A Pragmatic Strategy for Improving Diagnosis of Invasive Candidiasis in UK and Ireland ICUs

Author: mycolabadmin
10/31/2025
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Summary

Diagnosing invasive candidiasis (a serious fungal infection in ICU patients) is challenging because current blood culture tests are slow and insensitive. This paper presents a practical five-step diagnostic guide for UK and Ireland hospitals that combines risk assessment, biomarker tests, and rapid identification methods to diagnose the infection faster and more accurately. Using this strategy helps doctors avoid unnecessary antifungal drugs while ensuring seriously ill patients receive appropriate treatment quickly, ultimately improving survival rates.

Background

Invasive candidiasis (IC) is a life-threatening fungal infection affecting critically ill ICU patients with mortality exceeding 40%. Current diagnostic methods relying on blood cultures have low sensitivity and prolonged turnaround times, leading to overuse of empirical antifungal therapy and increasing resistance. There is significant variability in diagnostic practices across UK and Ireland ICUs due to resource disparities.

Objective

This paper introduces a pragmatic five-step diagnostic strategy developed by an expert panel to optimize IC diagnosis and management in UK and Ireland ICUs. The strategy integrates predictive risk scores, biomarkers, and antifungal susceptibility testing to streamline diagnosis, identify high-risk patients, and promote antifungal stewardship.

Results

The five-step strategy provides a structured approach integrating risk prediction scores, baseline tests including blood cultures, β-D-glucan testing, imaging and biopsy testing, and MALDI-TOF MS for rapid identification. Two patient cases demonstrate safe discontinuation of antifungals based on negative biomarkers and rapid susceptibility testing enabling precise therapy adjustment.

Conclusion

The pragmatic five-step diagnostic strategy addresses diagnostic challenges and resource disparities in IC management by providing standardized, evidence-based guidance for UK and Ireland ICUs. Implementation can reduce diagnostic delays, lower mortality, optimize antifungal therapies, and promote judicious antifungal stewardship while reducing unnecessary treatment and resistance.

Published in:Journal of Fungi,
Study Type:Expert Consensus Review,
Source: PMID: 41295164, DOI: 10.3390/jof11110784