Non-Culture-Based Methods in Diagnostic Mycology

Isolation of fungal pathogens from clinical samples, particularly from sterile body sites, can aid in the diagnosis of invasive fungal infections (IFIs). By diagnosing IFIs and assisting clinicians who manage immunocompromised patients, clinical laboratories play an important role in improving clinical outcomes for patients with underlying conditions (e.g., immunosuppresion). Culture-based approaches for fungal diagnosis often require weeks to get an answer and therefore do not meet the clinical needs of patient care. Delayed diagnosis contributes greatly to high mortality rates in those patients at risk of developing IFIs. Non-culture-based methods allow clinical laboratories to identify potential fungal pathogens directly from clinical samples within hours, thus allowing the clinicians to initiate proper antifungal management without delay. In this review, the availability (focusing on commercial sources), the characteristics, and the performance of these non-culture-based methods are discussed with regard to their potential implementation and utilization by clinical laboratories.