title: Candida identification: a journey from conventional to molecular methods in medical mycology.
abstract: The incidence of Candida infections have increased substantially in recent years due to aggressive use of immunosuppressants among patients. Use of broad-spectrum antibiotics and intravascular catheters in the intensive care unit have also attributed with high risks of candidiasis among immunocompromised patients. Among Candida species, C. albicans accounts for the majority of superficial and systemic infections, usually associated with high morbidity and mortality often caused due to increase in antimicrobial resistance and restricted number of antifungal drugs. Therefore, early detection of candidemia and correct identification of Candida species are indispensable pre-requisites for appropriate therapeutic intervention. Since blood culture based methods lack sensitivity, and species-specific identification by conventional method is time-consuming and often leads to misdiagnosis within closely related species, hence, molecular methods may provide alternative for accurate and rapid identification of Candida species. Although, several molecular approaches have been developed for accurate identification of Candida species but the internal transcribed spacer 1 and 2 (ITS1 and ITS2) regions of the rRNA gene are being used extensively in a variety of formats. Of note, ITS sequencing and PCR-RFLP analysis of ITS region seems to be promising as a rapid, easy, and cost-effective method for identification of Candida species. Here, we review a number of existing techniques ranging from conventional to molecular approaches currently in use for the identification of Candida species. Further, advantages and limitations of these methods are also discussed with respect to their discriminatory power, reproducibility, and ease of performance.
authors.affiliation: King Fahd Medical Research Center, King Abdulaziz University, P. O. Box 80216, Jeddah, 21589, Saudi Arabia.
authors.forename: Mohammad Zubair
authors.initials: MZ
authors.lastname: Alam
authors.forename: Qamre
authors.initials: Q
authors.lastname: Alam
authors.forename: Asif
authors.initials: A
authors.lastname: Jiman-Fatani
authors.forename: Mohammad Amjad
authors.initials: MA
authors.lastname: Kamal
authors.forename: Adel M
authors.initials: AM
authors.lastname: Abuzenadah
authors.forename: Adeel G
authors.initials: AG
authors.lastname: Chaudhary
authors.forename: Mohammad
authors.initials: M
authors.lastname: Akram
authors.forename: Absarul
authors.initials: A
authors.lastname: Haque
mesh_terms: D002175:Candida / Q000145:classification / Q000235:genetics / Q000302:isolation & purification*; D058387:Candidemia / Q000175:diagnosis* / Q000235:genetics; D004271:DNA, Fungal / Q000032:analysis*; D021903:DNA, Ribosomal Spacer / Q000032:analysis*; D006801:Humans; D057089:Pathology, Molecular; D016133:Polymerase Chain Reaction; D012150:Polymorphism, Restriction Fragment Length; D013057:Spectrum Analysis
chemical_list: D004271:DNA, Fungal; D021903:DNA, Ribosomal Spacer