Respiratory syncytial virus (RSV) primarily infects pediatric patients, but occasionally infects adults and may be of particular concern for the elderly and immunocompromised. Corewell Health Laboratories offers two tests for RSV. A rapid antigen test may be used to confirm RSV diagnosis in pediatric patients. This test is not approved by the FDA for testing adult patients, so tests will be cancelled if ordered on an off-label age group. There are no age restrictions for RSV testing by way of a molecular panel that also includes COVID and influenza as viruses with overlapping symptoms.
||Epic Test ID
||Nasopharyngeal (NP) swab
||Approved for patients 0 – 18 years of age
|COVID, Influenza, RSV PCR
||Nasopharyngeal (NP) swab
||No age restriction
Influenza cases numbers are currently 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
Effective immediately, the following Regional Hospital Laboratories have the 4-Plex (COVID-19, Influenza A, Influenza B, RSV) test available for ordering and testing:
- Big Rapids Hospital Laboratory
- Blodgett Hospital Laboratory
- Gerber Hospital Laboratory
- Ludington Hospital Laboratory
- Pennock Hospital Laboratory
- Reed City Hospital Laboratory
- United/Greenville Hospital Laboratory
- Zeeland Hospital Laboratory
Effective Tuesday, September 27, 2022, the following laboratories will be going live with the GeneXpert Xpress for COVID-19 testing: Big Rapids, Gerber, Ludington, Pennock, Reed City, United, and Zeeland.
Please ensure your sites are stocked with the correct collection devices listed below in preparation of the changeover. Continue Reading
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
Effective May 9th, 2022, Spectrum Health Laboratory’s Microbiology Department will no longer be preemptively setting up cultures on swabs without a source and order, when received on Thursdays through Sundays and Holidays. Note: The specimen will still be held, but cultures will not be set up in anticipation of the order. Continue Reading
West Michigan influenza infections peaked mid-March 2022 and have been declining in the weeks that followed. Now with a low prevalence of circulating influenza, using the most sensitive diagnostic test is recommended in order to obtain accurate and actionable results. Influenza antigen testing (e.g. Sofia instrument) is no longer appropriate at this time and Influenza PCR testing should be ordered when clinically indicated.
More detailed information can be found as published by the CDC:
Algorithm to assist in the interpretation of influenza testing results and clinical decision-making during periods when influenza viruses are NOT circulating in the community, and in previous lab newsletters: Influenza Diagnosis and Test Utilization
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.
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.
As of March 21, 2022, Spectrum Health Laboratories will adopt a new C. difficile testing approach that no longer reflexes to PCR testing for indeterminate toxin enzyme immunoassay (EIA) results. Rather, PCR testing will only be available upon consultation with Infectious Disease. Continue Reading