Work

Usefulness of approved and newly emerging non-cultural assays for early detection of invasive fungal infections in pediatric patients: A scoping review

Year: 2026

Type: article

Abstract: INTRODUCTION AND OBJECTIVE: Invasive fungal infections (IFI) affect millions worldwide, especially the immunocompromised and pediatric patients. The standard fungal culture has low sensitivity and is slow for fungal identification. Rapid and accurate laboratory assays may support early successful treatment. Although the European Organization for Research and Treatment of Cancer/Mycoses Study Group Education and Research Consortium (EORTC/MSGERC) has proposed IFI diagnostic criteria, there are few recommendations for children. This scoping review analyzed the sensitivity, specificity, and positive and negative predictive value of standard and recently developed non-cultural laboratory assays to diagnose IFI in children. METHODS: PubMed, Embase, Scopus, and Web of Science were searched from January 1, 2016, to March 23, 2025, for free, full-text publications for pediatric IFI and the EORTC/MSGERC-recommended fungal antigen assays (1,3)-ß-D-glucan and galactomannan. The same databases were searched for articles published before January 30, 2025, for emerging assays, Matrix-assisted laser desorption/ionization-time of flight mass spectrometry (MALDI-TOF MS), T2Candida, and lateral flow immunoassays (LFA). RESULTS: From the fungal antigen studies reviewed, (1,3)-ß-D-glucan and galactomannan assays exhibit varying rates of sensitivity and specificity, poor positive predictive value, and high negative predictive value. From the emerging assay studies, MALDI-TOF MS had near 100% sensitivity, T2Candida reported high specificity, and only one article reviewed LFA. CONCLUSION: Despite varying accuracy and reliability, the fungal antigen assays offer the benefits of speed, noninvasive collection, and serial testing. The emerging assays appear faster and more sensitive, but few outcomes were reported. This limits comparisons between emerging laboratory assays and fungal culture.

Source: Journal of Microbiological Methods

DOI: 10.1016/j.mimet.2026.107389

Authors: Jarom Kuhre, Manav Jain, Sheri Hohmann, Elena Y. Enioutina

Institutions: University of Utah, ARUP Laboratories (United States)

Language: English

Topic: Antifungal resistance and susceptibility

Subfield: Infectious Diseases

Field: Medicine

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: hybrid

Estimated APC paid: $3,120