{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,29]],"date-time":"2026-09-29T23:50:10Z","timestamp":1790725810497,"version":"4.1.0"},"reference-count":49,"publisher":"MDPI AG","issue":"3","license":[{"start":{"date-parts":[[2021,3,3]],"date-time":"2021-03-03T00:00:00Z","timestamp":1614729600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JoF"],"abstract":"<jats:p>Invasive candidiasis is a common healthcare-associated infection with high mortality and is difficult to diagnose due to nonspecific symptoms and limitations of culture based diagnostic methods. T2Candida, based on T2 magnetic resonance technology, is FDA approved for the diagnosis of candidemia and can rapidly detect the five most commonly isolated Candida sp. in approximately 5 h directly from whole blood. We discuss the preclinical and clinical studies of T2Candida for the diagnosis of candidemia and review the current literature on its use in deep-seated candidiasis, its role in patient management and prognosis, clinical utility in unique populations and non-blood specimens, and as an antifungal stewardship tool. Lastly, we summarize the strengths and limitations of this promising nonculture-based diagnostic test.<\/jats:p>","DOI":"10.3390\/jof7030178","type":"journal-article","created":{"date-parts":[[2021,3,3]],"date-time":"2021-03-03T20:33:57Z","timestamp":1614803637000},"page":"178","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":49,"title":["T2Candida for the Diagnosis and Management of Invasive Candida Infections"],"prefix":"10.3390","volume":"7","author":[{"given":"Lea M","family":"Monday","sequence":"first","affiliation":[{"name":"Division of Infectious Diseases, Department of Internal Medicine, Henry Ford Hospital, Detroit, MI 48202, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4235-4379","authenticated-orcid":false,"given":"Tommy","family":"Parraga Acosta","sequence":"additional","affiliation":[{"name":"Division of Infectious Diseases, Department of Internal Medicine, Henry Ford Hospital, Detroit, MI 48202, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"George","family":"Alangaden","sequence":"additional","affiliation":[{"name":"Division of Infectious Diseases, Department of Internal Medicine, Henry Ford Hospital, Detroit, MI 48202, USA"},{"name":"School of Medicine, Wayne State University, Detroit, MI 48202, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2021,3,3]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"133","DOI":"10.1128\/CMR.00029-06","article-title":"Epidemiology of Invasive Candidiasis: A Persistent Public Health Problem","volume":"20","author":"Pfaller","year":"2007","journal-title":"Clin. Microbiol. Rev."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"1546","DOI":"10.1056\/NEJMoa022139","article-title":"The Epidemiology of Sepsis in the United States from 1979 through 2000","volume":"348","author":"Martin","year":"2003","journal-title":"N. Engl. J. Med."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"1110","DOI":"10.1093\/cid\/cis021","article-title":"Impact of Treatment Strategy on Outcomes in Patients with Candidemia and Other Forms of Invasive Candidiasis: A Patient-Level Quantitative Review of Randomized Trials","volume":"54","author":"Andes","year":"2012","journal-title":"Clin. Infect. Dis."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"25","DOI":"10.1086\/504810","article-title":"Time to Initiation of Fluconazole Therapy Impacts Mortality in Patients with Candidemia: A Multi-Institutional Study","volume":"43","author":"Garey","year":"2006","journal-title":"Clin. Infect. Dis."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"1284","DOI":"10.1093\/cid\/cit006","article-title":"Finding the \u201cmissing 50%\u201d of invasive candidiasis: How nonculture diagnostics will improve un-derstanding of disease spectrum and transform patient care","volume":"56","author":"Clancy","year":"2013","journal-title":"Clin. Infect. Dis."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"1123","DOI":"10.1093\/cid\/cis023","article-title":"The end of an era in defining the optimal treatment of invasive candidiasis","volume":"54","author":"Clancy","year":"2012","journal-title":"Clin. Infect. Dis."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"2903","DOI":"10.3389\/fmicb.2019.02903","article-title":"A New Age in Molecular Diagnostics for Invasive Fungal Disease: Are We Ready?","volume":"10","author":"Kidd","year":"2020","journal-title":"Front. Microbiol."