|
The type of method | The basis of detection | Problems in correct diagnosis | References |
|
Phenotypic tests |
Comparison of fungal phenotypes | The ability to grow at 42°C and formation of germ tubes and chlamydospores | Incorrect identification of C. albicans and C. dubliniensis | [204, 205] |
Chromogenic differential media |
Albicans ID (bioMérieux, Marcy l'Etoile, France) | Growth of colonies of different color; detection of hexosaminidase activity | Possible misidentification of C. albicans and C. tropicalis; C. auris cannot be identified | [206, 207] |
Chromalbicans Agar (Biolife Italiana, Milan, Italy) | Growth of colonies of different color; detection of hexosaminidase activity | Possible misidentification of C. albicans and C. dubliniensis; C. auris cannot be identified | [208] |
Brilliance Candida Agar (Oxoid, Hants, UK) | Growth of colonies of different color; detection of hexosaminidase activity with 5-bromo-4-chloro-3-indolyl N acetyl ß-D-glucosaminide as a substrate and alkaline phosphatase activity with 5-bromo-6-chloro-3-indolyl phosphate p-toluidine salt | Inability to distinguish C. albicans from C. dubliniensis; C. auris cannot be identified | [209] |
CHROMagar Candida plates (CHROMagar, Paris, France) | Growth of colonies of different color; detection of species-dependent enzyme activity | Possible misidentification of C. albicans and C. dubliniensis; C. auris cannot be identified | [210–212] |
CHROMagarTMCandida Plus (CHROMagar, Paris, France) | Growth of colonies of different color; detection of species-dependent enzyme activity | Possible differences in color interpretation, although enabling C. auris identification from other Candida | [213] |
Commercially available biochemical systems |
API 20C AUX, ID32C, and Vitek YBC System; Vitek 2 YST (bioMérieux, Marcy l’Etoile, France) Micronaut-Candida (Merlin Diagnostika GmbH, Bornheim, Germany) MicroScan (Beckman Coulter, Brea, CA, USA) | Determining the ability of fungi to assimilate, ferment, or decompose specific chemical compounds | Only known species might be identified; possible misidentification of C. auris as a different Candida species due to the similarity of assimilation patterns | [214–218] |
Antibody-based tests |
PlateliaTM Candida antigen/PlateliaTM Candida antibody (Bio-Rad Laboratories, Marnes-la-Coquette, France) | Detection of the presence of Candida mannan antigen or anti-mannan antibodies | Does not distinguish between species | [219–222] |
Germ tube antibody assay (CAGTA) | Detection of the immune response against the Hwp1 protein found in yeast hyphae | Low sensitivity; does not distinguish between species; does not identify C. tropicalis | [223–225] |
Bichro-dubli Fumouze test (Fumouze Diagnostics, Asnières, France) | A latex agglutination test with monoclonal antibodies 12F7-F2 | Detection only for C. dubliniensis | [226] |
Physicochemical techniques |
Mass spectrometry | Differences in ribosomal proteins identified with the mass spectrometry-based proteomic technique with the MALDI-TOF detection system | Sophisticated equipment required; high costs | [188, 227–232] |
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