Mycology

Fungal Specimen Collection Guide

 

This document provides detailed fungal specimen submission instructions to the Public Health and Microbiology Laboratory (PHML) including collection transportation, storage, and rejection criteria.

 

Fungal Specimen Types Collection/Transport/Storage Rejection Policy *
Dermatological specimens (hair, nails, skin, and scalp scraping) Hair

Collect 10-12 hairs including base of shaft (root) with forceps. Submit specimen in sterile dry container or clean envelope.

Nail

The nail should be cleaned with 70% alcohol. The shavings and material under the nail plate should be collected in sterile dry container or clean envelope.

Skin scrapings and scalp brushings

The skin or scalp should be cleaned with 70% alcohol. Subsurface scrapings should be collected from the active margin of lesion after removing and discarding superficial material. Submit specimen in sterile dry container or clean envelope.

· Transport/store at room temperature (RT)

· Do not refrigerate

 · >7 days from collection

· Refrigerated specimen

 
Sputum · Collect first-morning sputum

· Transport/store at 4-8 ºC

 

 · Saliva

· Nasal secretions

· Pooled 24-hour sputum

· Swabs

· Sputum>72 hours from collection
Bronchial washing, bronchoalveolar lavage (BAL) · Bronchial wash and BAL should be sent in sterile, leak-proof container.

· Transport/store at 4-8 ºC

  
Bronchial brushing, esophageal brushing · Bronchial/esophageal brush should be sent in a sterile, leak-proof container with at least 1 ml of sterile normal saline.

· Transport/store at 4-8 ºC

  
Cerebrospinal fluid (CSF) · Collect as much as possible

· Immediately transport to lab at RT

· Store at RT if delayed transport

· Do not refrigerate

 · Consult MOC for test prioritization if insufficient volume collected.

 
Sterile body fluids (pericardial, peritoneal, synovial fluid, vitreous fluids in sterile container, abscess fluids collected by surgical procedure, etc.) · Ideally, collect 5-10 mL specimen aseptically in sterile, leak-proof container

· Transport to lab promptly/store at 4-8 ºC

 

  
Wounds (ear lesions, scalp lesions, nasal sinus/nasal aspirate collected by endoscopy, etc.)

 

 

 · Aspirated fluids and tissue are the preferred specimens.

· Remove the surface exudate with preservative-free, sterile saline or 70% ethanol.

· Aseptic aspiration from undrained abscesses should be performed using a needle and syringe.

•     Tissue from the deepest part of the

Lesion plus the advancing margin

•    Transport/store at 4-8 ºC

 · Swab is not recommended for fungal culture due to the inferior capacity to recover fungal growth. If a swab is the only available specimen for collection, the physician should consult Microbiologist on Call (MOC) for test approval.

· Wound swab will be rejected if without MOC approval or >72 hours old

· Dried swab is unacceptable
Tissue (tissue, biopsy collected by surgical procedures, bone marrow, etc.) · The size of the tissue specimen should approximately 1 gram or 1 cm long. Consult MOC for test prioritization if insufficient specimen

· Collect in sterile, leak-proof container with a small amount of sterile normal saline to prevent drying

· Transport to lab promptly/store at 4-8 ºC

 · Tissue in formalin is unacceptable

· Consult MOC for test prioritization if insufficient volume collected.

 
Ocular specimens (corneal scraping, vitreous fluid)

 

 

 · Ophthalmologists consult MOC before specimen collection. MOC will arrange fungal culture plates to be shipped to ward/clinic.

· Inoculate specimen at bedside in “C” shapes in the center of the plate.

· Transport plates ASAP to the lab at RT. Store at RT.

  
Ocular specimens

(corneoscleral donor rims)

 Collect in sterile, leak-proof container with 1–5 mL sterile normal saline to prevent drying. · Swab or dried specimen is unacceptable
Ocular specimens

(conjunctiva)

 

 · Aspirated purulent material is preferred.

· If a swab is the only available specimen for collection, the physician should consult MOC for test approval.

· If a swab is approved, rotate the swab to collect exudate.

· Transport/store at 4-8 ºC

 · Swab is not recommended for fungal culture due to the inferior capacity to recover fungal growth

· Swab will be rejected if without MOC approval or >72 hours old

· Dried swab is unacceptable
Fungal blood culture · Consult MOC before blood collection for Myco/F lytic bottles to be shipped to ward

· Collect blood in MycoF/Lytic bottle

· Transport as soon as possible at RT

· Store at RT. Do not refrigerate!

 · If regular blood culture bottles are received, MOC recommends recollection by MycoF/Lytic bottle if indicated.
Mouth, throat, vaginal swab

 

 

 

 

 

 Candida culture will be set up if the following test criteria are indicated on the requisition form or Meditech:

·  Recurrent (resistant) yeast (candida) infection

· Treatment failure

· Recurrent thrush

· MOC approval

 · Swab will be rejected if not meeting the testing criteria or >72 hours old

· Dried swab is unacceptable
The following specimens will be rejected for fungal culture:

·  24-hour urine collection, Foley catheter urine, urinary catheter tips, lochia, vomitus, colostomy discharge materials, gastric contents or gastric washings, stool, and swabs without MOC approval or meeting test criteria.

· Specimens submitted in leaking or incorrect container, mislabelled or incomplete patient information, aged specimen outside acceptable stability time.

Consult MOC if any questions about specimen collection or test interpretation through hospital paging at 709-777-6300 or email at microbiologistoncall@easternhealth.ca

 

 
 

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