Table 3.
Advantages and disadvantages of the methods for identification of Candida spp. in patients with fungemia.
| Identification methods | Advantages | Disadvantages |
|---|---|---|
| Conventional; culture in microbiological media | It can quickly guide the diagnosis (visualization of yeast-like structures). | Long process (24–72 h) |
| Economic | Low sensitivity | |
| Allows for antifungal susceptibility testing | ||
| Widely available | ||
| Extensive experience | ||
| Automated and semi- automated methods | Faster, more sensitive and require less manual labor than conventional methods | Less rapid and accurate than methods based on nucleic acid amplification or proteomics. |
| Economic | ||
| Widely available | ||
| Extensive experience | ||
| Nucleic acid amplification (PCR)-based methods | Very fast results (hours) | Mostly developed “in house”, with limited clinical validation |
| Sensitive, specific, and precise | Performed only in reference laboratories, which limits the advantage of short detection time | |
| Extensive clinical validation for the detection of Candida species. | The heterogeneity of the tests makes it difficult to interpret the data | |
| Need for trained laboratory personnel to perform the test | ||
| Not universally available | ||
| Mass Spectrometry (MALDI-TOF) | Very fast results (minutes) | High initial cost of MALDI- TOF equipment |
| Sensitive, specific, and precise | Not universally available | |
| Identification of microbial pathogens directly from positive blood cultures | Requires positive blood culture | |
| Less expensive than molecular and immunological methods. |