T2MR, invasive candidiasis

BackgroundInvasive candidiasis (IC) remains a major challenge in critically ill patients, requiring rapid and accurate diagnosis to improve patient outcomes. Traditional blood culture methods often fail to detect Candida spp. in the early stages of infection. This study aimed to assess the utility of modern diagnostic biomarkers: T2Candida®, (1,3)-β-D-glucan (BDG), Presepsin (PSEP), and Pentraxin 3 (Ptx3) in differentiating fungal from bacterial infections and improving early IC detection in septic patients.MethodsThis prospective clinical study was conducted at University Hospital Ostrava from May to December 2024. Ten intensive care unit (ICU) patients were enrolled and monitored daily using a panel of biomarkers (BDG, PSEP, Ptx3) in conjunction with molecular (T2Candida®) and microbiological (blood culture) diagnostic methods. Serum BDG was measured using Fungitell®, PSEP was analyzed with Pathfast®, and Ptx3 was assessed via ELISA on the ThunderBolt Analyzer. All biomarker results were correlated with clinical findings, including patient colonization status, intra-abdominal candidiasis (IAC), and bacterial co-infections.ResultsSerum BDG levels exceeding 200 pg/mL and PSEP levels above 700 pg/mL were indicative of probable IC. Ptx3 demonstrated potential as an additional diagnostic marker, with elevated levels correlating with suspected fungal infections. The T2Candida® assay showed limited sensitivity for IAC, detecting Candida spp. in only a small subset of cases. Despite the application of molecular diagnostics, direct blood culture positivity for Candida spp. was rare, aligning with previous findings that candidemia often remains undetected in IAC patients. For detailed biomarker profiles, refer to Biomarker Profiles in Invasive Candidiasis Diagnosis.ConclusionsThe combination of BDG, PSEP, and Ptx3 shows promise for early IC detection, particularly in differentiating fungal from bacterial sepsis. The findings highlight the limitations of T2Candida® in IAC cases and suggest the need for further validation in a larger patient cohort. These preliminary results represent the first phase of an ongoing prospective study, which will continue in 2025 to expand the patient cohort and refine diagnostic algorithms. Future research should focus on optimizing the use of multiple biomarkers to enhance early IC diagnosis and improve antifungal treatment strategies.

BackgroundInvasive candidiasis (IC) remains a major challenge in critically ill patients, requiring rapid and accurate diagnosis to improve patient outcomes. Traditional blood culture methods often fail to detect Candida spp. in the early stages of infection. This study aimed to assess the utility of modern diagnostic biomarkers: T2Candida®, (1,3)-β-D-glucan (BDG), Presepsin (PSEP), and Pentraxin 3 (Ptx3) in differentiating fungal from bacterial infections and improving early IC detection in septic patients.MethodsThis prospective clinical study was conducted at University Hospital Ostrava from May to December 2024. Ten intensive care unit (ICU) patients were enrolled and monitored daily using a panel of biomarkers (BDG, PSEP, Ptx3) in conjunction with molecular (T2Candida®) and microbiological (blood culture) diagnostic methods. Serum BDG was measured using Fungitell®, PSEP was analyzed with Pathfast®, and Ptx3 was assessed via ELISA on the ThunderBolt Analyzer. All biomarker results were correlated with clinical findings, including patient colonization status, intra-abdominal candidiasis (IAC), and bacterial co-infections.ResultsSerum BDG levels exceeding 200 pg/mL and PSEP levels above 700 pg/mL were indicative of probable IC. Ptx3 demonstrated potential as an additional diagnostic marker, with elevated levels correlating with suspected fungal infections. The T2Candida® assay showed limited sensitivity for IAC, detecting Candida spp. in only a small subset of cases. Despite the application of molecular diagnostics, direct blood culture positivity for Candida spp. was rare, aligning with previous findings that candidemia often remains undetected in IAC patients. For detailed biomarker profiles, refer to Biomarker Profiles in Invasive Candidiasis Diagnosis.ConclusionsThe combination of BDG, PSEP, and Ptx3 shows promise for early IC detection, particularly in differentiating fungal from bacterial sepsis. The findings highlight the limitations of T2Candida® in IAC cases and suggest the need for further validation in a larger patient cohort. These preliminary results represent the first phase of an ongoing prospective study, which will continue in 2025 to expand the patient cohort and refine diagnostic algorithms. Future research should focus on optimizing the use of multiple biomarkers to enhance early IC diagnosis and improve antifungal treatment strategies.