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Mayo Test ID FGEN Fungal Culture, Routine


Ordering Guidance


Nocardia and the other aerobic actinomycetes are not fungi, therefore a fungal culture should not be ordered. However, these organisms grow well on mycobacterial medium. When infection with this group of organisms is suspected, order CTB / Mycobacteria and Nocardia Culture, Varies.



Shipping Instructions


Specimen should arrive within 24 hours of collection.



Necessary Information


Specimen source is required.



Specimen Required


Preferred Specimen Type: Body fluid

Container/Tube: Sterile container

Specimen Volume: Entire collection

 

Preferred Specimen Type: Fresh tissue

Container/Tube: Sterile container

Specimen Volume: Pea size

Collection Instructions: Tissue should be placed in small amount of sterile saline or sterile water.

 

Specimen Type: Bone marrow

Container/Tube: Sterile container, SPS/Isolator system, or green top (lithium or sodium heparin)

Specimen Volume: Entire collection

 

Specimen Type: Respiratory specimen

Container/Tube: Sterile container

Specimen Volume: Entire collection

 

Acceptable Specimen Type: Swab

Sources: Dermal, ear, mouth, ocular, throat, or wound

Container/Tube: Culture transport swab (non-charcoal) Culturette or ESwab

Specimen Volume: Swab

Collection Instructions:

1. Before collecting specimen, wipe away any excessive amount of secretion and discharge, if appropriate.

2. Obtain secretions or fluid from source with sterile swab.

3. If smear and culture are requested or both a bacterial culture and fungal culture are requested, collect a second swab to maximize test sensitivity.

 

Specimen Type: Urine

Container/Tube: Sterile container

Specimen Volume: 2 mL

Collection Instructions: Collect a random urine specimen.


Useful For

Diagnosing fungal infections from specimens other than blood, skin, hair, nails, and vagina (separate tests are available for these specimen sites)

Reflex Tests

Test ID Reporting Name Available Separately Always Performed
D2F D2 Fungal Sequencing Identification No, (Bill Only) No
FUNA Fungal Ident Panel A No, (Bill Only) No
FUNB Fungal Ident Panel B No, (Bill Only) No
LCCI Ident Rapid PCR Coccidioides No, (Bill Only) No
LCHB Id, Histoplasma/Blastomyces PCR No, (Bill Only) No
RMALF Id MALDI-TOF Mass Spec Fungi No, (Bill Only) No
TISSR Tissue Processing No, (Bill Only) No
RMALY Id MALDI-TOF Mass Spec Yeast No, (Bill Only) No
LCCA Id, Candida auris Rapid PCR No, (Bill Only) No

Testing Algorithm

When this test is ordered, the reflex tests may be performed at an additional charge.

 

For more information see Meningitis/Encephalitis Panel Algorithm.

Method Name

Conventional Agar Culture/Macroscopy/Microscopy/D2 rDNA Gene Sequencing/Real-Time Polymerase Chain Reaction (rtPCR)/Matrix-Assisted Laser Desorption/Ionization Time-Of-Flight Mass Spectrometry (MALDI-TOF MS)

Dimorphic Pathogen Identification Confirmation: D2 rDNA Gene Sequencing/rtPCR/MALDI-TOF MS

Reporting Name

Fungal Culture, Routine

Specimen Type

Varies

Specimen Minimum Volume

Bone marrow or body fluid: 1 mL; Cerebrospinal fluid: 0.5 mL; Respiratory specimen: 1.5 mL; All other specimen types: See Specimen Required

Specimen Stability Information

Specimen Type Temperature Time
Varies Refrigerated (preferred) 7 days
  Ambient  7 days

Reject Due To

Blood or fixed tissue
Specimen in viral transport medium (including but not limited to M4, M5, BD viral transport media, thioglycolate broth)
Swab sources of respiratory fluids (eg, sputum) or nasal swab
Wood shaft or charcoal swab
Catheter tips
Petri dish
Stool
Blades from scalpels or razors		 Reject

Clinical Information

Many fungi in the environment cause disease in immunocompromised human hosts. Accordingly, the range of potential pathogenic fungi has increased as the number of immunosuppressed individuals (persons with AIDS, patients receiving chemotherapy or transplant rejection therapy, etc) has increased. Isolation and identification of the infecting fungus in the clinical laboratory can help guide patient care.

