Detection of Candida in Stool

Diagnostic Methods

Microscopy with KOH detects yeast in gemination with pseudohyphae, but identifies both viable and non-viable cells, and requires experience for interpretation, according to the European Society of Clinical Microbiology and Infectious Diseases 1
Culture on selective media only grows viable organisms, requires 5-14 days of incubation for some species, and must include species-level identification, as recommended by the Clinical Microbiology and Infection guidelines 2, 1

A negative culture does not exclude infection, as classic methods have limited sensitivity for detecting invasive candidiasis, according to the Clinical Microbiology and Infection guidelines 2, 1
The European Society of Clinical Microbiology and Infectious Diseases recommends that asymptomatic colonization should not be treated, as the presence of Candida without specific symptoms does not require treatment 1

The European Society of Clinical Microbiology and Infectious Diseases establishes that for invasive candidiasis, blood cultures are the standard method, although they can be negative in one-third of cases in ICU patients, and recommends the use of hemocultures, tissue and sterile body fluid samples, and β-1,3-D-glucano (BDG) testing 3, 2, 4
β-1,3-D-glucano (BDG) testing is recommended for detection of candidemia and invasive candidiasis, with a sensitivity of >65% and specificity of >80%, and should be performed twice a week, according to the Clinical Microbiology and Infection guidelines 4, 5
The identification of Candida species is mandatory, as different species have variable susceptibility patterns, as recommended by the Praxis Medical Insights guidelines 1