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The State-of-the-Art Mycology Laboratory: Visions of the Future

  • Current Management of Fungal Infections (L Ostrosky-Zeichner, Section Editor)
  • Published:
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Abstract

Invasive infections have emerged over the past decades as important causes for morbidity and mortality. Favorable outcome is associated with early and appropriate antifungal treatment. Therefore, rapid and correct diagnosis is of utmost importance. The clinical mycology field has evolved over the past decade. Reference methods for susceptibility testing and associated clinical breakpoints for Candida and Aspergillus have been developed, and several commercial susceptibility tests have been marketed. New diagnostic tests have become available including ELISA and lateral flow devices for the detection of Aspergillus, Candida, and Cryptococcus antigens; β-d-glucan detection test; diagnostic PCRs; and matrix-assisted laser desorption ionization-time of flight (MALDI-TOF) techniques for identification and perhaps in the future also for susceptibility screening (testing). Finally, molecular sequencing and genotyping methods have been described and increasingly used for outbreak and resistance detection. Some of these tests are straightforward to implement in the routine laboratory for clinical microbiology, whereas others require mycological expertise. Here, we present an overview of the newer diagnostic options, review options for improving sensitivity of classical diagnostic techniques, and also comment on which levels of mycological expertise are required for the different diagnostic tests. The goal of this review is to summarize current diagnostic options and discuss benefits and pitfalls on how these are best implemented in order to obtain state-of-the-art mycology service.

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Conflict of Interest

MC Arendrup reports grants and personal fees from Astellas, grants and personal fees from Gilead, grants and personal fees from Pfizer, and personal fees and other from MSD. B Posteraro and M Sanguinetti both declare no conflicts of interest. J Guinea has received research grants from FIS; speaker honorarium from Astellas, Gilead, Pfizer, Hikma Pharma, United Medical, and MSD; and travel reimbursement from ESCMID and Astellas.

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Authors and Affiliations

  1. Unit of Mycology, Department Microbiology and Infection Control, Statens Serum Institut, Artillerivej 5, 2300, Copenhagen S, Denmark

    Maiken Cavling Arendrup

  2. Institute of Public Health (Section of Hygiene), Università Cattolica del Sacro Cuore, Rome, Italy

    Brunella Posteraro

  3. Institute of Microbiology, Università Cattolica del Sacro Cuore, Rome, Italy

    Maurizio Sanguinetti

  4. Clinical Microbiology and Infectious Diseases Department, Hospital General Universitario Gregorio Marañón, Universidad Complutense de Madrid, Madrid, Spain

    Jesús Guinea

  5. CIBER de Enfermedades Respiratorias (CIBERES CB06/06/0058), Madrid, Spain

    Jesús Guinea

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  1. Maiken Cavling Arendrup
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  4. Jesús Guinea
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Correspondence to Maiken Cavling Arendrup.

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This article is part of the Topical Collection on Current Management of Fungal Infections

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Arendrup, M.C., Posteraro, B., Sanguinetti, M. et al. The State-of-the-Art Mycology Laboratory: Visions of the Future. Curr Fungal Infect Rep 9, 37–51 (2015). https://doi.org/10.1007/s12281-014-0212-z

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