Fungal Culture or Yeast Culture Routine


Abbrev Code:FUNGCX   
Order Code:LAB241Order Name:Fungal Culture or Yeast Culture Routine
Order Instructions:C. auris screening should be ordered as a Laboratory Miscellaneous Order (LAB4909). See Associated Link for the Lab Guide page.
Synonyms:Culture Fungal; CX; Fungus, Yeast
Methodology:Culture
CPT Codes: 87101 x1, 87102 x1, 87102 x1, 87103 x1, 87106 x1, 87107 x1
Test Includes:Culture for yeast and filamentous fungi. KOH preparation is available upon request on all specimen types except blood, bone marrow, CSF and urine.
Turnaround Time:Performed 24 hours/day; preliminary results are updated Mon-Fri. Negative finals are reported between 4 days and 4 weeks, based on specimen type.
Special Instructions:The same specimen may be submitted for bacterial and fungal culture, and KOH preparation. Indicate organism suspected or relevant clinical history on request form.
Associated Links:

IDDL (Microbiology/Virology) Collection Container Guidelines, C. auris Screen Lab Guide


Collection Instructions

Collection Instructions:
Specimen Type Instructions Volume Container Alternate Container
Abscess Prepare surface with povidone iodine solution; let dry.
Aspirate fluid/purulent material with syringe. Expel air bubbles from syringe; inject sample into sterile container
Deliver to laboratory immediately.		 Optimal: 5 mL
Minimum: 1.0  mL		 Sterile Container
 Eswab – for use only if fluid/material cannot be aspirated.
 
Aspirate
Cyst
CSF
Body Fluid:
Amniotic, Aqueous, Ascites, Gastric, Ocular, Pericardial, Pleural, Peritoneal, Synovial, Vitreous, Milk
Blood If suspecting Candida species order:LAB3337 instead.
For patient preparation: See blood collection for cultures.
For patients where Histoplasma, Blastomyces, Coccidioides or Cryptococcus are suspected (e.g., HIV patients may be at risk for these agents), place 8 mL blood into SPS (Liquoid) culture tube (blood or bone marrow) or 6 mL Isolator tube (blood only). If 8 mL blood cannot be obtained, place minimum of 1.5 mL blood into an 8 mL (SPS) fungal culture tube. Specify suspected organism on request form.
In infants (less than 11 lb/5 Kg) with suspected Malassezia or Histoplasma, inoculate an SPS tube. Specify suspected organism on request form.		 Optimal: 8mL
Minimum: 1.5mL		 SPS
 Isolator

 
Bone Marrow Cultures should be taken after specimens for cell morphology studies, genetic studies, cell marker studies and other cell studies. Use a new syringe for each. Clean top of anticoagulant tube with alcohol wipe before injecting. Optimal: 4-8 mL
Minimum: 1.5 mL		 SPS
  
Bronchial Lavage Collect in sterile leakproof container Optimal:5 mL
Minimum: 0.5 mL		 Sterile container
 N/A
 
Brushing Bronchial Brush: Using standard bronchoscopy technique, identify the lesion in question and obtain a brushing sample of the lesion. Upon withdrawing the brush, agitate the brush vigorously in a 5-10 mL vial of sterile saline. Transport to the laboratory immediately. N/A Brush in sterile container.
N/A
Bone:
Biopsy, Core Biopsy, Curetting, Fracture, Fragments, Resection, Exostosis, Osteophyte, Resection 		Place specimen in sterile leakproof container. Visible amount of specimen. Sterile Container
 Eswab – for use only if specimen cannot be removed.
 
Calculus/Stone
Foreign Body
Tissue:
Biopsy, Fine needle aspiration
Placenta Place patient in lithotomy position, insert speculum, and visualize cervical os.
Remove mucous plug, wipe cervical os with povidone iodine solution. Wipe off povidone iodine solution.
Aspirate material through the sleeve of a rush or curette sampling implement to avoid normal flora contamination.
Place the aspirate in sterile container.
Do not collect on swabs to prevent contamination with normal cervical/vaginal flora and to ensure adequate material is collected. Specimen can be swabbed after removal if shared with Surgical Pathology.
 		 Visible amount of specimen. Sterile Container
 		 Eswab – for use only if shared with surgical pathology.
 
