Beginning October 1, 2022, Spectrum Health Laboratory will update the current Chlamydia and Gonococcus testing using Abbott multi-Collect kit and Abbott m2000 platform to the Abbott Alinity m multi-Collect kit and Alinity m platform. This platform update will include an orderable name change and change in collection materials.
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Emergency Medicine
Effective September 21, 2022, the resulting options for the following Hepatitis lab result components will be updated from “Positive”/”Negative” to “Reactive”/”Nonreactive”. Any additional current resulting options, such as “Equivocal” or “See Comment”, will remain available. This will only affect applicable tests that have not yet been resulted.
At the beginning of the COVID-19 pandemic Spectrum Health Laboratory implemented a protocol to call providers and patients to notify of positive COVID-19 PCR testing. The pandemic has shifted to an endemic phase and a positive COVID-19 test is no longer considered a critical value. Effective Friday, August 26, 2022, Spectrum Health Laboratory will no longer call positive COVID-19 PCR testing, for inpatient or outpatient specimens.
Results for COVID-19 PCR will still file to the patient’s chart in Epic and reported to the ordering provider through usual means of receiving results (fax or electronic) and to the Michigan Department of Health and Human Services (MDHHS). Patient’s will still be notified via their MyChart as well.
If you have any questions or concerns, please use the “contact us” link above.
Cell Count w/ Differential if indicated, Cerebrospinal Fluid [LAB2111025] and Cell Count with Differential, Cerebrospinal Fluid (Pediatric Oncology) [LAB212] currently result nucleated cell counts as a White Blood Cell (WBC) count.
Effective Tuesday, August 16, 2022, the WBC component will be removed and instead reported as a Total Nucleated Cell (TNC) Count for CSF.
Effective August 2, 2022, reference ranges for the below tests will be updated to better align with the vendor’s recommendation and with Spectrum Health Lakeland Laboratory. Please click on the links below and scroll to the Reference Range field to see the updated ranges.
• Lithium Level [LAB29]
• PTH Intact [LAB108]
• IgM Level [LAB72]
• IgA Level [LAB73]
• CA 125 Level [LAB155]
• C4 Complement Level [LAB151]
• C3 Complement Level [LAB152]
• Albumin Level [LAB45]
• Transferrin Level [LAB133]
Questions or inquiries may be directed to the “Contact Us” link above.
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.
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.
| Low Influenza Prevalence |
High Influenza Prevalence |
|
| Recommended Order | Influenza PCR (LAB3255) | Influenza Rapid Antigen (LAB2111530) or Influenza PCR (LAB3255) |
More detailed information can be found as published by the CDC:
TEST INFORMATION
| Test name | Epic code | Interface EMR Code | CPT Code |
| Influenza PCR | LAB3255 | 11594 | 87502 |
| Influenza Rapid Antigen | LAB2111530 | 11208 | 87804 x4 |
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.
• 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.