T2 magnetic resonance enables nanoparticle-mediated rapid detection of candidemia in whole blood

Sci Transl Med. 2013 Apr 24;5(182):182ra54. doi: 10.1126/scitranslmed.3005377.

Abstract

Candida spp. cause both local and disseminated infections in immunocompromised patients. Bloodstream infections of Candida spp., known as "candidemia," are associated with a high mortality rate (40%), which is mainly attributed to the long diagnostic time required by blood culture. We introduce a diagnostic platform based on T2 magnetic resonance (T2MR), which is capable of sensitive and rapid detection of fungal targets in whole blood. In our approach, blood-compatible polymerase chain reaction is followed by hybridization of the amplified pathogen DNA to capture probe-decorated nanoparticles. Hybridization yields nanoparticle microclusters that cause large changes in the sample's T2MR signal. With this T2MR-based method, Candida spp. can be detected directly in whole blood, thus eliminating the need for analyte purification. Using a small, portable T2MR detection device, we were able to rapidly, accurately, and reproducibly detect five Candida species within human whole blood with a limit of detection of 1 colony-forming unit/ml and a time to result of <3 hours. Spiked blood samples showed 98% positive agreement and 100% negative agreement between T2MR and blood culture. Additionally, performance of the assay was evaluated on 21 blinded clinical specimens collected serially. This study shows that the nanoparticle- and T2MR-based detection method is rapid and amenable to automation and offers clinicians the opportunity to detect and identify multiple human pathogens within hours of sample collection.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Candida / pathogenicity*
  • Candidemia / blood*
  • Candidemia / diagnosis*
  • Humans
  • Magnetic Resonance Spectroscopy / methods*
  • Nanoparticles*
  • Polymerase Chain Reaction