Clinical impact of molecular identification of rare yeasts and nonsporulating molds recovered in culture from clinical specimens

Research output: Contribution to journalArticle

Abstract

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.

Original languageEnglish
Article number114945
JournalDiagnostic Microbiology and Infectious Disease
Volume96
Issue number3
DOIs
StatePublished - Mar 2020

Keywords

  • DNA sequencing
  • Fungi
  • Nonsporulating mold

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