Early Diagnosis of Blood Culture Isolates in Patients with Candidemia Using PNA FISH

Candidemia is associated with high mortality, especially with neutropenic and intensive care unit patients. A delay in early, effective antifungal therapy has been associated with increased mortality and hospital costs. Peptide nucleic acid fluorescent in-situ hybridization (PNA FISH) can identify Candida species within 3 hours after a positive blood culture demonstrates yeast. A Candida albicans probe and a dual C. albicans/Candida glabrata probe are available in clinical practice, and multi-Candida species probes and flow cytometry are in development. Recent data suggest that the rapid identification of Candida species with PNA FISH can provide early targeted therapy to patients and thus reduce antifungal costs and improve patient care. This review evaluates the clinical and laboratory effects of the Candida probes and their limitations, and competing technologies. Candida PNA FISH probes offer clinicians the early knowledge of the species they are treating, allowing them to appropriately tailor therapy.