Candida species
Clinical Specimen Submission Guidance
Submit all specimens to 50 Orms St, Providence RI 02904. Open Monday to Friday 8:30 AM to 4:30 PM
Special Pathogens & Biothreats Laboratory 401-222-5586
Candida auris, Candida species (other than Candida albicans)
Candidiasis / Candidemia
Collect and confirm Candida species isolates (other than C. albicans).
The Matrix-Assisted Laser Desorption/Ionization Time -of -Flight Mass Spectrometry (MALDI-TOF MS) Biotyper CA (Bruker Daltonics Inc.) and its reference library of species are cleared by the U.S. Food and Drug Administration (FDA) for the identification of microorganisms. The performance characteristics of the MALDI-TOF system were verified by the Rhode Island State Health Laboratories. Additional species not contained in the FDA-approved reference library were extensively validated prior to reporting.
Per request of the CDC, isolates are being collected for potential shipment to the Regional Reference Laboratory for further characterization.
Isolates to submit to RISHL:
All confirmed or suspected Candida auris isolates from any specimen source
Antifungal resistant candida species, other than C. albicans, from any specimen source, especially invasive sites
Yeast isolates from any specimen source after attempt to identify was unsuccessful
Additional Information:
Candida species and CRE/CRPA testing letter sent to RI Sentinel Microbiology Laboratories https://health.ri.gov/publications/specimenguidances/Candida-2022-Letter-To-Sentinel-Labs.pdf
Update to the Standardized Case Definition and Notification for Candida auris https://health.ri.gov/publications/specimenguidances/Candida-CSTE-22-ID-05_C_auris.pdf
Preferred: an 18-24 hour pure isolate on a Sabouraud Dextrose agar plate or a blood agar plate sealed with parafilm or other appropriate barrier film.
If transport is delayed, minimize excessive subculturing and keep plate refrigerated at 2-8°C to preserve resistance mechanism.
CLIA regulations require specimens be labeled with at least two patient identifiers. Examples of identifiers are first and last name, date of birth, chart/medical record number. The specimen container must be labeled to match the test requisition or the electronic order.
Rhode Island State Health Laboratories (RISHL) test requisition form https://health.ri.gov/forms/LabRequisitionForm.pdf
Copies of all susceptibility and mechanistic testing reports.
Bacterial Isolate (ID/Confirmation)
Write Resistant Candida ID (including C. auris) under Comments/Other Test Requests.
Indicate whether the isolate is derived from a clinical or screening/surveillance culture.
Specimens must be packaged & transported in accordance with current federal shipping regulations.
Transport swabs for surveillance testing within 24 hours of collection at 2-8°C in a cooler able to maintain specimen temperature. A plug-in electric cooler is recommended, however, a cooler packed with excess frozen gel packs is acceptable as long as the transport temperature is maintained at 2-8°C.
Transport isolates at ambient temperature 15-30°C.
The following rejection criteria will be used to ensure accurate specimen information and specimen condition for testing:
- Specimen received outside acceptable transport range
- Demographics different of specimen
- Two identifiers required on specimen / Unable to read identifiers on specimen
- Expired/ incorrect collection kit
- Insufficient quantity
- Urine cup received
- No specimen received
- Specimen leaked in transit
- Test not evaluated in adolescents < 14
- No swab received
- Specimen too old
Providers must report patient information on Candida auris immediately using the RIDOH reportable disease form.
2 business days
Containers specifically labeled for transport of specimens and isolates to the RISHL Special Pathogens and Biotreats Laboratory are available in all Microbiology Laboratories and Laboratory Send-out Departments.