},{"key":"ref_8","first-page":"305","article-title":"T2 Magnetic Resonance for Fungal Diagnosis","volume":"1508","author":"Zervou","year":"2016","journal-title":"Adv. Struct. Saf. Stud."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"324","DOI":"10.1016\/j.diagmicrobio.2013.07.007","article-title":"Comparison of the T2Dx instrument with T2Candida assay and automated blood culture in the detection of Candida species using seeded blood samples","volume":"77","author":"Beyda","year":"2013","journal-title":"Diagn. Microbiol. Infect. Dis."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"182ra54","DOI":"10.1126\/scitranslmed.3005377","article-title":"T2 Magnetic Resonance Enables Nanoparticle-Mediated Rapid Detection of Candidemia in Whole Blood","volume":"5","author":"Neely","year":"2013","journal-title":"Sci. Transl. Med."},{"key":"ref_11","doi-asserted-by":"crossref","unstructured":"Zacharioudakis, I.M., Zervou, F.N., and Mylonakis, E. (2018). T2 Magnetic Resonance Assay: Overview of Available Data and Clinical Implications. J. Fungi, 4.","DOI":"10.3390\/jof4020045"},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"103","DOI":"10.2217\/fmb.15.111","article-title":"T2MR and T2Candida: Novel technology for the rapid diagnosis of candidemia and inva-sive candidiasis","volume":"11","author":"Pfaller","year":"2016","journal-title":"Future Microbiol."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"JCM.00471\u201318","DOI":"10.1128\/JCM.00471-18","article-title":"In Vitro Evaluation of BacT\/Alert FA Blood Culture Bottles and T2Candida Assay for Detection of Candida in the Presence of Antifungals","volume":"56","author":"Beyda","year":"2018","journal-title":"J. Clin. Microbiol."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"892","DOI":"10.1093\/cid\/ciu959","article-title":"T2 magnetic resonance assay for the rapid diagnosis of candidemia in whole blood: A clinical trial (DIRECT1)","volume":"60","author":"Mylonakis","year":"2015","journal-title":"Clin. Infect. Dis."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"1678","DOI":"10.1093\/cid\/cix1095","article-title":"Detecting Infections Rapidly and Easily for Candidemia Trial, Part 2 (DIRECT2): A Prospective, Multicenter Study of the T2Candida Panel","volume":"66","author":"Clancy","year":"2018","journal-title":"Clin. Infect. Dis."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"01756-17","DOI":"10.1128\/JCM.01756-17","article-title":"Efficacy of T2 Magnetic Resonance Assay in Monitoring Candidemia after Initiation of Antifungal Therapy: The Serial Therapeutic and Antifungal Monitoring Protocol (STAMP) Trial","volume":"56","author":"Mylonakis","year":"2018","journal-title":"J. Clin. Microbiol."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"iv2","DOI":"10.1093\/jac\/dky050","article-title":"T2 magnetic resonance for the diagnosis of bloodstream infections: Charting a path forward","volume":"73","author":"Clancy","year":"2018","journal-title":"J. Antimicrob. Chemother."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1186\/s12879-019-4419-z","article-title":"Pooled analysis of T2 Candida for rapid diagnosis of candidiasis","volume":"19","author":"Tang","year":"2019","journal-title":"BMC Infect. Dis."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"iv13","DOI":"10.1093\/jac\/dky048","article-title":"T2MR contributes to the very early diagnosis of complicated candidaemia. A prospec-tive study","volume":"73","author":"Munoz","year":"2018","journal-title":"J. Antimicrob. Chemother."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"iv6","DOI":"10.1093\/jac\/dky047","article-title":"T2Candida MR as a predictor of outcome in patients with suspected invasive candidia-sis starting empirical antifungal treatment: A prospective pilot study","volume":"73","author":"Munoz","year":"2018","journal-title":"J. Antimicrob. Chemother."},{"key":"ref_21","first-page":"S67","article-title":"T2Candida and blood culture results predict mortality among patients with candidemia","volume":"56","author":"Clancy","year":"2018","journal-title":"Med. Mycol."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"1165","DOI":"10.2217\/fmb-2018-0079","article-title":"Use of T2MR in invasive candidiasis with and without candidemia","volume":"13","author":"Zacharioudakis","year":"2018","journal-title":"Future Microbiol."