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Emergency Medicine

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

Test Utilization

Test Update: Chlamydia Culture Discontinued

Effective September 13, 2023, Corewell Health Laboratory will discontinue the Chlamydia Culture orderable. For patients 14 years of age and older, please order Chlamydia PCR.

• This specimen can be either a swab (genital, rectal, or throat) or a urine sample.
• The collection container is the STD-Multi-Collection Kit.
• For more information please visit: Chlamydia PCR

For patients that are under 14 years of age, a “Reference Miscellaneous Test” [LAB 848], must be ordered.

• This specimen can be either a swab (genital, rectal, or throat) or a urine sample.
• The collection container is the Aptima
• For more information please visit: APTIMA Chlamydia, NAAT, ThinPrep, Swab, Urine

As a reminder, PCR testing is also preferred for gonorrhea, when the specimen types are compatible. Continue Reading

Referral/Sendouts, Test Utilization

Test Update: COVID-19 Total Antibody Discontinued

Effective August 30, 2023, the COVID-19 Total Antibody test, which includes the qualitative detection of spike and nucleocapsid antibodies against COVID-19, will be discontinued as an orderable test at Corewell Health West Laboratories. Symptomatic patients suspected to have acute COVID-19 infection should be tested using a molecular assay.

To aid in the clinical diagnosis of multisystem inflammatory syndrome in children or adults (MIS-C or MIS-A), the COVID-19 IgG, Qualitative by CIA will be available as a send out test. This test is a qualitative detection of IgG antibodies against the nucleocapsid protein of COVID-19 that develop in response to natural infection with COVID-19. This test is performed on Monday, Wednesday, and Fridays, and reported within 1-5 days. Continue Reading

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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Test Utilization

Influenza Testing Update: April 2023

This winter, West Michigan influenza infections peaked in December 2022 and significantly declined throughout February and March 2023. 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. Continue Reading

General Information

Albumin Testing Update

Albumin Reagent Conversion

Corewell Health Laboratories (formerly Spectrum Health) has utilized the Bromcresol Purple (BCP) method for the measurement of albumin concentration in serum, plasma, and serous body fluids for well over 20 years. The test principle consists of a reaction where the BCP binds selectively with albumin, causing a color change that is measured photometrically. A vast majority of labs across the country, including reference labs such as Mayo Medical Laboratories, utilize an alternative method for albumin measurement that consists of Bromcresol Green (BCG) instead of BCP. To align with the majority of institutions this size, and to be included in a larger peer group for proficiency testing purposes, Corewell Health Laboratories – West, has been transitioning to BCG for the measurement of albumin over the last few weeks. Continue Reading

Advanced Technology Laboratory

New Tests: Trichomonas PCR, Mycoplasma genitalium PCR, and STI Panel (Alinity)

New Test Announcement

Corewell Health Advanced Technology Laboratory is pleased to announce the addition of Trichomonas, Mycoplasma Genitalium (Mgen), and STI Panel testing on the Alinity m platform.

As of 1/5/2023, Trichomonas vaginalis (TV) and Mycoplasma genitalium (MG) STI tests are available using the Alinity m collection kit and a panel which includes the above plus Chlamydia trachomatis (CT) and Neisseria gonorrhoeae (NG).

All four tests may be run on one urogenital sample, saving cost and time, and reducing human error.

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