Mycology Reference Laboratory: Introduction, Requirements, Mycological Tests, Importance and Keynotes

Introduction of Mycology Reference Laboratory

A Mycology Reference Laboratory is a specialized laboratory that focuses on the identification, characterization, and study of fungi. Fungi are a diverse group of organisms that can cause a variety of infections in humans, animals, and plants, as well as contribute to the decay of organic matter.

The Mycology Reference Laboratory is responsible for providing accurate and reliable diagnostic services for patients suspected of having fungal infections. These services may include direct microscopic examination of clinical specimens, fungal culture and identification, susceptibility testing, and molecular techniques such as PCR (polymerase chain reaction) and DNA sequencing.

The laboratory also serves as a resource for healthcare providers, providing guidance on appropriate antifungal therapy and recommendations for the management of patients with fungal infections. Additionally, the laboratory may conduct research on various aspects of fungal biology and pathogenesis, contributing to the development of new diagnostic tools and treatments.

Overall, the Mycology Reference Laboratory plays an important role in the diagnosis and treatment of fungal infections, as well as advancing our understanding of these fascinating and diverse organisms.

Requirements for Mycology Reference Laboratory

To operate a Mycology Reference Laboratory, there are several requirements that must be met. These may include:

  1. Trained Personnel: The laboratory must have trained personnel with expertise in the identification and characterization of fungi. This may include clinical microbiologists, medical mycologists, and laboratory technologists who are familiar with the specific techniques used in mycology.
  2. Equipment and Supplies: The laboratory must be equipped with appropriate instruments and supplies for the isolation and identification of fungi. This may include incubators, laminar flow hoods, microscopy equipment, culture media, and reagents for molecular techniques.
  3. Quality Control: The laboratory must have a quality control program in place to ensure the accuracy and reliability of the test results. This may include participation in external quality assurance programs and regular monitoring of test performance.
  4. Accreditation and Certification: The laboratory may need to be accredited or certified by regulatory agencies or accrediting organizations, such as the Clinical Laboratory Improvement Amendments (CLIA) or the College of American Pathologists (CAP).
  5. Safety and Biosecurity: The laboratory must have appropriate safety and biosecurity measures in place to protect personnel and prevent the spread of infectious agents. This may include the use of personal protective equipment, adherence to standard precautions, and compliance with regulatory requirements for the handling and disposal of biological materials.
  6. Data Management: The laboratory must have a system for managing test results, including the proper storage and retrieval of records, and the maintenance of patient confidentiality.

Overall, the requirements for a Mycology Reference Laboratory are designed to ensure the quality and safety of laboratory testing and to provide accurate and reliable diagnostic services for patients suspected of having fungal infections.


  • Ordinary microscope
  • Dissecting microscope
  • Phase-contrast microscope
  • Microscope with phase attachment
  • Fluorescence microscope (for examination under calcofluor stain)
  • Electron microscope
  • Thermal cycler
  • RT-PCR
  • Bio-safety hood
  • BOD incubator
  • MALDI-TOF mass spectrometryStereoscope
  • Counter-immunoelectrophoresis (CIEP)
  • Sanger’s sequencer
  • Next-generation sequencer
  • Phadebas

Fungal Tests

Diagnostic facilities

  • Direct microscopy for yeast/mycelial fungi
  • Culture for isolation of fungi
  • Histopathology support
  • Identification of fungi
  • Antifungal susceptibility testing
  • Serological tests
  • Molecular diagnosis
  • Antifungal drug test
  • Therapeutic drug monitoring

Fungal Identification Facilities/Services Available

  • Non-commercial phenotypic and morphological technique
  • Commercial phenotypic
  • Molecular– DNA sequencing


  1. Antifungal susceptibility testing (AFST) can be performed by micro broth, Disk diffusion and
    commercial tests.
  2. Interpretation of antifungal susceptibility testing is done by either CLSI or
  3. Antifungal susceptibility testing should be available in the reference lab for both
    yeast and mycelial fungi.
  4. IgE estimation can be tested for Aspergillus-specific IgE estimation and total IgE estimation.
  5. Cryptococcus (antigen) tests can be assayed by latex agglutination test (LA), ELISA, and Lateral flow assay.
  6. Histoplasma and Candida antigen testing should be facilitated in the reference center. Candida antigen testing is performed by Mannan antigen (without anti-mannan antibody), Mannan antigen plus anti-mannan antibody, and Anti-mannan antibodies(1→3)-β-d-glucan (BDG).
  7. Advanced diagnostic tests like galactomannan (antigen),beta-glucan (antigen) testing, and PCR for fungal diagnosis are also beneficial in a reference laboratory.
  8. Therapeutic drug monitoring is assayed by High-performance liquid chromatography (HPLC) and liquid chromatography-mass spectrometry (LC-MS).
  9. Clinical correlation of mycological findings is useful with radiological findings like ordinary X-rays, CT scans, MRIs, and PET scans.
  10. Reference laboratories should have responsibility for national surveillance like fungal infection rate, antifungal resistance surveillance, and for outbreak investigation.

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