Reference Values

Negative

If positive, fungus will be identified.

Interpretation

Positive cultures of yeast and filamentous fungi are reported with the organism identification.

 

The clinician must determine whether the presence of an organism is significant or not. A final negative report is issued after 24 days of incubation.

Cautions

For optimal recovery of organisms, sufficient specimen should be transported within 24 hours of collection.

 

Fungi can be pathogens, colonizers, or contaminants. Correlation of the patient clinical condition with culture results is necessary.

Clinical Reference

Ashbee HR: General approaches for direction detection and identification of fungi. In: Carroll KC, Pfaller MA, Landry ML, et al, eds. Manual of Clinical Microbiology. 12th ed. Vol 1. ASM Press; 2019:2035-2055

Method Description

Specimens are cultured on selective fungal media (eg, inhibitory mold agar and brain heart infusion blood agar with chloramphenicol and gentamicin). Respiratory sources also are cultured on brain heart infusion agar with chloramphenicol, gentamicin, and cycloheximide. Cultures are incubated for 24 days at 30° C.

 

Identification of fungi is based on colonial and microscopic morphology, matrix-assisted laser desorption/ionization time-of-flight (MALDI-TOF) mass spectrometry, laboratory-developed real-time polymerase chain reaction assays and/or D2 ribosomal RNA gene sequencing, as applicable.(Babady NE, Buckwalter SP, Hall L, Le Febre KM, Binnicker MF, Wengenack NL. Detection of Blastomyces dermatitidis and Histoplasma capsulatum from culture isolates and clinical specimens by use of real-time PCR. J Clin Microbiol. 2011;49(9):3204-3208; Binnicker MJ, Buckwalter SP, Eisberner JJ, et al. Detection of Coccidioides species in clinical specimens by real-time PCR. J Clin Microbiol. 2007;45(1):173-178; Dhiman N, Hall L, Wohlfiel SL, Buckwalter SP, Wengenack NL. Performance and cost analysis of matrix-assisted laser desorption ionization time of flight mass spectrometry for routine identification of yeast. J Clin Microbiol. 2011;49[4]:1614-1616; Hall L, Wohlfiel SL, Roberts GD. Experience with the MicroSeq D2 large-subunit ribosomal DNA sequencing kit for identification of filamentous fungi encountered in the clinical laboratory. J Clin Microbiol. 2004;42(2):622-626; Theel ES, Schmidt BH, Hall L, et al. Formic acid-based direct, on-plate testing of yeast and Corynebacterium species by Bruker Biotyper matrix-assisted laser desorption ionization-time of flight mass spectrometry. J Clin Microbiol. 2012;50(9):3093-3095; Theel ES, Hall L, Mandrekar J, Wengenack NL: Dermatophyte identification using matrix-assisted laser desorption ionization-time of flight mass spectrometry. J Clin Microbiol. 2011;49(12):4067-4071; Fida M, Wengenack NL, Theel ES. Mycology: General approaches for direct and indirect detection and identification of fungi. In: Carroll KC, Pfaller MA, Pritt BS, et al. Manual of Clinical Microbiology. 13th ed. ASM Press; 2023)

Day(s) Performed

Monday through Sunday

Report Available

24 to 35 days

Specimen Retention Time

Raw specimen:7 days

Performing Laboratory

Mayo Clinic Laboratories in Rochester

Test Classification

This test has been cleared, approved, or is exempt by the US Food and Drug Administration and is used per manufacturer's instructions. Performance characteristics were verified by Mayo Clinic in a manner consistent with CLIA requirements.

CPT Code Information

87102-Fungal culture, routine

87106-Id MALDI-TOF Mass Spec Yeast (if appropriate)

87107-Id MALDI-TOF Mass Spec Fungi (if appropriate)

87107-Fungal identification panel A (if appropriate)

87107-Fungal identification panel B (if appropriate)

87150 x 2-Identification Histoplasma/Blastomyces, PCR (if appropriate)

87153-D2 fungal sequencing identification (if appropriate)

87176-Tissue processing (if appropriate)

87150- Id, Candida auris Rapid PCR (if appropriate)

LOINC Code Information

Test ID Test Order Name Order LOINC Value
FGEN Fungal Culture, Routine 51723-5

 

Result ID Test Result Name Result LOINC Value
FGEN Fungal Culture, Routine 51723-5