International Journal of Multidisciplinary Health Sciences and Research

Category: Original Article,      DOI: Recived: 12/11/2023, Accepted: 25/12/2023, Published online: 29/10/2023

Comparison of Culture-Based and Molecular Methods for Diagnosis of Invasive Fungal Infections

Anjali Singh1 , Sashi Kant2 , Ramesh Yadav3

Abstract:

Background: Invasive fungal infections (IFIs) are a significant cause of morbidity and mortality in immunocompromised patients. Rapid and accurate diagnosis is crucial for effective management. Objective: To compare the diagnostic performance of culture-based and molecular methods for detecting IFIs in high-risk patients. Methods: This prospective study enrolled 500 immunocompromised patients with suspected IFIs. Clinical specimens (blood, bronchoalveolar lavage fluid, tissue biopsies, and cerebrospinal fluid) were analyzed using both conventional culture methods and PCR-based molecular assays. Diagnostic performance, turnaround time, and species distribution were evaluated. Results: Molecular methods demonstrated higher sensitivity (91.2% vs 68.5%, p<0.001) and faster turnaround time (median 8 hours vs 72 hours, p<0.001) compared to culture-based techniques while maintaining high specificity (97.8% vs 99.1%, p=0.08). The overall agreement between methods was good (kappa = 0.78). Molecular techniques detected fungal pathogens in 10% of cases missed by culture. Candida albicans (39.5%) and Aspergillus fumigatus (20.9%) were the most frequently identified species. Conclusions: Molecular methods offer superior sensitivity and rapid turnaround time for diagnosing IFIs compared to conventional culture techniques. These findings support the integration of molecular diagnostics into clinical algorithms for managing suspected IFIs in immunocompromised patients. However, the complementary roles of both methods should be recognized, and implementation should consider cost-effectiveness and the potential for detecting colonizing fungi.