In this section
For details of individual test requirements and information see the handbook.
Additional Tests
Additional tests can be requested by contacting the laboratory, although it must be recognised that the archive sample available will have a limited volume. Furthermore, samples may be beyond the validation period for particular tests. Verbal requests for additional tests must be followed up in writing. The written request must include 3 patient identifiers, and the name of the requesting clinician.
Measurement Uncertainty
All assays have a margin of error associated with the calculation of the numerical value. This is referred to as the measurement uncertainty and is usually expressed as a percentage of the reported figure. This calculation allows the user to understand the uncertainty of any numerical results and can be assured with 95% confidence that the true result lies plus or minus the measurement uncertainty around the reported value. Further information on the measurement of uncertainty for our assays is available by contacting the laboratory.
Antifungal Drug Levels
Please ensure that details of all antifungal drugs the patient is receiving are given – this information is essential to ensure appropriate testing is performed.
Please record the date and time the specimen is taken, together with the time of last dose. These details ensure correct interpretation of results.
Indications for monitoring
• All patients receiving flucytosine
• Patients receiving itraconazole – to check drug absorption and to monitor compliance
• Patients receiving posaconazole – to check drug absorption and to monitor compliance
• Patients receiving isavuconazole – to check drug absorption and to monitor compliance
• All patients receiving voriconazole – a pre-dose sample is required
• Fluconazole in patients on dialysis/haemofiltration
• Patients failing azole therapy
• If drug interactions are suspected
References
• Richardson MD and Warnock DW. Fungal Infection: Diagnosis and Management. 4th Ed. Oxford, Wiley-Blackwell, 2012.
Identification and susceptibility testing of medically important fungi
Genital, oral and wound swabs, along with respiratory and tissue specimens, will be cultured within our laboratory. Identification and/or susceptibility testing will be performed as appropriate.
Indications for testing
• All life-threatening fungal infections, to ensure that the optimal therapy is administered
• Isolates from patients at increased risk of fungal infection, such as those infected with HIV immunosuppressed or on ICU, so that appropriate antifungal therapy can be given
• Mucosal candidosis not responding to therapy
• Clinically significant non-Candida albicans species due to increasing incidences of both infection and fluconazole resistance
• Rare pathogens because of an increased incidence of resistance and unpredictability of resistance patterns.
(Last reviewed June 2021)