Fungal diagnostics: culture, molecular, mass spectrometry

Invasive fungal diseases (IFDs) are a growing threat to human health, affecting more than 150 million people and taking 1.5 million lives per year. Incidence continues to rise owing to a growing population with an altered immune system, cancer, organ transplantation, and aging. Early and accurate diagnosis is crucial to enable early treatment and optimum patient outcomes.

Culture, microscopy, histopathological examination have been the “gold standard” for mycological diagnosis, but these decade-old methods have limited sensitivity and prolonged time to diagnosis. Immunochromatography technologies have ushered a new era of point-of-care diagnostics for Aspergillus, Cryptoccocus, and Histoplasma infections. Other non-culture-based approaches using molecular amplification methods, DNA barcoding, non-bias next generation sequencing, and mass spectrometry offer advantages in speed, accuracy, and the ability to identify fungi to the species level. Whilst considerable progress has been made, these technologies are not ready to replace conventional microscopy and culture yet. There are many technical challenges to overcome to improve accuracy of detection and ease of use. Further work is needed to ensure that these technologies are standardized, are scaled to routine clinical use, and are optimized for appropriate clinical settings. This Research Topic will focus on emerging and innovative approaches to improve the diagnosis of IFDs and vision for implementing these technologies. We cordially invite researchers to submit their work.