Blood is inoculated into MycoF Lytic (Becton Dickinson) and Isolator (Wampole) tubes. Continuously monitored blood culture instruments provide for the detection of bloodstream infections due to most Candida species and Cryptococcus species. The Isolator tube contains saponin to lyse the blood cells, enabling the release of intracellular organisms. Centrifugation generates a concentrated layer of organisms that is inoculated onto solid media for recovery of fungi and this appears to be the most sensitive method for recovery of Histoplasma capsulatum, other dimorphic fungi, and filamentous fungi.(Sutton DA: Specimen collection, transport, and processing: Mycology. In Manual of Clinical Microbiology. Ninth edition. Edited by Murray PR, Baron EJ, Jorgensen JH, et al. ASM Press, Washington DC. 2007, pp 1728-1736)
Identification of fungi is based on colonial and microscopic morphology, MALDI-TOF mass spectrometry, nucleic acid hybridization probes, laboratory-developed real-time PCR assays and/or D2 rDNA gene sequencing, as applicable.(Babady NE, Buckwalter SP, Hall L: Detection of Blastomyces dermatitidis and Histoplasma capsulatum from culture isolates and clinical specimens by use of real-time PCR. J Clin Microbiol 2011;49:3204-3208; Binnicker MJ, Buckwalter SP, Eisberner JJ: Detection of Coccidioides species in clinical specimens by real-time PCR. J Clin Microbiol 2007;45:173-178; Dhiman N, Hall L, Wohlfiel SL: 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;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;42:622-626; Theel ES, Schmidt BH, Hall L: 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;50:3093-3095; Theel ES, Hall L Mandrekar J: Dermatophyte identification using matrix-assisted laser desorption ionization-time of flight mass spectrometry. J Clin Microbiol 2011;49:4067-4071)
30 days/positive cultures reported as soon as detected.