological signs appear late in the course of the disease (Fig. 1). On the other side of the coin, it is difficult to distinguish colonization from invasive disease in high-risk patients.

Blood cultures are positive in only 50% of cases of invasive candidiasis (some studies have suggested less than 30% of cases). Less than 10% of invasive aspergillosis cases have positive blood cultures. The use of prophylactic fluconazole has decreased the sensitivity of blood cultures even further.

The gold standard has remained the histopathologic demonstration of organisms in tissue (Fig. 2), or the growth of fungi from sterile specimens. This is, however, difficult to apply in the clinical setting.

Delaying anti-fungal therapy has a significant impact on mortality.

What is the Fungitell assay? 

This is a colorimetric assay based on the activation of Factor G in the presence of 1,3-B-D-glucan. This then cleaves p­nitoaniline from the chromogenic peptide substrate to generate a coloured product which is measured.

 

 

Read the full article here.