Molecular detection, not extended culture incubation, contributes to diagnosis of fungal infection

Abstract Background Despite its low sensitivity, fungal culture remains one of the key methods for diagnosis and treatment of fungal infections, as it identifies the etiology at the genus and species level and affords the opportunity for susceptibility testing. The Manual of Clinical Microbiology re...

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Autores principales:	Alex Zhu, Teresa Zembower, Chao Qi
Formato:	article
Lenguaje:	EN
Publicado:	BMC 2021
Materias:	Fungal infections Fungal culture ITS PCR Infectious and parasitic diseases RC109-216
Acceso en línea:	https://doaj.org/article/acbc792a858a4af38027e40bbf7bb7a1
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spelling	oai:doaj.org-article:acbc792a858a4af38027e40bbf7bb7a12021-11-21T12:42:42ZMolecular detection, not extended culture incubation, contributes to diagnosis of fungal infection10.1186/s12879-021-06838-61471-2334https://doaj.org/article/acbc792a858a4af38027e40bbf7bb7a12021-11-01T00:00:00Zhttps://doi.org/10.1186/s12879-021-06838-6https://doaj.org/toc/1471-2334Abstract Background Despite its low sensitivity, fungal culture remains one of the key methods for diagnosis and treatment of fungal infections, as it identifies the etiology at the genus and species level and affords the opportunity for susceptibility testing. The Manual of Clinical Microbiology recommends that fungal culture screening for all pathogens should routinely be held for 4 weeks to maximize the recovery of slow-growing species. Information on the optimal fungal culture time in this era of expansion of immunocompromised populations and availability of molecular diagnostics is lacking. We reviewed our experience with fungal culture to determine the optimal culture incubation time. In addition, our experience of broad-range ITS PCR for diagnosis of culture-negative fungal infections was also reviewed. Methods Fungal culture and ITS PCR results from January 1, 2013, to December 31, 2017, were reviewed. Results This study included 4234 non-duplicated positive cultures. Ninety-six percent (4058) of the positive cultures were detected in the first 7 days of incubation. During the second week of incubation, 111 (2.8%) positives were detected from day 8 to day 10, and 71 (1.7%) were detected from day 11 to day 14. Only 6 (0.1%) positive cultures were detected in the third week of incubation, and no positive culture was detected in the fourth week of incubation. No clinically significant fungal isolates were recovered after 14 days. Clinically significant pathogens were detected in 16 (0.2%) culture-negative samples by ITS PCR. Conclusion Extending culture incubation beyond 2 weeks did not generate clinically relevant results. When culture failed to make a laboratory diagnosis, broad-range internal transcribed spacer (ITS) rRNA gene PCR followed by sequencing produced clinically significant results.Alex ZhuTeresa ZembowerChao QiBMCarticleFungal infectionsFungal cultureITS PCRInfectious and parasitic diseasesRC109-216ENBMC Infectious Diseases, Vol 21, Iss 1, Pp 1-7 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Fungal infections Fungal culture ITS PCR Infectious and parasitic diseases RC109-216
spellingShingle	Fungal infections Fungal culture ITS PCR Infectious and parasitic diseases RC109-216 Alex Zhu Teresa Zembower Chao Qi Molecular detection, not extended culture incubation, contributes to diagnosis of fungal infection
description	Abstract Background Despite its low sensitivity, fungal culture remains one of the key methods for diagnosis and treatment of fungal infections, as it identifies the etiology at the genus and species level and affords the opportunity for susceptibility testing. The Manual of Clinical Microbiology recommends that fungal culture screening for all pathogens should routinely be held for 4 weeks to maximize the recovery of slow-growing species. Information on the optimal fungal culture time in this era of expansion of immunocompromised populations and availability of molecular diagnostics is lacking. We reviewed our experience with fungal culture to determine the optimal culture incubation time. In addition, our experience of broad-range ITS PCR for diagnosis of culture-negative fungal infections was also reviewed. Methods Fungal culture and ITS PCR results from January 1, 2013, to December 31, 2017, were reviewed. Results This study included 4234 non-duplicated positive cultures. Ninety-six percent (4058) of the positive cultures were detected in the first 7 days of incubation. During the second week of incubation, 111 (2.8%) positives were detected from day 8 to day 10, and 71 (1.7%) were detected from day 11 to day 14. Only 6 (0.1%) positive cultures were detected in the third week of incubation, and no positive culture was detected in the fourth week of incubation. No clinically significant fungal isolates were recovered after 14 days. Clinically significant pathogens were detected in 16 (0.2%) culture-negative samples by ITS PCR. Conclusion Extending culture incubation beyond 2 weeks did not generate clinically relevant results. When culture failed to make a laboratory diagnosis, broad-range internal transcribed spacer (ITS) rRNA gene PCR followed by sequencing produced clinically significant results.
format	article
author	Alex Zhu Teresa Zembower Chao Qi
author_facet	Alex Zhu Teresa Zembower Chao Qi
author_sort	Alex Zhu
title	Molecular detection, not extended culture incubation, contributes to diagnosis of fungal infection
title_short	Molecular detection, not extended culture incubation, contributes to diagnosis of fungal infection
title_full	Molecular detection, not extended culture incubation, contributes to diagnosis of fungal infection
title_fullStr	Molecular detection, not extended culture incubation, contributes to diagnosis of fungal infection
title_full_unstemmed	Molecular detection, not extended culture incubation, contributes to diagnosis of fungal infection
title_sort	molecular detection, not extended culture incubation, contributes to diagnosis of fungal infection
publisher	BMC
publishDate	2021
url	https://doaj.org/article/acbc792a858a4af38027e40bbf7bb7a1
work_keys_str_mv	AT alexzhu moleculardetectionnotextendedcultureincubationcontributestodiagnosisoffungalinfection AT teresazembower moleculardetectionnotextendedcultureincubationcontributestodiagnosisoffungalinfection AT chaoqi moleculardetectionnotextendedcultureincubationcontributestodiagnosisoffungalinfection
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Molecular detection, not extended culture incubation, contributes to diagnosis of fungal infection

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