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HelpTest Code FBL Fungal Culture, Blood
Reporting Name
Fungal Culture, BloodUseful For
Diagnosis and treatment of the etiologic agents of fungemia
Performing Laboratory
Mayo Clinic Laboratories in Rochester
Specimen Type
Whole bloodSpecimen 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 daysSpecimen Retention Time
7 daysReject 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 |
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.