As we enter the winter months, there are often questions about the various respiratory pathogen tests available, including a multiplex molecular panel and influenza testing.
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Microbiology
General Information, Microbiology
Supply Notification – LAB490 Infectious Disease Requisition Update
Spectrum Health Laboratory provides paper requisitions to our clients that cannot send an order electronically.
The Infectious Disease requisition (formerly Microbiology) has been updated. A copy is located in the online laboratory catalog. The new requisition will be available to order on Monday, November 12, 2016.
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.
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.
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.
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).
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.
Education & Training, Microbiology, Test Spotlight
Only Liquid Stools Should be Sent for C-Diff Testing
Effective June 1, 2016, Malaria testing will be updated. Recommended first line testing for suspected malaria is called Malaria Rapid Screen which is a combination of a rapid BinaxNow test in Hematology and a blood smear review in Microbiology. The BinaxNow test has a reported sensitivity of 97.7% and specificity of 94.2% for detection of P. falciparum species if a patient has a parasitemia level of over 5000 parasites/uL; sensitivity is lower for other malaria species. The BinaxNow test is not reported to cross react with babesia species. BinaxNow testing will be available for all shifts in Hematology at the Spectrum Health Regional Laboratory. The specimen requirements are unchanged from previous malaria testing. Previous test “Malaria Smear for Protozoa” will be discontinued.