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Title: A dedicated fungal culture medium is useful in the diagnosis of fungemia: A retrospective cross-sectional study
Authors: Zheng S.
Ng T.Y. 
Li H. 
Tan A.L.
Tan T.T. 
Tan B.H.
Keywords: antifungal agent
culture medium
blood culture
Candida albicans
Candida dubliniensis
Candida glabrata
Candida parapsilosis
Candida tropicalis
controlled study
cross-sectional study
Cryptococcus neoformans
culture medium
fungal detection
fungus culture
fungus growth
retrospective study
Saccharomyces cerevisiae
Trichosporon asahii
culture medium
hospital laboratory
isolation and purification
laboratory technique
odds ratio
Clinical Laboratory Techniques
Cross-Sectional Studies
Culture Media
Laboratories, Hospital
Odds Ratio
Retrospective Studies
Issue Date: 2016
Citation: Zheng S., Ng T.Y., Li H., Tan A.L., Tan T.T., Tan B.H. (2016). A dedicated fungal culture medium is useful in the diagnosis of fungemia: A retrospective cross-sectional study. PLoS ONE 11 (10) : e0164668. ScholarBank@NUS Repository.
Abstract: Background: Mortality for candidemia ranges from 15% to 35%. Current guidelines recommend inoculating blood into three aerobic and three anaerobic blood culture bottles when candidemia is suspected, without mention of a fungal blood culture bottle. Objective: To determine the value of the BACTEC Myco/F Lytic blood culture media in the diagnosis of fungemia. Methods: A two-year retrospective cross-sectional study was performed for patients who had fungemia with submitted BACTEC Plus Aerobic/F (Aer), BACTEC Plus Anaerobic/F (Anaer) or Myco/F Lytic (Myco) blood culture bottles. Results: The detection rate of fungemia was 77.4% in 93 patients with contemporaneously submitted blood culture bottles when limited to only Aer/Anaer culture results. The detection rate improved significantly with the addition of the Myco culture bottle results (p<0.0001). A logistic regression model showed that Myco culture bottle submissions were less useful for patients with appropriate anti-fungal therapy administered within 48 hours [OR = 0.18, 95% CI = (0.06, 0.49), p = 0.001] and those with fungal growth detected within 48 hours [OR = 0.33, 95% CI = (0.12, 0.89), p = 0.001]. Among a subset of patients with concordant blood culture results, those with Myco culture bottles submission allowed earlier fungal detection and speciation by at least one day in 27.5% and 25.0% of the cases respectively. Conclusion: Our study highlights the importance of a dedicated fungal blood culture when fungemia is clinically suspected. Nearly a quarter of fungemias may be missed if a fungal blood culture is not performed. © 2016 Zheng et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
Source Title: PLoS ONE
ISSN: 19326203
DOI: 10.1371/journal.pone.0164668
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