Fungal infections: advances in diagnosis and treatment

Fungal infections are on the rise worldwide. Newer and rare species of fungi are frequently reported to be causative agents of life-threatening infections. They are intrinsically resistant or have a higher MIC to the first-line antifungal agents. This makes a higher class of antifungal agents as the choice of drug for treatment. However, these organisms are fast acquiring resistance to the available drugs, making the development of newer antifungal agents imperative. In addition, timely diagnosis and identification of the infectious agent has become the need of the hour for a better patient outcome.
Molecular techniques play an important role in the rapid diagnosis of infections. They extend from polymerase chain reaction (PCR), microarray, karyotyping, nucleic acid sequencing to the most recent next-generation sequencing. Although most of these techniques have been around for quite some time, they are primarily used for research and only a few have found their way into mainstream diagnosis. Also, they are mainly used in the diagnosis of bacterial and viral infections and scarcely used in fungal diagnosis.
The common techniques used in fungal diagnosis are PCR and modifications of the PCR, which include real-time PCR, multiplex-tandem PCR, loop-mediated isothermal amplification PCR (LAMP PCR), and more. Fluorescent in situ hybridization (FISH), matrix-assisted laser desorption ionization–time-of-flight mass spectrometry (MALDI–TOF–MS) and T2 magnetic resonance spectroscopy are also used.