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"e1","DOI":"10.1093\/cid\/civ933","article-title":"Clinical practice guideline for the management of candidiasis: 2016 update by the Infectious Diseases Society of America","volume":"62","author":"Pappas","year":"2016","journal-title":"Clin. Infect. Dis."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"2650","DOI":"10.1007\/s00268-011-1305-2","article-title":"Candida Peritonitis: An Update on the Latest Research and Treatments","volume":"35","author":"Carneiro","year":"2011","journal-title":"World J. Surg."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"159","DOI":"10.1016\/j.riam.2018.03.002","article-title":"T2 magnetic resonance for the diagnosis of deep-seated invasive candidiasis in a liver re-cipient without candidemia","volume":"35","author":"Fortun","year":"2018","journal-title":"Rev. Iberoam. Microl."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"ofz136","DOI":"10.1093\/ofid\/ofz136","article-title":"Diagnostic Performance of T2Candida Among ICU Patients With Risk Factors for Invasive Candidiasis","volume":"6","author":"Arendrup","year":"2019","journal-title":"Open Forum Infect. Dis."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"632","DOI":"10.1093\/mmy\/myz101","article-title":"T2Candida magnetic resonance in patients with invasive candidiasis: Strengths and limitations","volume":"58","author":"Zurl","year":"2019","journal-title":"Med. Mycol."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"ofaa075","DOI":"10.1093\/ofid\/ofaa075","article-title":"Performance of the T2Candida Panel for the Diagnosis of Intra-abdominal Candidiasis","volume":"7","author":"Lamoth","year":"2020","journal-title":"Open Forum Infect. Dis."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"S175","DOI":"10.1093\/infdis\/jiaa394","article-title":"Core Recommendations for Antifungal Stewardship: A Statement of the Mycoses Study Group Education and Research Consortium","volume":"222","author":"Johnson","year":"2020","journal-title":"J. Infect. Dis."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"1133","DOI":"10.2217\/fmb.15.29","article-title":"The economic impact of rapid Candida species identification by T2Candida among high-risk patients","volume":"10","author":"Bilir","year":"2015","journal-title":"Future Microbiol."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"718","DOI":"10.1128\/JCM.02971-15","article-title":"Cost-Effectiveness Analysis of Multiplex PCR with Magnetic Resonance Detection versus Empiric or Blood Culture-Directed Therapy for Management of Suspected Candidemia","volume":"54","author":"Walker","year":"2016","journal-title":"J. Clin. Microbiol."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"683","DOI":"10.1177\/1060028014529928","article-title":"Clinical Practice Patterns in Hospitalized Patients at Risk for Invasive Candidiasis","volume":"48","author":"Aitken","year":"2014","journal-title":"Ann. Pharmacother."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"2856","DOI":"10.1093\/jac\/dky247","article-title":"Potential role of T2Candida in the management of empirical antifungal treatment in patients at high risk of candidaemia: A pilot single-centre study","volume":"73","author":"Giannella","year":"2018","journal-title":"J. Antimicrob. Chemother."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"iv27","DOI":"10.1093\/jac\/dky046","article-title":"Impact of rapid, culture-independent diagnosis of candidaemia and invasive candidiasis in a community health system","volume":"73","author":"Patch","year":"2018","journal-title":"J. Antimicrob. Chemother."},{"key":"ref_35","first-page":"12","article-title":"T2 Magnetic Resonance Assay Improves Timely Management of Candidemia","volume":"1","author":"Wilson","year":"2017","journal-title":"JAMS"},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"162","DOI":"10.1016\/j.diagmicrobio.2019.04.016","article-title":"T2 Candida versus beta-D-glucan to facilitate antifungal discontinuation in the intensive care unit","volume":"95","author":"Gill","year":"2019","journal-title":"Diagn. Microbiol. Infect. Dis."},{"key":"ref_37","first-page":"01408","article-title":"Evaluation of a Rapid Fungal Detection Panel for Identification of Candidemia at an Academic Medical Center","volume":"58","author":"Bomkamp","year":"2019","journal-title":"J. Clin. Microbiol."