Evaluation of Serum Biomarkers for Improved Diagnosis of Candidemia

Abstract

Background: Candidemia, associated with high morbidity and mortality, remains challenging to diagnose due to the limitations of blood cultures. Serological biomarkers offer faster detection, enabling earlier treatment and improving outcomes. Methods: This study, conducted at CHU UCL Namur (August 2023–January 2025), evaluated three diagnostic biomarkers for candidemia: CAGTA IgG VirClia Monotest, Wako β-D-glucan test, and CandId OLM RT-PCR. A total of 35 candidemia cases and 20 controls were included. Results: CAGTA IgG VirClia Monotest demonstrated low sensitivity (46%) and moderate specificity (75%). Both Wako β-D-glucan test and CandId OLM RT-PCR exhibited higher sensitivity (74% and 71%, respectively) and excellent specificity (100%). The combined use of Wako β-D-glucan test and CandId OLM RT-PCR further enhanced diagnostic performance, achieving 91% sensitivity and 100% specificity. Misidentification between Candida albicans and Candida dubliniensis was observed with CandId PCR, underlining a potential limitation in species-level discrimination. Conclusions: Both Wako β-D-glucan test and CandID OLM RT-PCR outperformed CAGTA IgG VirClia Monotest in diagnosing candidemia, and their combination significantly improved diagnostic accuracy, albeit at a higher cost. These findings highlight the potential of integrating multiple biomarkers into diagnostic workflows to optimize early detection, though further studies are needed to refine strategies and address challenges.

Keywords

• candidemia
• Wako β-D-glucan
• CandId PCR
• CAGTA VirClia
• serum biomarkers