Hair Send strands/clippings in sterile container. Visible amount of specimen. Sterile Container
 N/A
Nail Cleanse with 70% alcohol. Using sterile scalpel blade, scrape surface. Discard initial portion. Send deeper scrapings for culture in sterile container. Visible amount of specimen. Sterile Container
 N/A
Skin-excision, punch or shave Cleanse with 70% alcohol. Scrape off skin at active border lesion; include some healthy skin. Place in sterile container. Visible amount of specimen. Sterile container
 N/A
Scraping
 
Sinus Contents		  
Clean Surface with sterile sponge and sterile water.
If purulent material is available to be aspirated collect in Sterile Container for improved sensitivity. 		Sterile Container Optimal: 3 mL
Minimum: 0.5 mL
 
Eswab: N/A 		 
 
Sterile Container
 Eswab – for use only if fluid/material cannot be aspirated.
 
Stripping
Vaginal Fluid
Wound
Sputum Expectorated sputum is not recommended for routine bacterial/fungal culture because of unavoidable contamination with upper respiratory flora. If possible, have the patient rinse mouth and gargle with water first. Ask the patient to cough deeply and expectorate coughed-up material into a sterile container. In seriously ill or debilitated patients, a transtracheal aspirate may be necessary. Optimal: 3 mL
Minimum: 1 mL		 Sterile Container
 N/A
Stool Collect in clean, dry bedpan or onto newspaper placed over toilet seat. Those portions of stool containing blood, pus or mucus are especially significant. Visible amount of specimen. Sterile Container
 N/A
Swab Swab of mucosal membrane N/A Eswab
 N/A
Urine CATHETER COLLECTION: Clean catheter with alcohol sponge, puncture with sterile needle, and collect urine in sterile syringe. (Note: This technique is unsatisfactory for certain silicone catheters which may then leak).
Obtain first morning specimen for best results (overnight incubation in bladder yields highest bacterial counts). Refrigerate specimen if not delivered to laboratory within 30 minutes.
Female:
1.  Wash hands with soap and water; dry with disposable paper towel.
2.  With one hand, patient or personnel should spread the labia and keep them apart for remainder of procedure.
3.  Using povidone-Iodine swab, wipe down one side from front to back; with fresh swab, wipe other side from front to back. With fresh swab, wipe center from front to back. Repeat as necessary to clean thoroughly.
4.  Wipe and dry area with sterile gauze.
5.  Void small amount of urine into toilet or bedpan. Stop flow for a minute then continue flow into sterile container. Be careful not to touch inner part of container or lid as container is being capped.
Male:
1.  Wash hands with soap and water; dry with disposable paper towel.
2.  Retract foreskin if necessary.
3.  Using povidone/iodine swabs, clean glans and urethral opening thoroughly.
4.  Wipe and dry area with sterile gauze.
5.  Follow step 5 above.
Infants and Small Children:
1.  After cleaning appropriately, as above, place sterile urine bag over labia or penis.
2.  After 30 minutes, observe for the presence of urine. If no urine is present, re-clean patient and attach new bag.
3.  If impossible to obtain urine or if culture results yield a mixture of organisms, a suprapubic aspiration is recommended.		 Optimal: 5-10 mL
Minimum: 0.2 mL		 Sterile Container
Urine culture tube (Boric Acid)
Washings Collect in Sterile Leakproof container Optimal: 5 mL
Minimum:0.5 mL		 Sterile Container
 N/A


Processing and Shipping

Specimen Processing:Store at room temperature.
Shipping Instructions:Ship at room temperature. Must arrive within 24 hours.
Stability:Samples are stable at room temperature or refrigerated.
Test Performed at or Referral Lab Infectious Diseases Diagnostic Laboratory   (UMMC East Bank)


Interpretive

Reference Range:No growth
Use:Isolate and identify fungi in patients whose clinical situation places them at risk for a fungal infection whether focal or disseminated.


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