Mycology testing information

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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.

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. Further information on the measurement of uncertainty for our laboratory 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


  • Richardson MD and Warnock DW. Fungal Infection: Diagnosis and Management. 4th Ed. Oxford, Wiley-Blackwell, 2012.
  • Ashbee HR, Barnes RA, Johnson EM, Richardson MD, Gorton R, Hope WW. Therapeutic drug monitoring (TDM) of antifungal agents: guidelines from the British Society for Medical Mycology. J Antimicrob Chemother 2014; 69: 1162–1176.

Identification and susceptibility testing of medically important fungi

Respiratory, vaginal and oral swabs will be cultured within our laboratory. Identification and/or susceptibility testing will be performed as appropriate. Other original specimens will be processed by the Microbiology Department, MFT Manchester Royal Infirmary. If fungus is isolated, the Microbiology Department will then send the culture on to the Mycology Reference Centre for identification and/or susceptibility testing. Please ensure that the request form states that mycological investigations (identification and susceptibility testing) are required.

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 February 2020)