Mucorales DNA detection by PCR

General Information

Lab Name

Mucorales DNA detection by PCR

Lab Code

MUCDNA

Epic Name

Mucorales DNA detection by PCR

Description

Detection and identification of fungal DNA in the Order Mucorales

Mucormycosis is caused by molds from the Order Mucorales. These fungi are ubiquitous in nature and are increasingly becoming recognized as opportunistic pathogens in immunocompromised or immunosuppressed patients. Infections are most commonly caused by Rhizopus oryzae, Rhizopus microsporus, Mucor spp, Rhizomucor sp. and Abisidia corymbifera. Mucorales fungi pose difficult diagnostic and therapeutic challenges because (i) the spectrum of opportunistic mucormycoses is expanding (ii) their clinical manifestations can be fatal without rapid diagnosis and treatment and (iii) strains that fail to sporulate under normal laboratory conditions may be encountered, thereby making morphological identification difficult.

The Molecular Microbiology laboratory designed a specific primer mix that can amplify most commonly encountered Zygomycetes i.e. Rhizopus oryzae, Rhizopus microsporus, Mucor spp. Rhizomucor sp. and Lichtheimia corymbifera. These specific primers are used in a nested PCR following amplification of the ITS2 region.

References

Ribes et al. (2000) Zygomycetes in Human Disease in Clinical Microbiology Reviews, pp236-301

Synonyms

Fungal sequencing, molecular Mucorales, Mucorales detection, Mucorales identification, Mucorales PCR, Mucorales sequencing, Mucormycosis PCR, universal PCR, Zygomycete detection, Zygomycete identification, Zygomycete PCR, Zygomycete sequencing, Zygomycosis PCR

Components

Code Name
MUCRS Mucorales PCR: Detection, nested ITS
MUCID Mucorales PCR: Identification, nested ITS
MUCSI Mucorales PCR: Specimen Description
MUCSPI Mucorales PCR: External Identifier
MUCSR Mucorales PCR: Special Requests
MUCSC Mucorales PCR: Specimen Comments
MUCNAE Mucorales PCR: Specimen DNA Extraction
MUCREV Mucorales PCR: Pathologist Review
MUCME Mucorales PCR: Method Note

Interpretation

Method

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

Reference Range

See individual components

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 over scrolls/unstained slides 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.

    Fresh tissue is the optimal specimen of choice, as it reduces the chance of introducing exogenous DNA templates or microorganisms during embedding/fixation. Formalin fixation dramatically reduces the sensitivity of the assays due to reduced template yield and quality.

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    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

    42805-2

    Interfaced Order Code

    UOW4414