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Microbiology

Microbiology, Test Utilization

Clostridium difficile Two-Step Algorithm Testing

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. Continue Reading

Microbiology, Test Spotlight

OSOMⓇ Trichomonas Antigen test replaces Trichomonas Wet Prep

The Trichomonas Wet Prep test has been replaced with the OSOM® Trichomonas Antigen test.

This new lateral flow immunochromatographic test offers enhanced sensitivity through the detection of Trichomonas antigen as opposed to the traditional wet prep method, which relied on the labor intensive microscopic visualization of motile Trichomonas trophozoites. Because this new assay detects antigen as opposed to viable organism, specimen stability is also extended. When collected with a single eSwab™, specimens are stable for up to 24 hours at ambient temperature and 36 hours when refrigerated. Swabs collected for the wet prep method were only stable for 3-5 hours, so there is no longer a need for STAT delivery to the laboratory.

Education & Training, Microbiology, Test Utilization

Influenza Diagnosis and Test Utilization

In anticipation of “Flu season”, it is valuable to revisit available testing methods for influenza and discuss when each test should be ordered. Though generally a self-limited infection for otherwise healthy individuals, influenza can be particularly severe for high-risk populations including infants, elderly, pregnant women, and immunocompromised hosts. Influenza incidence is largely seasonal with the majority of cases occurring between December and April of each year. Continue Reading

Education & Training, Microbiology

Fecal Leukocyte Specimen Collection Update

The collection requirement for Fecal Leukocyte has been updated from Empty Vial (Plain Container) to SAF Preservative (usually yellow lid with clear liquid). Empty vial is still acceptable but SAF Preservative container is preferred.

SAF Preservative container is part of the stool specimen collection kit. Specimen should be sent at ambient temperature and is stable for 7 days, however, for quality of results please send to the laboratory as soon as possible.

Collection requirements are found in our laboratory catalog.

Patient instructions are also found in the catalog.

Microbiology, Test Utilization

Enteric Pathogens by PCR replacing Stool Culture Orderable

Effective August 18, 2016, the Spectrum Health Regional Laboratory Microbiology Department will begin offering the Verigene® Enteric Pathogens Test, a new rapid molecular test that simultaneously detects and identifies the following pathogenic enteric bacteria, viruses, and toxins that commonly cause acute community-acquired diarrhea. Testing occurs directly from stool in Cary-Blair preservative with a 1 day turnaround time (2-3 days faster than current methods). Continue Reading

Microbiology

New Orderable: Gram stain for BV and Yeast

The new orderable for the Gram stain for BV and yeast is available

The Gram stain for bacterial vaginosis (BV) and yeast is considered the gold standard for the diagnosis of various vaginal infections. The Gram stain utilizes the Nugent scoring method to evaluate the ratios of Lactobacillus, Gardnerella vaginalis, Mobiluncus, and Atopobium vaginae. Accurate diagnosis of BV relies upon both the increase in abundance of specific urogenital pathogens (such as Gardnerella) as well as the concordant decrease in the amount of otherwise protective “usual flora” (Lactobacillus). In addition to scoring the abundance of these organisms, the Gram stain may also be used to quantify yeast making suspected contributions to BV. Continue Reading