To remain up to date with the scientific literature, microbiology must periodically update the official taxonomic nomenclature for organisms as published in the International Journal of Systematic and Evolutionary Microbiology (IJSEM). These updates also satisfy the laboratory’s accreditation checklist item MIC.11375 from the College of American Pathologists (CAP). Current organism classification is typically revised based on genetic relatedness among genera and species, as opposed to historical phenotypic biochemical characteristic studies.
Influenza is currently widespread throughout the nation at epidemic proportions. During influenza epidemics, clinical assessment predicts the presence of influenza infection virtually as well as laboratory testing. Therefore, it is no longer necessary to perform viral testing on ambulatory patients who present with illness consistent with influenza before beginning antiviral treatment. Antiviral treatment for Influenza should be started as soon as possible to have a beneficial effect.
Shortages of supplies and medications frequently occur during Influenza epidemics. However, diagnosis of specific viral respiratory infection remains important for hospitalized patients.
Please follow the current recommendations:
- Limit availability of viral transport media at ambulatory sites.
- Emergency departments are to limit viral respiratory testing to patients expected to be admitted.
- Do not perform testing for test of cure.
Thank you for your support during this time. Please direct any questions to Laboratory Services via the “contact us” link above.
There has been a minor change to the influenza testing methods performed by the Spectrum Health Regional Laboratory (SHRL) to improve the accuracy and timeliness of patient results, while simplifying the ordering process for providers. In past years during respiratory illness season, the lab performed influenza rapid antigen testing due to its low cost and rapid turnaround time, with negative specimens reflexed to PCR for confirmatory testing. Approximately 85% of specimens tested by a rapid antigen method typically reflexed, with those patients charged for performing both tests.
As of July 11, 2017, Spectrum Health Regional Laboratory will offer Streptococcus pneumoniae urine antigen testing. This testing is currently sent to Mayo Medical Laboratories. By bringing testing in-house, result turnaround time will be improved by 1 day, testing will be available 7 days per week (instead of Monday – Friday), and testing can be offered at a reduced charge to our patients.
On June 27th, the name of the current order “Respiratory (non-sputum) Culture without Gram stain” will change to “Throat Culture Comprehensive.” All other specimen collection details and culture workup will remain the same. Given the fact that there are currently several similarly named tests, this change is being made to reduce confusion regarding test selection and to clarify acceptable specimen types.
As of May 2, 2017, Spectrum Health’s Infection Control & Prevention department has declared the system to be officially within “Non-Influenza Season” based on a return to baseline prevalence at both the local and state levels.
Spectrum Health Regional Laboratory is preparing to switch Clostridium difficile testing methods from solely using a molecular approach to a 2-step algorithm utilizing an Enzyme Immunoassay (EIA) that detects two C. difficile-specific proteins (glutamate dehydrogenase or GDH, and A/B toxin) with indeterminant EIA specimens reflexed to PCR (see flowchart below). It is estimated that approximately 90% of patients tested will be resolved by EIA and not require reflexive PCR testing. This algorithm decreases expenses to the patient by an average of 65% as compared to current testing without sacrificing result quality. Specimens will be batched for EIA testing at a frequency to ensure that results are available within 6 hours of receipt by the laboratory so that proper contact isolation precautions may be initiated when indicated.