Rapid differentiation of Candida albicans from non-C. albicans directly in a variety of clinical specimens using fluorescent in situ hybridisation.

Rapid differentiation of Candida albicans from non-C. albicans species in direct clinical samples is crucial to optimise empirical antifungal therapy at an early stage, which can lead to the reduction in caspofungin usage with an overall cost saving. Traditional phenotypic methods are time-consuming and difficult to accurately differentiate Candida albicans from non-C. albicans species. There is an urgent clinical need for a rapid, sensitive and specific method for the differentiation of Candida albicans from non-C. albicans species in clinical specimens. In this study, we established a protocol for the application of a fluorescent in situ hybridisation (FISH) assay on different clinical samples, and analysed the effectiveness of this protocol for discriminating these organisms without prior cultivation. The FISH protocol for differentiating C. albicans from non-C. albicans species showed 95% sensitivity and 100% specificity. The positive predictive value was 100% and the negative predictive value was 94% compared with results obtained using traditional methods. Three clinical samples were FISH negative and culture positive, the percentage of false negatives with FISH was 4.0%. The results indicate that the FISH protocol is effective and reliable for the rapid differentiation of C. albicans from non-C. albicans species directly in clinical samples.