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Closing the diagnostic gap in medical mycology: The LODDY Test for identification of Lodderomyces elongisporus

Summary

Researchers developed a simple and affordable test called the LODDY Test to identify a dangerous yeast called Lodderomyces elongisporus that is often mistaken for a similar but less dangerous yeast. This test uses color changes on a special culture medium to distinguish between different yeast species in just 48 hours without expensive equipment. The test works perfectly in laboratories worldwide and could help doctors in developing countries diagnose and treat serious fungal infections more quickly and accurately.

Background

Lodderomyces elongisporus is an emerging opportunistic yeast pathogen frequently misidentified as Candida parapsilosis due to phenotypic overlap, leading to delayed diagnosis and treatment. The organism exhibits reduced susceptibility to echinocandins, making accurate identification clinically critical. Current diagnostic methods lack discriminatory power for this cryptic pathogen, particularly in resource-limited settings.

Objective

To develop and validate the LODDY Test, a novel pH-indicator-based differential culture medium for rapid and accurate identification of L. elongisporus using four carbohydrates and bromocresol purple. The test aimed to provide a cost-effective alternative to molecular methods suitable for decentralized laboratories in low- and middle-income countries.

Results

The LODDY Test achieved 100% sensitivity and specificity, distinctly identifying L. elongisporus by neutral pH coloration versus yellow-producing Candida species and purple N. glabratus. Performance matched MALDI-TOF MS and ITS sequencing while outperforming API 20C AUX (84.2% sensitivity) and CHROMagar (78.9% sensitivity). Perfect inter-laboratory concordance was confirmed across three institutions.

Conclusion

The LODDY Test is a low-cost, high-accuracy diagnostic tool suitable for decentralized laboratories that achieves molecular-level precision without requiring advanced equipment. This innovation addresses a critical diagnostic gap in fungal identification, particularly benefiting resource-limited settings, with future validation needed using clinical bloodstream isolates.
  • Published in:Medical Mycology,
  • Study Type:Diagnostic Validation Study,
  • Source: 10.1093/mmy/myaf076; PMID: 40844825
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