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Test Code SOFT: ZG193 Fungal Culture, Blood

Additional Codes

Ordering Mnemonic Mayo Test ID
EPIC NAME: CULTURE-FUNGUS, BLOOD FBL

EPIC CODE: LAB242

Reporting Name

Fungal Culture, Blood

Useful For

Diagnosis and treatment of the etiologic agents of fungemia

Performing Laboratory

Mayo Clinic Laboratories in Rochester

Specimen Type

Whole blood


Specimen Required


Container/Tube:

Preferred: Green top (sodium or lithium heparin)

Acceptable: SPS

Specimen Volume: 4 mL

Pediatric Volume: 3 mL

Collection Instructions:

1. Send whole blood specimen in original tube. Do not aliquot.

2. SPS tubes are acceptable, but not preferred.

Note: SPS tubes must be clearly labeled as SPS. If label is obscured, sample may be cancelled, as ACD (also yellow top) is not an acceptable tube type.


Specimen Minimum Volume

Adults: 3 mL
Pediatrics: 1 mL

Specimen Stability Information

Specimen Type Temperature Time Special Container
Whole blood Ambient (preferred) 7 days
  Refrigerated  7 days

Reference Values

Negative

If positive, notification is made as soon as the positive culture is detected or identified.

Day(s) Performed

Monday through Sunday

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

87103-Blood

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-Identification rapid PCR coccidioides (if appropriate)

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

87153-D2 fungal sequencing identification (if appropriate)

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

LOINC Code Information

Test ID Test Order Name Order LOINC Value
FBL Fungal Culture, Blood 601-5

 

Result ID Test Result Name Result LOINC Value
FBL Fungal Culture, Blood In Process

Clinical Information

Due to the high mortality rate from fungemia, the expeditious detection and identification of fungi from the patient's blood can have great diagnostic prognostic importance. Risk factors for fungemia include, but are not limited to, extremes of age, immunosuppression, and those individuals with burns or indwelling intravascular devices.

Interpretation

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

 

Positive cultures are usually an indication of infection and are reported as soon as detected. Correlation of culture results and the clinical situation is required for optimal patient management. A final negative report is issued after 42 days of incubation.

Clinical Reference

1. Procop GW, Church DL, Hall GS, et al. Mycology. In: Koneman's Color Atlas and Textbook of Diagnostic Microbiology. 7th ed. Walters Kluwer; 2017:1322-1416

2. Zheng S, Ng TY, Li H, Tan AL, Tan TT, Tan BH. A dedicated fungal culture medium is useful in the diagnosis of fungemia: a retrospective cross-sectional study. PLoS One. 2016;11(10):e0164668. doi:10.1371/journal.pone.0164668

3. Magallon A, Basmaciyan L, Chapuis A, et al. Evaluation of the relevance of use of the BD-BACTEC MycosisIC/F, BD-BACTEC PlusAerobic/F, BD-BACTEC Lytic/10 anaerobic/F and BD-BACTEC PedsPlus/F culture bottle system for fungemia detection: A 4-year retrospective study at the Dijon university hospital, France. J Mycol Med. 2022;32(4):101295. doi:10.1016/j.mycmed.2022.101295

Method Description

Blood is inoculated into a MycoF Lytic culture bottle (Becton Dickinson) bottle and continuously monitored on a blood culture instrument.

 

Identification of fungi is based on colonial and microscopic morphology, matrix-assisted laser desorption ionization time-of-flight mass spectrometry, laboratory-developed real-time polymerase chain reaction assays and/or D2 rDNA gene sequencing, as applicable.(Babady NE, Buckwalter SP, Hall L, Le Febre KM, Binnicker MJ, 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)

Report Available

42 to 45 days

Specimen Retention Time

7 days

Reject Due To

Blood culture bottles (eg, BACTEC MycoF Lytic)
Isolator
Clotted
Reject

Cautions

No significant cautionary statements

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
RMALY Id MALDI-TOF Mass Spec Yeast No, (Bill Only) No
LCCA Id, Candida auris Rapid PCR No, (Bill Only) No
Saint Francis Healthcare System Note:

The reflex test listed in the chart above will not automatically charge post. Manually charge post. 

Testing Algorithm

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

Method Name

Conventional Broth Culture/Macroscopic/Microscopic/D2 rDNA Gene Sequencing/Real-Time Polymerase Chain Reaction (PCR)/Matrix-Assisted Laser Desorption/Ionization-Time of Flight Mass Spectrometry (MALDI-TOF MS)

 

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

Forms

If not ordering electronically, complete, print, and send a Microbiology Test Request (T244) with the specimen.

Secondary ID

50022