Cryptococcus DNA detection by PCR

General Information

Lab Name

Cryptococcus DNA detection by PCR

Lab Code

CRYDNA

Epic Name

Cryptococcus DNA detection by PCR

Description

Detection and differentiation of Cryptococcus neoformans and Cryptococcus gattii DNA.

Cryptococcus is a genus of fungus of which Cryptococcus neoformans is the most medically important species that primarily affects immunocompromised individuals. More recently genetic evidence for two distinct species, Cryptococcus neoformans and Cryptococcus gattii has been reported among strains of C. neoformans. C. gattii can infect even non-immunocompromised individuals and has been recognized as an emerging pathogen in US Northwest and adjoining Canadian state of British Columbia. It is therefore critical to correctly identify the exact type of C. neoformans to completely understand a given case of cryptococcal infection. Histology (mucicarmine stain), serology and culture are routinely used for a diagnosis. However, culture is not always successful or not possible in many cases where histology suggests the presence of Cryptococcus. PCR can be particularly useful in such cases to confirm or rule out a Cryptococcus neoformans infection and also determine the exact species i.e. C. neoformans or C. gattii.

Cryptococcus PCR detects Cryptococcus neoformans and Cryptococcus gattii with higher specificity and sensitivity than the broad-range fungal PCR. The analytical sensitivity is 1 genome per PCR reaction.

References

Synonyms

Cryptococcus detection, Cryptococcus gattii identification, Cryptococcus gattii PCR, Cryptococcus gattii sequencing, Cryptococcus identification, Cryptococcus neoformans identification, Cryptococcus neoformans PCR, Cryptococcus neoformans sequencing, Cryptococcus sequencing, Filobasidiella bacillispora, Fungal sequencing, molecular Cryptococcus, Synonyms: Cryptococcus PCR, universal PCR

Components

Code Name
CRYRS Cryptococcus PCR: Detection, nested IGS
CRYID Cryptococcus PCR: Identification, nested IGS
CRYSI Cryptococcus PCR: Specimen Description
CRYSPI Cryptococcus PCR: External Identifier
CRYSR Cryptococcus PCR: Special Requests
CRYSC Cryptococcus PCR: Specimen Comments
CRYNAE Cryptococcus PCR: Specimen DNA Extraction
CRYREV Cryptococcus PCR: Pathologist Review
CRYME Cryptococcus PCR: Method Note

Interpretation

Method

DNA extraction, nucleic acid purification, polymerase chain reaction (PCR), sequencing

Reference Range

See individual components

Guidelines

Ordering & Collection

Specimen Type

Tissue (Fresh frozen or paraffin-embedded), Fluid (see Acceptable Specimens for details)

Collection

Acceptable specimens are listed below. Please see Molecular Microbiology Specimen Submission for complete specimen collection and handling instructions.

Shipping/Handling

  • Fresh frozen tissue/fluid specimens should be collected into a DNA free container labeled with at least two identifiers and be submitted and maintained on dry ice.
  • Formalin Fixed Paraffin-embedded tissues (FFPE, PET) can be sent ambient or with ice packs during warmer summer months to prevent melting.

Acceptable Specimens

*Mycobacterium avium complex DNA Detection [MAVDNA] can be ordered on sputum

**Fungal PCR reflex NGS [FUNDNA] and Fungal DNA Detection by PCR (without reflex to NGS) [NRFDNA] may have interference due to some lots of eSwabs which have been found to contain Saccharomyces cerevisiae DNA, resulting in false positive detection. Clinical correlation and/or retesting with a different collection method is advised. The detection of S. cerevisiae from eSwab specimens can interfere with our ability to rule out other fungal DNA.

    Unacceptable Specimens

    • Blood, serum, plasma, stool/rectal swabs
    • No citrated or heparinized solutions
    • Tissues floating in formalin
    • Swab/fluid collected in tube containing agar

    Optimal Quantity:

    • Fresh Tissue: 0.3-1.0 cm^3
    • Fluid: 0.2-1 mL
    • Formalin Fixed Paraffin-embedded Tissue (FFPE/PET): blocks are preferred and will be sent back to client upon completion of testing
    • Scrolls/unstained slides: cross-sectional area >1cm^2 send 10 sections of 10µm thickness, if <1cm^2 send 20 sections if available

    Please note: We do not need a separate specimen aliquot for each test ordered. Only a single specimen aliquot or block of optimal quantity is necessary for performing multiple tests. If multiple aliquots or blocks of optimal quantity are sent, up to 2 will be pooled.

Forms & Requisitions

Molecular Microbiology Order Form

Handling Instructions

Please see Molecular Microbiology Specimen Submission for complete specimen collection and handling instructions.

Quantity

requested: See "Collection" for Optimal Quantity
minimum: Specimens below optimal quantity are acceptable for testing, however, diagnostic yield is generally proportional to specimen size.

Processing

UWMC/HMC: Store and send fresh tissue/fluid specimens refrigerated, if specimen storage and transport will exceed 8 hours, freeze at -20°C. Freeze all fresh tissue/fluid specimens at -20°C upon arrival in UW Molecular Microbiology.

Performance

LIS Dept Code

Micro Molecular Diag (MMD)

Performing Location(s)

UW-MT Microbiology, Molecular Diagnostics
206-520-4600

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Shipping Address

Attn: Molecular Microbiology
UW CLSPS
1601 Lind Ave SW Room 117
Renton, WA 98057
Phone: 206-520-4600
Alternate phone: 206-598-6147

Performing Lab Address

Clinical Microbiology Lab, NW177
University of Washington Medical Center
1959 NE Pacific Street
Seattle, WA 98195
Phone: 206-598-5735
Alternate phone: 206-598-6147

Contact Information

Please e-mail us with any questions or comments you may have. Your inquiry will be answered as soon as possible.

email: molmicdx@uw.edu

The Molecular Microbiology lab is open from Monday-Friday, 7am-4pm PDT.

Billing inquiries and requests for faxed reports can be made to our Client Services Department at (206) 520-4600 or (800) 713-5198.

For results or other inquiries, we can be reached by phone at the following numbers:

  • Phone: (206) 598-5735
  • Alternate phone: (206) 598-6147
  • FAX: (206) 520-4903

For assistance during weekends, holidays and after hours, please contact Lab Medicine Resident at (206) 598-6190

Frequency

Fresh frozen tissues/fluids result in 2-3 business days after receipt of specimen. Formalin Fixed Paraffin-embedded tissues result in 3-4 business days after receipt of specimen.

Available STAT?

No

Billing & Coding

CPT codes

87801

LOINC

81649-6

Interfaced Order Code

UOW4434