RESEARCH Presence of Candida cell w

from 28 % in cases of single organ candidosis to 58%59045 Lille, France Full list of author information is available at the end of the articleIntroduction Invasive candidosis (IC) is one of the leading causes of nosocomial infection and Candida species rank fourth among the pathogens involved in bloodstream infections [1]. Despite current progress in research and antifungal therapy, the incidence and attributable mortality of candidaemia remain high [2] due to difficulties in the establishment of an accurate and early diagnosis. In the ICU, candidaemia has a prevalence of 7/1,000 patients, with an attributable mortality of>40 % compared with 30 % for bacteraemia [3]. Mortality increases from 10 % if antifungal therapy is introduced within 12 hours of the onset of candidaemia to 35 % when treatment is initiated more than 48 hours after [4]. These figures are worse in cases of septic shock due to Candida species [5]. The challenge is therefore to manage the delay in initiation of antifungal treatment, especially as 50 % of cases of IC are not detected by blood cultures (BCs) and 48 hours are generally required for yeast isolation [6]. This low sen-sitivity of BCs was observed in several large postmortem studies evaluating the sensitivity of BCs for the diagnosis of deep-seated Candida invasion [7] and was shown t