Tests & diagnoses

The set of tests required to make a proven, probably or possible diagnosis of a fungal infection or allergy is usually set out in the guidelines for that disease, and will depend on patient factors as well as local availability of laboratory and imaging facilities. Visit our dedicated imaging page for more information.

Generally multiple tests will be required because there are often many conditions in the differential diagnosis, and fungal infections may co-exists with other infections (e.g. influenza with aspergillosis) or diagnoses (e.g. bronchiectasis and aspergillosis). Certain fungal conditions may require specialist tests such as dermoscopy or skin testing for endemic mycoses.

Zhu et al have published a paper on importance of molecular testing for fungal infection detection.

You can find out more about the main diagnostic steps for fungal infections here.

Laboratory tests explained, including current suppliers

Find out more about how to perform specimen collection. When submitting hair/skin/nail samples, always include plenty of sample material. Contact your local mycology reference centre for specific packaging requirements.

NameLink
Rapid Trehalose Assimilation Broth  www.fishersci.nl/shop/products/remel-rapid-trehalose-assimilation-broth-rat-broth/10691345  
Rapid trehalose + sucrose assimilation with Rosco disks (Diatabs™)  www.rosco.dk/?id=15&c=Antifungals
RAT (Mayo Clinic method)  https://biolynx.ca/products/DL761  
GlabrataQuick™ Kit  https://catalog.hardydiagnostics.com/cp_prod/product/z298-glabrataquick-for-the-identification-of-icandida-glabratai-24-tests-by-hardy-diagnostics-order-by-the-package-rapid-id-test-kits  
Brilliance™ Candida  www.fishersci.co.uk/shop/products/brilliance-candida-agar/12987188  
Candi Select ™  www.bio-rad.com/en-uk/product/candiselect-agar?ID=OMERJB15  
CHROMagar™ Candida  www.chromagar.com/en/product/chromagar-candida/   Also:   www.chromagar.com/en/product/chromagar-candida-plus/ (for detecting c. auris)
chromID™ Candida  www.biomerieux-diagnostics.com/chromid-fungal-infections  
micro flex™ LT instrument  www.bruker.com/en/products-and-solutions/microbiology-and-diagnostics/microbial-identification.html  
Vitek ® MS™ (bioMérieux ®)  

api ® Candida (bioMérieux ®)  

api ® 20C AUX (bioMérieux ®)  

Vitek ® 2 YST (bioMérieux ® )  

ID 32 C (bioMérieux ® )    
www.biomerieux.co.uk/product/vitekr-ms  


www.biomerieux.co.uk/product/apir-id-strip-range    


https://biomerieuxdirect.com/industry/Bacteriology/ID-AST-Manual/ID-AST-API/ID-Manual/Api-galleries-Yeasts/API%26reg-20-C-AUX-%2825-STRIPS%2B25MEDIA%29/p/20210  

www.biomerieux-diagnostics.com/vitekr-2-2-yst-id-card  

https://biomerieuxdirect.com/industry/Bacteriology/ID-AST-Auto/ID-AST-Semi-automated-%3A-ATB-system/ATB-Galleries-ID/ATB-Identification-Yeasts/API%26reg-ID-32-C-%2825STRIPS%2B25MEDIA%29/p/32200  
Auxacolor™ (Bio-Rad)  www.bio-rad.com/en-uk/sku/56513-auxacolor-2-kit?ID=56513  
Candifast ® (ELITech Group)  www.elitechgroup.com/product/candifast  
Fungifast ® (ELITech Group)  www.elitechgroup.com/product/fungifast   Also:   www.elitechgroup.com/product/fungifast-afg  
RapID™ Yeast Plus  www.thermofisher.com/order/catalog/product/R8311007  
Biolog YT Microplate™www.fishersci.com/shop/products/yt-micro-plates-10-pkyt-micro/NC9976855  
MicroScan ® Rapid YS (Siemens)www.beckmancoulter.com/en/products/microbiology/specialty-id-panels?id=B1017-70
Sherlock ® MIS (MIDI, Inc.)http://midi-inc.com/pages/microbial_id.html  
ELIChrom Glabratawww.elitechgroup.com/product/elichrom-glabrata    

Why carry out identification?

  • Knowing which fungus is involved guides appropriate antifungal choice, dose and duration of therapy. It may also indicate the source of infection.
  • Additional or dual infections can often be identified (i.e. 3-5% of Candida bloodstream infections).
  • Severity of infection may be revealed from the extent of involvement on skin or scans, the number or load of organisms visible on microscopy or histology, or the strength of signal on antigen or PCR tests. These factors may assist in determining whether additional therapy should be added and in following response to therapy.
  • Assessing whether antifungal resistance is present, and whether an alternative antifungal agent is required.

Different tests

The tests that should be done on different samples, depends on the disease being considered. 

guide on to how to process different samples can be viewed here.

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