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This Article Full Text (Papers in Press[PDF]) All Versions of this Article: jmm.0.007906-0v1 58/8/1106    most recent Alert me when this article is cited Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via CrossRef Google Scholar Articles by Wellinghausen, N. Articles by Gebert, S. PubMed PubMed Citation Articles by Wellinghausen, N. Articles by Gebert, S. Agricola Articles by Wellinghausen, N. Articles by Gebert, S.

Rapid diagnosis of candidaemia by real-time PCR detection of Candida DNA in blood samples

¹ Institute of Medical Microbiology and Hygiene;

² Institute of Medical Microbiology and Hygiene, University of Ulm, Germany

³ E-mail: nele.wellinghausen{at}labor-gaertner.de

Received November 9, 2008
Accepted April 15, 2009

We prospectively evaluated a 18S rRNA gene targeted real-time PCR approach in comparison to standard blood culture diagnostic for rapid diagnosis of candidemia in a large study population of 384 patients, including 902 whole blood samples from 468 infectious episodes of 329 adults and 55 children with hematological malignancies, various forms of immunodeficiency, and ICU patients. Seven out of eight blood culture proven cases (87.5%) of candidemia and seven out of 12 blood culture-positive samples (58.3%), respectively, were positive by the Candida-specific PCR. A positive PCR result was also obtained in 28 of 460 blood culture-negative infectious episodes, including eight patients with culture-confirmed Candida infection at primary sterile body sites. Out of the PCR-positive, culture-negative patients more than 50% received systemic antifungal therapy. In 432 of 460 BC-negative infectious episodes, the Candida specific-PCR was negative, resulting in a negative predictive value of 99.8%. In conclusion, the Candida specific-PCR approach facilitated rapid detection of Candida DNA in blood samples of patients with risk for candidemia within a few hours. Although standard BC diagnostic appears still indispensable for detection of all cases of candidemia, the PCR assay allowed detection of candidemia at an average of three days earlier than BC diagnostic. Thereby, it enables earlier antifungal therapy of patients with suspected candidemia and may prevent further complications of candidemia.