Laboratory: Clinical Microbiology
Test Name:
YEAST, CULTURE, VAGINAL SWAB/VULVA SWAB/THROAT SWAB/MOUTH SWAB/CONJUNCTIVAL SWAB/ESOPHAGEAL BRUSHINGS
Test Code: YEAS
Clinical Information:
Test Inidcations:
Aid in the diagnosis of candidiasis (e.g., thrush) or to rule out Candida infections.
Candidiasis is caused by yeasts belonging to the genus Candida with Candida albicans being the most common. Other species frequently recovered from patients include Candida parapsilosis, Candida glabrata, Candida tropicalis, and Candida krusei. Candida auris is an emerging Candida species that presents a global health threat since it is frequently multi-drug resistant and can cause severe disease in hospitalized patients. Candida species are colonizers of mucous membranes and skin.  As such, they rarely cause disease unless overgrowth occurs (mainly in the context of immunosuppression, catheters, prolonged use of antibiotics, surgery, trauma, or neonates). Positive culture does not always mean that Candida is causing the symptoms and clinical evaluation is important.
Thrush (oropharyngal candidiasis) is common in patients with HIV or other immunocompromising condition (e.g., leukemia, diabetes) as well as newborns and toddlers while vaginal candidiasis is common during pregnancy.
Female patients experiencing vaginal candidiasis may have pruritis and vaginal discharge that may be foul smelling.  In these patients, collect specimen from the vaginal cavity with a sterile swab.  (Do NOT use a cotton tip or wooden shaft swabs for collection as these are unacceptable).  Use a sterile, rayon tipped swab with a plastic shaft.  Place swab back in companion transport media.

Recommendations:
Vaginal swab for yeast vaginitis:
1. Vaginal swabs are assessed by Gram smear for bacterial vaginosis and yeast (if patient ≥12 years). If culture is required please specify reason for culture on ordering requisition (treatment failure or recurrent vaginitis).
2. Gram stain is the recommended test for bacterial vaginosis (rejected for patients ≥60 years); culture is inaccurate and misleading and is not routinely performed.
3. A separate swab (ideally not in transport medium) is required, if Trichomonas antigen testing is requested.
Samples and requisitions must be labeled/completed in accordance with the Shared Health Specimen Acceptance Policy.
Accurate patient identification must be made prior to sample collection. Patient identification should be done in accordance with the site policy.

Patient Preparation Instructions:
Vaginal swab:
1. Wipe away old secretion or discharge.
2. Obtain secretions from the mucosal membrane or the vaginal vault with a sterile swab.
Collection Devices:
Preferred Device:
Specimen Required: Throat, mouth, palate, esophageal, vaginal, eye, skin, or other swab for Candida culture (Adult and Pediatric)
Adult vaginal specimens are not suitable for Neisseria gonorrhoeae evaluation unless the patient has had a hysterectomy. 
- N. gonorrhoeae will only be reported from pediatric specimen if isolated.
- Please denote if culture is required due to repeat candidiasis.
Referral:

Ensure samples that are being sent to a referral laboratory are packaged in accordance with Transport of Dangerous Goods recommendations for diagnostic samples.
Requisition:
Reference Values:
No yeast-like organism isolated.
A final negative report will be sent after 7 days.
Availability:
Daily
See Also:
More Information:
Specimen Handling:
Local: ≤2 hrs, store at room temperature
Courier/local storage: ≤24 hrs, store at 4°C