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Performance Evaluation of Five Real-Time PCR Assays for the Detection of Candida auris DNA

Summary

Candida auris is a dangerous fungal infection that spreads in hospitals and resists common antifungal medications. Researchers compared five different rapid tests (PCR assays) to see which ones best detect this pathogen. The study found that different tests vary widely in their ability to detect the fungus, with some being much more sensitive than others. The findings highlight the need for standardized testing methods worldwide to ensure hospitals can reliably identify and control C. auris infections.

Background

Candida auris is a multidrug-resistant fungal pathogen that presents a significant threat to global healthcare systems. Real-time PCR-based assays provide rapid and sensitive detection of C. auris colonisation and infection. Several commercially available and laboratory-developed assays exist for this purpose, but direct comparisons between these assays are limited.

Objective

This study aimed to systematically evaluate and compare the performance of two laboratory-developed assays (LDAs) and three commercially available real-time PCR assays for the detection of Candida auris. The analytical sensitivity, specificity, limit of detection (LOD), and clinical sensitivity were assessed.

Results

EMC LDA exhibited the highest analytical sensitivity with LOD of 8 conidia/reaction, followed by CDC LDA (16 conidia/reaction), AurisID and FungiXpert (19 conidia/reaction), and Fungiplex (596 conidia/reaction). Cross-reactivity was observed in CDC LDA and AurisID with C. pseudohaemulonii at high conidia levels. EMC LDA showed highest clinical sensitivity (100%) while Fungiplex had lowest positivity rate (71%).

Conclusion

Real-time PCR is crucial for rapid detection of C. auris in clinical settings. Significant variation in assay sensitivity demonstrates the importance of establishing international reference standards and proficiency panels to enhance accuracy and comparability of assay performance across laboratories.
  • Published in:Mycoses,
  • Study Type:Comparative Laboratory Study,
  • Source: PMID: 40317536, DOI: 10.1111/myc.70065
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