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Microbiology

Main lab, Microbiology, Referral/Sendouts

Measles Ordering and Collecting Specimens

With several suspected cases of measles within Michigan, we thought it would be an excellent time to highlight Corewell Health West’s guidance on testing suspected patients. Specimens are sent to a reference lab for testing, which must be coordinated with local public health departments. Typically an upper-respiratory swab (throat or nasopharyngeal)  is collected for PCR testing in addition to a serum for measles IgM if collection is possible.

  • Patients should not be directed to a Corewell Health Laboratory or other healthcare facility for serum collection if patient is within 4 days after the onset of rash (with onset of rash considered to be Day 0). If Day 5 of rash or later, immunocompetent patients are no longer considered contagious and may be sent to a laboratory for a serum draw.
  • Corewell Health Providers:
    • Please reach out to Corewell Health Infection Prevention (IP) via Perfect Serve to make them aware of the situation.
    • Corewell Health Infection Prevention will contact the appropriate county.
  • Non-Corewell Health Facilities:
    • The provider’s office must coordinate with the county health department that the patient lives in to obtain permission to send measles testing.
    • Visit the following link for county health department contact information: Slide 1 (michigan.gov)
      • The county will coordinate with MDHHS for testing permission.

The preferred testing specimen is a throat or nasopharyngeal swab collected in office. Corewell Health Laboratories do not collect swabs.​

For further collection and ordering instructions, please visit: Measles PCR – Laboratory Test Catalog | West

Any additional questions or concerns, please use the contact us link above or reach out to your local health department.

April 11, 2024 by
Microbiology

Test Update: Influenza Rapid and RSV Rapid Tests Discontinued

Effective October 3, 2023, Corewell Health Laboratories will discontinue the Influenza Rapid and Respiratory Syncytial Virus (RSV) Rapid tests. These antigen tests are less sensitive than the nucleic acid amplification tests (NAAT; such as PCR) that are now the standard of care for diagnosing these respiratory viruses. Specimen collection remains unchanged with PCR testing available for nasopharyngeal and nasal swabs collected in a universal transport media (UTM) tube.

Discontinued:

• Influenza (Flu) A/B Rapid – Epic Code: LAB9240
• Influenza (Flu) A/B Rapid, Influenza A/B PCR if Negative – Epic Code: LAB2111530
• Respiratory Syncytial Virus (RSV) Rapid – Epic Code: LAB495

Replace with:

• Influenza (Flu) A/B PCR – Epic Code: LAB3255
• COVID-19, Influenza A/B, RSV PCR – Epic Code: LAB1230746

September 20, 2023 by
Microbiology

Sinus Culture Order Considerations

The management of sinusitis is often aided by bacterial and fungal cultures from which Streptococcus pneumoniae, Haemophilus influenzae, Moraxella catarrhalis, Staphylococcus aureus, and occasionally aerobic Gram-negative bacilli are the most commonly recovered pathogenic organisms. The Corewell Health West Microbiology Lab has several orders available for culturing sinus specimens collected as fluid aspirates, tissue, or swabs. Though more challenging to collect, aspirates are preferred over swab cultures that often grow mixed normal upper respiratory flora for which it is difficult to interpret the clinical significance.

Available Sinus Culture Orders Default Specimen Type Comments
Body Fluid Culture [LAB2111016]

Respiratory Culture [LAB3095]

Tissue Culture [LAB2111173]

 Aspirated fluid

Swabbed collection

Tissue

 For aerobic bacteria
Fungal Culture [LAB240] Aspirated fluid or tissue, preferred

Swabbed collection

 For fungal organisms
Anaerobic Culture [LAB233] Aspirated fluid or tissue* For anaerobic bacteria

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June 30, 2023 by
Microbiology, Test Utilization

Enteric Pathogens PCR Panel: New Order Criteria

The Enteric Pathogens PCR test performed by Spectrum Health Laboratory may be used to detect common pathogenic bacteria and viruses in stool collected from individuals with symptoms of gastrointestinal infection. Specifically, this test detects Campylobacter, Salmonella, Shigella, Vibrio, Yersinia enterocolitica, Norovirus, Rotavirus, and the Shiga toxin virulence factor. Effective August 17, 2022, Spectrum Health’s Epic EMR will contain new ask-at-order questions to help improve the clinical decision support and appropriate utilization of this testing. Continue Reading

July 28, 2022 by
General Information, Microbiology, Test Utilization

Discontinuation of Placenta Microbiology Cultures

As of April 12, 2022, Spectrum Health Laboratory will no longer add microbiology cultures to placental tissues received based on paper requisition forms.

