T2 Candida Panel: A Game Changer in Diagnosis of Fungal Infections

In invasive fungal infections, early initiation of treatment within the day of symptom onset is related with a significantly reduced mortality.Early initiation of treatment and specifically treatment initiation within the day of symptom onset and blood culture draw is related to a significantly reduced mortality.However, automated blood culture methodologies, which are routinely used for the diagnosis of candidemia, take up to 2-5 days to grow and lead to a crucial delay in treatment initiation.Therefore, a highly sensitive, specific, and rapid diagnostic method is expected to allow early initiation of antifungal therapy and subsequently improve outcomes.Rapid diagnostic methods for fungal infections are long-awaited and are expected to improve outcomes through early initiation of targeted antifungal therapy.T2 Candida panel is a novel qualitative diagnostic platform that was recently approved by the US Food and Drug Administration (FDA) for diagnosis of candidemia with a mean time to species identification of <5 hours.Technological advances in the field of nanotechnology coupled with the proven applications of magnetic resonance have recently presented a rapid, fully automated, qualitative, sensitive, and specific diagnostic platform, the "T2 Candida panel".The introduction of this technology in diagnostic algorithms will increase the cost per patient tested, but it is expected to provide an economically self-supporting policy if savings from shorter hospital stays and termination of excess empiric antifungal treatment are taken into account.Expected benefits in terms of morbidity, mortality, and costs remain to be confirmed in clinical practice.The T2 Magnetic Resonance (T2MR) assay can detect and speciate the five most common Candida spp.; namely, Candida albicans, Candida glabrata, Candida parapsilosis, Candida tropicalis, and Candida krusei, in approximately 5 hours.The five detectable Candida spp.are responsible for >95% of the total Candida infections.T2 Magnetic Resonance demonstrated a sensitivity and specificity of 91.1 and 98.1%, respectively.The utility of T2MR in candidemia depends on the prevalence of the disease in each clinical setting.In intensive care units and other high-prevalence settings, the incorporation of T2MR in diagnostic algorithms is very appealing.T2 Magnetic Resonance is expected to allow timely initiation of antifungal therapy and help with antifungal stewardship.In low-prevalence settings, the positive predictive value of T2MR might not be enough to justify the initiation of antifungal treatment in itself.