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Culture, Fungus, Routine

Athlete’s Foot, Tinea, Ringworm, Mold, Mould, Fungal Culture

Test Codes

EPIC: LAB5487

Department

Microbiology

Instructions

• If the specimen source is blood, please see Culture, Fungus, Blood. If the specimen source is hair, skin, or nails, please see Culture, Fungus, Hair, Skin, and Nails.
• Do NOT submit samples collected on swabs. Swabs are the least optimal means of submitting specimens for fungal testing. Swab specimens will be accepted but are not recommended.

Specimen Collection Criteria

Collect: Fungal specimens using aseptic technique, placed into a sterile collection container. Specimen sources and collection instructions are listed below.

• Body fluids: Collect specimen aseptically. Place a minimum of 2.0 mL in a sterile collection container. Sterile heparin can be used as an anticoagulant if needed for specimens such as synovial fluid that have a tendency to clot. If heparin is added, a separate specimen without heparin must be submitted for bacterial culture.
• Bone Marrow:
  • Preferred specimen: Bone marrow in a pediatric Isolator tube [1.5 mL lysis centrifugation (Isolator) tube].
  • Also acceptable: If the pediatric Isolator tube is unavailable the following tubes are acceptable:
    • Sterile tubes containing SPS:
      • Can be used for bacterial, fungal, and mycobacterial culture.
      • Fastidious organisms such as Streptococcus pneumoniae may be inhibited from growth.
    • Sterile tubes containing Lithium or Sodium Heparin:
      • Can be used for fungal and mycobacterial cultures.
      • Can not be used for bacterial culture.
    • Sterile, screw-capped tubes (not recommended):
      • Can be used for bacterial, fungal, and mycobacterial cultures.
      • The bone marrow will clot and will need to be ground prior to culture. This may adversely affect the ability to recover microorganisms (especially fungi).  
• Bronchoscopy specimens [Bronchial brushings, biopsies, bronchial washes, bronchoalveolar lavage (BAL)]: Place specimen in a sterile collection container.
• Cerebrospinal Fluid (CSF): Collect spinal fluid (1-2 mL) and place it into a sterile collection container.
• Eye: Eye cultures are best done when the medium is directly inoculated by the ophthalmologist. Corneal scrapings can be transferred to a BAP or SAB agar using a series of C-shaped cuts into the medium. Intra-ocular fluid can be placed in a sterile tube and transported to the laboratory. Swabs acceptable for conjunctiva.
• Pus, exudates, drainage and miliary abscesses: Aspirate material from undrained abscesses. Place material in a sterile collection container. Collection via swab is acceptable but strongly discouraged as swab collection offers a much lower yield compared to aspirated material in sterile cup.
• Sinus Contents: Aspirate material or tissue from sinus preferred, swabs also acceptable.
• Sputum: Collect approximately 5-10 mL of an early morning specimen and place into a sterile collection container.
• Tissue: Collect tissue aseptically from center and edge of lesion. Place specimen in a sterile collection container. Add 0.5 mL sterile, non-bacteriostatic saline to the container.
• Urine: Collect the first early morning clean-catch midstream specimen, collected into a Gray-top Boric Acid urine transport tube.
• Vaginal Material: For detection of yeast vaginitis, collect material from the vagina and place swab into an Affirm transport tube. See Vaginosis Screen. If specific identity of yeast is required, submit ESwab of vaginal secretions in Amies transport medium.

Specimens collected from sterile sites must be transported to the Laboratory immediately. Specimens from non-sterile sites, other than hair, skin, or nails, must be immediately refrigerated and transported to the Laboratory within 8 hours of collection.

Physician Office/Draw Specimen Preparation

• All sterile site specimens must be delivered to the Laboratory immediately. Courier Services may be contacted for a STAT pickup. Maintain specimens at room temperature prior to transport.
• All non-sterile site specimens (other than hair, skin, or nails) must be refrigerated (2-8°C or 36-46°F) immediately after collection and maintained refrigerated until transport. Specimens must be received in the Laboratory within 8 hours of collection.

Preparation for Courier Transport

Transport: Sterile site specimens, at room temperature (20-26°C or 68-78.8°F), and non-sterile site specimens (other than hair, skin, or nails), refrigerated, 2-8°C or 36-46°F).

Rejection Criteria

• Swabs for any specimen not already defined, or swabs not in an approved commercial Amies transport system.
• Unlabeled specimens.
• Insufficient volume, determined by specimen source.
• 24 hour sputum or urine samples.
• Specimens received in leaking containers.

Inpatient Specimen Preparation

Specimens must be transported to the Laboratory immediately after collection.

Storage

Specimen Stability for Testing:

Specimens Collected from Sterile Sites
Room Temperature (20-26°C or 68-78.8°F): 8 hours
Refrigerated (2-8°C or 36-46°F): Unacceptable
Frozen (-20°C/-4°F or below): Unacceptable

Specimens Collected from Non-Sterile Sites (Other than Hair, Skin, or Nails)
Room Temperature (20-26°C or 68-78.8°F): Unacceptable
Refrigerated (2-8°C or 36-46°F): 8 hours
Frozen (-20°C/-4°F or below): Unacceptable

Specimen Storage in Department Prior to Disposal:

Refrigerated (2-8°C or 36-46°F): 7 days for non-sterile site specimens, 30 days for sterile site specimens.

Laboratory

Dearborn Microbiology Laboratory
Taylor, Trenton and Wayne sent to Dearborn Microbiology Laboratory for testing.

Royal Oak Microbiology Laboratory
Farmington Hills, Grosse Pointe, and Troy sent to Royal Oak Microbiology Laboratory for testing.

Performed

Monday – Friday, 7:00 am – 3:30 pm.
Preliminary results available within 72 hours.

Reference Range

No growth.

Test Methodology

Fungal culture, microscopy, phenotypic tests, mass spectrometry and biochemical tests for identification of organisms.

Clinical Utility

Identification of fungi in clinical specimens may aid the physician in diagnosing and treating a patient.

Reference

1. Hazen, K.C., and S.A. Howell, 2016. Specimen Selection, Collection and Transport, Leber, A.L., Editor-in-Chief, Clinical Microbiology Procedures Handbook, 4^th Edition. ASM Press. Washington, D.C.

CPT Codes

87101, 87102, or 87103, dependent on source.
LOINC:  580-1

Contacts

Last Updated

8/27/2021