Browsing Tag

Infectious Disease

Test Utilization

Influenza Testing Recommendation (December 2023)

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 or point of care testing (e.g. Sofia instrument) to have improved performance. The use of point of care 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. Point of care 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 result if influenza is still suspected and if the result will impact clinical decision making.

Low influenza prevalence High influenza prevalence
Recommended order Influenza PCR  Influenza Point of Care Testing
or
Influenza PCR 

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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

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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Compliance & Safety, Education & Training, General Information, Main lab, Test Utilization

Inform: RSV Testing – Age Restrictions

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.

Test name Epic Test ID Methodology Specimen Age restriction
RSV Rapid LAB495 Antigen Nasopharyngeal (NP) swab Approved for patients 0 – 18 years of age
COVID, Influenza, RSV PCR LAB1230746 Molecular/PCR Nasopharyngeal (NP) swab No age restriction
General Information, Test Utilization

Influenza Testing Recommendation (November 2022)

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

General Information

Regionals New Test Communication: “4-Plex”

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

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Advanced Technology Laboratory, General Information, Molecular Diagnostics

Test Update: Chlamydia and Gonococcus Testing (Alinity m)

Effective October 31, 2022, the Advanced Technology Laboratory’s Molecular Diagnostics Department will accept oropharyngeal and rectal swab specimens as testing sources for Chlamydia and Gonococcus testing using the Alinity m multi-Collect Kit. This specimen type is FDA approved on the Alinity m platform.

NOTE: Specimens collected on patients under the age of 14 or collected for Child Protective Services, will still be sent out to a reference laboratory. Continue Reading