The following information was updated in the Lab Catalog.
Discontinuation of Low-Volume and Individual Fluorescence in situ Hybridization (FISH) Probes
Effective immediately, due to low test utilization and the high cost of maintaining proficiency, the following FISH tests will no longer be offered:
• Prader-Willi/Angelman (15q11-q13) by FISH
Recommended test is Angelman/Prader-Willi mPCR
• Smith Magenis (17p11) by FISH
If need arises for this test, please place an order for a Send out Genetics Miscellaneous and enter requested test in the comments. The testing will be sent out through Spectrum Health.
Any questions about referral testing may be directed to the Referral Department. Any questions or concerns regarding these changes may be directed to Dr. Salah Ebrahim in the Cytogenetics Laboratory.
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.
|Recommended Order||Influenza PCR (LAB3255)||Influenza Rapid Antigen (LAB2111530)
Influenza PCR (LAB3255)
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
|Test name||Epic code||Interface EMR Code||CPT Code|
|Influenza Rapid Antigen||LAB2111530||11208||87804 x4|
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.
• 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.