},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"858","DOI":"10.1093\/ajcp\/aqw063","article-title":"T2Candida Provides Rapid and Accurate Species Identification in Pediatric Cases of Candidemia","volume":"145","author":"Hamula","year":"2016","journal-title":"Am. J. Clin. Pathol."},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"96","DOI":"10.1177\/0896860819879874","article-title":"Evaluation of T2Candida Panel for detection of Candida in peritoneal dialysates","volume":"40","author":"Kouri","year":"2020","journal-title":"Perit. Dial. Int."},{"key":"ref_40","first-page":"826","article-title":"T2 magnetic resonance assay and detection of ocular candidiasis","volume":"60","author":"Mikkilineni","year":"2019","journal-title":"Investig. Ophthalmol. Vis. Sci."},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"S612","DOI":"10.1093\/ofid\/ofaa439.1359","article-title":"1173. Ocular Candidiasis in Patients with Candidemia Diagnosed by Blood Culture Versus T2Candida\u00ae Assay","volume":"7","author":"White","year":"2020","journal-title":"Open Forum Infect. Dis."},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"514","DOI":"10.15585\/mmwr.mm6619a7","article-title":"Notes from the field: Ongoing transmission of Candida auris in health care facilities\u2014United States, June 2016\u2013May 2017","volume":"66","author":"Tsay","year":"2017","journal-title":"MMWR Morb. Mortal Wkly. Rep."},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"786","DOI":"10.1111\/myc.12817","article-title":"Evaluation of a new T2 Magnetic Resonance assay for rapid detection of emergent fungal pathogen Candida auris on clinical skin swab samples","volume":"61","author":"Sexton","year":"2018","journal-title":"Mycoses"},{"key":"ref_44","doi-asserted-by":"crossref","unstructured":"Manning, B., Snyder, J.L., Chang, B., Wong, C., Higa, T., Shivers, R., and Lowery, T.J. (2021, January 12). Automated Detection of Candida Auris Direct from Whole Blood and Swab Specimens by T2MR. Available online: https:\/\/u4x2m9d8.rocketcdn.me\/wp-content\/uploads\/2017\/10\/Automated-Detectionn-of-Candida-Auris-IDWeek-2017.pdf.","DOI":"10.1093\/ofid\/ofx163.1599"},{"key":"ref_45","unstructured":"(2021, January 12). T2 Biosystems, Products & Technology International: Product Pipeline-T2Cauris Panel RUO. Available online: https:\/\/www.t2biosystems.com\/products-technology-ous\/pipeline-ous\/t2candida-auris-panel-ruo-ous\/."},{"key":"ref_46","doi-asserted-by":"crossref","unstructured":"Falces-Romero, I., Romero-G\u00f3mez, M.P., Moreno-Ramos, F., Mingorance, J., Garc\u00eda-Rodr\u00edguez, J., and Cendejas-Bueno, E. (2020). Epidemiology of bloodstream Candida species in a Spanish tertiary care hospital as a guide for implementation of T2MR (T2CANDIDA\u00ae) for rapid diagnosis of candidemia. Med. Mycol.","DOI":"10.1093\/mmy\/myaa056"},{"key":"ref_47","doi-asserted-by":"crossref","unstructured":"Medina, N., Soto-Debr\u00e1n, J.C., Seidel, D., Akyar, I., Badali, H., Barac, A., Bretagne, S., Cag, Y., Cassagne, C., and Castro, C. (2020). MixInYeast: A Multicenter Study on Mixed Yeast Infections. J. Fungi, 7.","DOI":"10.3390\/jof7010013"},{"key":"ref_48","unstructured":"(2021, January 16). National Healthcare Safety Network (NHSN) 2021 Patient Safety Component Manual, Available online: https:\/\/www.cdc.gov\/nhsn\/pdfs\/pscmanual\/pcsmanual_current.pdf."},{"key":"ref_49","doi-asserted-by":"crossref","first-page":"326","DOI":"10.1111\/myc.12746","article-title":"EQUAL Candida Score: An ECMM score derived from current guidelines to measure QUAlity of Clinical Candidaemia Management","volume":"61","author":"Mellinghoff","year":"2018","journal-title":"Mycoses"}],"container-title":["Journal of Fungi"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2309-608X\/7\/3\/178\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T05:31:56Z","timestamp":1760160716000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2309-608X\/7\/3\/178"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,3,3]]},"references-count":49,"journal-issue":{"issue":"3","published-online":{"date-parts":[[2021,3]]}},"alternative-id":["jof7030178"],"URL":"https:\/\/doi.org\/10.3390\/jof7030178","relation":{},"ISSN":["2309-608X"],"issn-type":[{"value":"2309-608X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,3,3]]}}}