|
| 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] |
|
