Fungus Testing Laboratory

To: / FTL Clients
From: / Michael G. Rinaldi, PhD /
Date: / 8/1/2012
Re: / Price Changes

Effective September 1, 2012, the Fungus Testing Laboratory will be making some significant changes regarding the methods used for the identification of fungal isolates. Historically, the mainstay of fungal identification has included a combination of analyses which included examination of growth rates, the colonial or macroscopic characteristics, key microscopic features, and in some genera, particularly the yeasts, a number of physiologic tests such as assimilations and/or fermentations. With the anamorphic (mitosporic) fungi, the emphasis has been on methods of conidial production and features of the conidia. For those genera exhibiting their sexual (teleomorphic) phases in culture, determining the types of structures and the features of the spores (ascospores, zygospores,etc) has been key.

After twenty years of evaluation, molecular sequencing combined with phenotypic/physiologic characterization has become the “gold standard” and will be the method by which new fungi will be described. Molecular sequencing has also discovered many cryptic species within complexes of fungi, for example, the different species contained within the Pseudallescheria boydii complex, which were not appreciated when examined solely by phenotypic methods. Additionally, the separation of these cryptic species has highlighted differences in their antifungal susceptibility patterns, and hence, an important consideration in the optimal patient therapy.

As an academic reference laboratory, the Fungus Testing Laboratory has been and continues to be involved in many of the taxonomic changes resulting from the molecular study of several genera, and as such, considers the addition of molecular sequencing to be a necessary adjunct to phenotypic characterization. Therefore both methods will be employed, effective September 1, 2012, to provide a more rigorous/definitive identification, and, in many instances, to the species level. Correlation of the macroscopic, microscopic, and/or physiologic features with the molecular identification results are also mandated in the Clinical and Laboratory Standards Institute document MM18-A, Interpretive Criteria for Identification of Bacteria and Fungi by DNA Target Sequencing; Approved Guideline, page 54,where they state “Sequence-based identifications should always be correlated with isolates’ phenotypic characteristics.” Molecular characterization will be via DNA sequencing of two loci, commonly the ITS and D1/D2 regions. For some other genera, however, more informative and/or genus-specific loci may be used depending upon an initial microscopic assessment of the isolate. These may include but are not limited to ITS plus beta-tubulin for Aspergillus spp., elongation factor 1 alpha for Fusarium spp, etc. Updates regarding changes in our methodologies will be posted on our website at

We realize the addition of molecular sequencing will increase client fees, but have made every effort to provide this enhanced, state-of-the-art identification at the lowest possible cost. We also believe that the combined methods will provide a more uniform turnaround time, particularly for unusual and/or atypical isolates.

We will also continue to maintain the research arm of our molecular testing to include sequencing additional loci for clinical strains, as warranted, and for epidemiologic studies to determine potential relatedness of isolates. Various other types of molecular studies are available upon request with pricing on an individual basis.

ISOLATES MUST BE SUBMITTED IN PURE CULTURE

ANTICIPATED TURNAROUND TIMES FOR MOST ISOLATES: 10 business days

YEAST IDENTIFICATION/$240.00: Phenotypic identification (CPT 87106) plus molecular sequencing (CPT 87153)

MOULD IDENTIFICATION/$240.00: Phenotypic identification (CPT 87107) plus molecular sequencing (CPT 87153)

Other pricing changes (Last price change 2006)

DNA PROBES/$155: CPT 87797 Anticipated Turn Around: 7-10 business days

ANTIFUNGAL DRUG LEVELS/$120: CPT 82491/HPLC/LCMS Anticipated Turn Around: 2 business days