106. Fungal diagnostics part 2: biomarkers, serology and molecular

Fungal diagnostics rely on a combination of antigen detection, serology, and molecular techniques to identify invasive infections. Professor Malcolm Richardson highlights that biomarkers like beta-D-glucan and galactomannan serve as essential tools for antifungal stewardship, despite frequent false positives caused by environmental contaminants or dietary factors, such as the presence of galactomannan in ice lollies. While molecular methods like PCR and ITS sequencing provide high sensitivity for detecting pathogens, they require rigorous laboratory controls to prevent contamination and currently lack universal standardization. Point-of-care testing offers significant potential for resource-limited settings, yet its integration into high-resource clinical workflows remains limited. Effective diagnosis necessitates a nuanced understanding of these assays' limitations and the importance of sequential sampling to monitor treatment response in immunocompromised patients.