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Test Code LAB7009 Mycology (fungal) culture

Infectious

Methodology

Note:

 

1. For Cerebrospinal fluid (CSF), order LAB7380.  For CSF samples, Cryptococcal Antigen, CSF (LAB927) will also be performed at an additional charge.

 

2. Refer to Candida (yeast) Culture (LAB925) if looking for yeast only on the following specimen types: cervical, endocervical, lesion, ulcer, penile, urethra, vaginal, oral, throat, skin scraping, esophageal brush, or urine.

 

3. For hair, nail, and superficial skin specimens, refer to Mycology (fungal) culture, hair, skin, and nails (LAB7007)

 

 

Testing Algorithm:

 

Identification of fungi is based on colonial and microscopic morphology, Matrix Assisted Laser Desorption Ionization – Time of Flight Mass Spectrometry (MALDI-TOF MS), and physiologic or biochemical tests, when applicable. Suspicious isolates resembling dimorphic fungi are sent to the Mayo Clinic for molecular confirmation, when applicable. When requested, fungal isolates difficult to identify are sent to the University of Texas Science Center at San Antonio, San Antonio, Texas 78229-3900 for identification by combined phenotypic characterization and DNA sequencing of the following targets: ITS,D1/D2. Isolates suspected of being Nocardia are sent to the University of Texas Health Center at Tyler for identification by both 16S rRNA and secA1 gene sequencing. 

Performing Laboratory

Barnes-Jewish Hospital Laboratory

Specimen Requirements

Acceptable Specimens:

 

Note: Swabs are not optimal for fungal culture; tissue and fluids in sterile containers are preferred.

 

Abscess, aspirate, drainage, or wound: ≥1 mL in a leakproof screw-capped, sterile container or 1 ESwab per test request in sterile collection tube. 

 

Tissue or lymph node: ≥1 g in a leakproof screw-capped, sterile container

 

Bronchial, tracheal: ≥5 mL in a leakproof screw-capped, sterile container

 

Ocular swab: 1 ESwab Minitip Collection Kit

 

Ocular fluid (anterior chamber, aqueous humor, vitreous): ≥0.5 mL in a leakproof screw-capped, sterile container or Anerobic Transport media

 

Sterile Fluids (CSF, pericardial, pleural, synovial, etc.): ≥1 mL in a leakproof screw-capped, sterile container

  

Sputum: ≥5 mL in a leakproof screw-capped, sterile container

 

Unacceptable Specimens:


Stool

 

Specimen collected with ESwab Collection Kit is unacceptable if received without fluid or swab in the transport tube.

 

Collection Procedure:

 

Note: Specimen source is required.

 

Abscess, Aspirate, Drainage, or Wound
1. Disinfect surface of abscess or wound.
2. Aseptically collect purulent material by aspiration (≥1 mL) or by using an ESwab. Frequently, viable organisms are only associated with abscess wall, so adequately sample this area. If material is aspirated, aseptically inject specimen into a leakproof screw-capped, sterile container or a plain, red-top tube.
3. If ESwab is used, return ESwab into transport tube following instructions on kit.
4. Maintain sterility and forward promptly.

5. If transport is delayed, keep specimen at room temperature.


Tissue or Lymph node
1. Aseptically collect ≥1 g of tissue. Because there may be only a few viable organisms, specimen must be large enough to permit their recovery.
2. Place specimen in a leakproof screw-capped, sterile container.
3. Maintain sterility and forward promptly.

4. If transport is delayed, keep specimen at room temperature.
 

Bronchial or Tracheal
1. Aseptically collect ≥5 mL.
2. Place specimen in a leakproof screw-capped, sterile container.
3. Maintain sterility and forward promptly.

4. If transport is delayed, refrigerate specimen.
 

Ocular swab
Call Barnes-Jewish Hospital Laboratory Customer Service at 314-362-1470 to obtain ESwab Minitip Collection Kit.
1. Collect specimen before application of topical anesthetics because topical anesthetics possess antimicrobial activity.
2. Cleanse skin around eye with mild antiseptic.
3. Gently remove makeup and ointment with sterile cotton and saline.
4. Collect specimen by passing ESwab 2 times over lower conjunctiva or over cornea. Avoid eyelid border and lashes (culture these separately in a similar fashion, if indicated).
5. Place ESwab in transport tube following instructions on kit. 
6. Maintain sterility and forward promptly.

7. If transport is delayed, keep specimen at room temperature. 

 

Ocular fluid (anterior chamber, aqueous humor, vitreous)
1. Aseptically collect ≥0.5 mL of fluid.
2. Place specimen in a leakproof screw-capped or sterile container.
3. Maintain sterility and forward promptly.

4. If transport is delayed, keep specimen at room temperature.

Additional information on ocular specimen collection requirements can be found here.

 

Fluid (CSF, Joint, Pericardial, Synovial, etc.)
1. Aseptically collect ≥1 mL of fluid.
2. Place specimen in a leakproof screw-capped, sterile container.
3. Maintain sterility and forward promptly.

4. If transport is delayed, keep specimen at room temperature.
 

Sputum
1. Aseptically collect early-morning specimen in a leakproof screw-capped, sterile container. It is optimal to collect a specimen each day for 3 consecutive days. (Saliva is not acceptable.)
2. Instruct patient to brush his/her teeth and rinse mouth well with water.
3. Have patient remove dentures.
4. Instruct patient to take a deep breath, hold it momentarily, and then cough deeply and vigorously into container. Collect ≥5 mL of discharged material.
5. Maintain sterility and forward promptly.

6. If transport is delayed, refrigerate specimen.

Specimen Transport Temperature

Ambient/Refrigerate OK

Reference Values

No growth of fungi after 28 days

 

Literature Reference:

Westblade, Lars F. Larone's Medically important fungi - a guide to identification. 7th ed. Washington, DC: American Society for Microbiology; 2023

Day(s) Test Set Up

Monday through Sunday

 

Turnaround Time:


STAT: not available
Routine: final negative report available after 28 days of incubation

Test Classification and CPT Coding

87102-Culture, fungi other

Additional Information

For BJH Laboratory Use Only


Minimum Volume: 

Abscess, aspirate, drainage, or wound: 0.5 mL in a leakproof screw-capped, sterile container or 1 ESwab per test request in a sterile collection tube.


Tissue or lymph node : any amount in a leakproof screw-capped, sterile container


Bronchial, tracheal, or sputum: 0.5 mL in a leakproof screw-capped, sterile container


Ocular swab: 1 ESwab Minitip Collection Kit

 

Ocular fluid (anterior chamber, aqueous humor, vitreous): any amount in a leakproof screw-capped, sterile container


Sterile Fluids (CSF, pericardial, pleural, synovial, etc.): 0.5 mL in a leakproof screw-capped, sterile container


Laboratory Processing Instructions:
Test performed in BJH Microbiology.