Fungal infections are a rising threat to our immunocompromised patient population as well as other non-immunocompromised patients with various medical conditions. However, little progress has been made in the past decade to improve fungal diagnostics. To jointly address this diagnostic challenge, the Fungal Diagnostics Laboratory Consortium (FDLC) was recently created. The FDLC consists of 26 laboratories from the United States and Canada that routinely provide fungal diagnostic services for patient care. A survey of fungal diagnostic capacity among the 26 members of the FDLC was recently completed, identifying the following diagnostic gaps: lack of molecular detection of mucormycosis; lack of an optimal diagnostic algorithm incorporating fungal biomarkers and molecular tools for early and accurate diagnosis of Pneumocystis pneumonia, aspergillosis, candidemia, and endemic mycoses; lack of a standardized molecular approach to identify fungal pathogens directly in formalin-fixed paraffin-embedded tissues; lack of robust databases to enhance mold identification with matrix-assisted laser desorption/ionization time-of-flight mass spectrometry; suboptimal diagnostic approaches for mold blood cultures, tissue culture processing for Mucorales, and fungal respiratory cultures for cystic fibrosis patients; inadequate capacity for fungal point-of-care testing, to detect and identify new, emerging or under-recognized, rare or uncommon fungal pathogens, and performance of antifungal susceptibility testing. In this commentary, the FDLC delineates the most pressing unmet diagnostic needs and provides expert opinion on how to fulfill them. Most importantly, the FDLC provides a robust laboratory network to tackle these diagnostic gaps and ultimately to improve and enhance the clinical laboratory’s capability to rapidly and accurately diagnose fungal infections.

中文翻译：

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真菌病实验室诊断诊断差距的识别：真菌诊断实验室联盟 (FDLC) 的专家意见

真菌感染对我们的免疫功能低下的患者群体以及其他患有各种疾病的非免疫功能低下的患者构成了日益严重的威胁。然而，在过去十年中，在改进真菌诊断方面进展甚微。为了共同应对这一诊断挑战，最近成立了真菌诊断实验室联盟 (FDLC)。FDLC 由来自美国和加拿大的 26 个实验室组成，这些实验室定期为患者护理提供真菌诊断服务。最近完成了对 FDLC 26 名成员的真菌诊断能力的调查，确定了以下诊断差距：缺乏毛霉菌病的分子检测；缺乏结合真菌生物标志物和分子工具的最佳诊断算法，用于早期和准确诊断肺孢子虫肺炎、曲霉病、念珠菌血症和地方性真菌病；缺乏直接在福尔马林固定石蜡包埋组织中鉴定真菌病原体的标准化分子方法；缺乏强大的数据库来增强基质辅助激光解吸/电离飞行时间质谱法的霉菌识别；霉菌血培养的次优诊断方法、毛霉的组织培养处理和囊性纤维化患者的呼吸道真菌培养；真菌即时检测能力不足，无法检测和识别新的、新兴的或未被充分认识的、稀有或不常见的真菌病原体，以及抗真菌药敏试验的性能。在这篇评论中，FDLC 描述了最紧迫的未满足的诊断需求，并就如何满足这些需求提供专家意见。最重要的是，