The Status and Tendency of Recent Five-year Fungal Cultures as a Diagnostic Measure in a Tertiary Hospital in the Southwestern Daegu Area

Kwon, Hyunjung; Kim, Hyungrok; Kim, Youngil; Park, Kyung Duck; Chung, Hyun; Park, Joonsoo

Abstract

BACKGROUND
Fungal culture is a conventional method for diagnosing fungal infections and is important for determining etiologic agents of the fungal infections.
OBJECTIVE
To study the prevalence and validity of fungus culture in various clinical departments.
METHODS
A retrospective study of 4373 fungal culture cases at Daegu Catholic University Medical Center from January 2010 to December 2014 was made to investigate the prevalence of fungus culture depending on age, clinical departments, specimens and to evaluate the positive rate along with the distribution factor.
RESULTS
The number of fungal culture increased with age. Fungal culture was more commonly performed in departments such as pulmonology (26.7%), ophthalmology (11.7%), dermatology (8.6%), emergency medicine (7.4%), neurology (7.3%). Among the cultured specimens, 43.6% were respiratory specimens, followed by CSF (17.2%), ophthalmic specimens (13.2%), skin (8.7%), and abscess (4.0%). Of the 4,373 specimens cultured, 222 (5.1%) were positive. The most commonly identified fungus was Trichophyton. Fungal culture was routinely performed with bronchoscopy and lumbar puncture. Prophylactic fungal evaluation was carried out for patients who had liver transplantation.
CONCLUSION
Our study showed that fungal culture has been excessively conducted, even to a level where some departments take the test on their regular routine basis. The unfettered use of this low-yield diagnostic tool can give a false sense accomplishment and is often cost-ineffective and difficult in altering subsequent diagnostic or therapeutic plans. Clinicians should appropriately assess medical indications of fungal culture counting in the risk of infection, mortality, and cost as well.