Uncommon fungi can cause opportunistic infections and are often unidentifiable using phenotypic methods. Molecular techniques, like DNA sequencing, may permit species-level identification but results may be challenging to interpret. To determine the clinical impact of molecular identification in this setting, we performed a retrospective review of fungal isolates referred for molecular identification. Seventy-five distinct fungal species were identified from 93 referred isolates, 31 (41%) of which are not known to be human pathogens. DNA sequencing prompted change in anti-infective therapy in only 3 (3.5%) cases but significantly delayed culture turnaround time (40 ± 31 vs. 30 ± 13 days, P < 0.001). Patient immune status and concurrent histologic or serologic testing significantly correlated with the proportion of pathogenic isolates recovered and patients treated (χ2, P < 0.05). Molecular identification of uncommon fungal isolates should be limited to specialized clinical settings such as patients with immunosuppression and/or concurrent positive histology or fungal serology.
|Journal||Diagnostic Microbiology and Infectious Disease|
|State||Published - Mar 2020|
- DNA sequencing
- Nonsporulating mold