[Opportunities offered by molecular diagnostics in the management of invasive fungal infections of oncohematological patients].

Abstract

Invasive fungal infections pose a particular threat to oncohematological patients. Candidiasis, aspergillosis, mucormycosis, cryptococcosis and Pneumocystis pneumonia are the most common manifestations. Despite various available approaches (culture, histology, serology, imaging), diagnosis of invasive mycoses is challenging. Owing to rapid technological advancements, molecular biological methods are routinely used in diagnostics of bacterial and viral infections. At the same time, molecular tests can be of substantial assistance in the detection and characterization of mycoses, therefore several international guidelines contain recommendations on them. Although some molecular fungal tests have been introduced in Hungarian healthcare, their widespread application is lagging. Here, we provide a review of molecular tools for clinical fungal diagnostics focusing on taxon-specific polymerase chain reaction (PCR), sequencing techniques (Sanger sequencing, next-generation sequencing) and their roles in identification of fungal pathogens and detection of resistance to antifungal medication. Tests available in South-Pest Central Hospital – National Institute of Hematology and Infectious Diseases and at the Department of Pathology and Experimental Cancer Research of Semmelweis University are briefly discussed. Finally, the utility of molecular fungal diagnostics is demonstrated through two case reports. This article aims to contribute to larger implementation of molecular tools in fungal diagnostics in the Hungarian healthcare system. Orv Hetil. 2025; 166(10): 363–376.