Viral and bacterial cultures from placental tissue are rarely clinically beneficial and are no longer the gold standard diagnostic approach due to the relative insensitivity of culture methods.

If viral studies are desired (possible indications could include known CMV exposure with positive IgM or intrauterine fetal demise at < 28 weeks), then molecular testing is the recommended diagnostic approach. HSV and CMV PCR tests may be ordered in Epic.

• Herpes Simplex 1/2 Qualitative PCR, Tissue (LAB1230413)

• Cytomegalovirus (CMV) Qualitative PCR, Tissue (LAB1230291)

Bacterial cultures are challenging to interpret since they typically grow normal genital flora and histopathological analysis used to diagnose acute chorioamnionitis correlates poorly with growth from bacterial placenta cultures. If indicated, culture and PCR tests may be ordered in Epic.

• Tissue Culture (LAB2111173)

• Metamycoplasma hominis, Molecular Detection, PCR, Varies (LAB848)

• Ureaplasma species, Molecular Detection, PCR, Varies (LAB848)

Placenta tissues sent to the lab in formalin are not acceptable for PCR or culture orders.

April 11, 2022 by
Microbiology

Herpes Simplex Virus PCR Update

As of April 5th, 2022, Herpes Simplex viral PCR testing will transition from being performed in the Spectrum Health Molecular department to the Microbiology department. There are no changes to the acceptable specimen sources for this test (cerebrospinal fluid and blood plasma specimens). Benefits of the new Microbiology testing method include:

• The new test method (DiaSorin Simplexa® HSV PCR) is FDA-cleared for testing spinal fluid specimens with a validated modification for testing plasma specimens. The prior method was a lab-developed test for both specimen types.

• Especially for pediatric patients, collecting sufficient specimen volumes can sometimes be challenging. The new method requires a minimum of 0.05 mL specimen per run whereas the prior method required 0.2 mL specimen.

• The frequency of testing will increase from typically one run per day to testing being performed at several times each day.

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April 4, 2022 by
General Information, Microbiology

New Test: Varicella Zoster Virus (VZV) PCR, Swab

Effective February 10, 2022, Spectrum Health Regional Laboratory will offer Varicella Zoster Virus (VZV) PCR testing on swab specimens collected from cutaneous and mucocutaneous lesions (e.g. anorectal, genital, nasal, ocular, oral, skin, urethral).

PCR is the test method of choice for the diagnosis of VZV infection due to its enhanced sensitivity and speed as compared to traditional viral cultures, which should no longer be used for VZV detection. Continue Reading

February 9, 2022 by
Microbiology, Test Spotlight

Influenza Testing Recommendation Update (December 2021)

The mitigation strategies enacted during the COVID-19 pandemic to reduce the spread of this virus led to essentially non-existent influenza prevalence during the 2020-2021 winter season. However, influenza has now returned and case numbers are increasing throughout West Michigan.

Influenza prevalence guides the most appropriate testing approach and sufficient prevalence has now been reached for influenza rapid antigen testing (e.g. Sofia instrument) to have improved performance. The use of rapid antigen testing as a screening method during high prevalence reduces both the cost to the patient and turn-around-time as compared to lab-based molecular methods. Rapid antigen tests generally have high analytical specificity, but lack the sensitivity of nucleic acid amplification methods (e.g. PCR). For this reason, PCR testing is still recommended for hospitalized patients and for outpatients with a negative antigen result if influenza is still suspected and if the result will impact clinical decision making. Continue Reading

December 16, 2021 by