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Infectious Disease

General Information, Test Spotlight

Influenza Testing Update: April 2022

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:

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 INFORMATION

Test name Epic code Interface EMR Code CPT Code
 Influenza PCR  LAB3255 11594 87502
 Influenza Rapid Antigen  LAB2111530 11208 87804 x4
April 15, 2022 by
Microbiology

Herpes Simplex Virus PCR Update

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.

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April 4, 2022 by
Compliance & Safety, Education & Training, General Information

Appropriate Labeling for Shared Specimen – COVID-19 & FLU AB PCR

To provide efficient and safe testing for patient specimens, please review the following information when sending COVID-19 PCR and Influenza A/B PCR testing in the same encounter to Spectrum Health Laboratories.

Two labels will be available for this testing. Labels must be fixed so that

• The test and patient information are shown
• The barcode may be easily scanned by Lab staff or instruments

When this is not done correctly, Laboratory staff removes the labels and re-fixes or re-prints it, which obstructs workflow, causes delays, and could result in patient information being peeled off. With patient safety and efficient testing being two of the Lab’s top priorities, it is vital that specimens arrive in such a way as to best accomplish both. Continue Reading

January 4, 2022 by
Microbiology, Test Spotlight

Influenza Testing Recommendation Update (December 2021)

The mitigation strategies enacted during the COVID-19 pandemic to reduce the spread of this virus led to essentially non-existent influenza prevalence during the 2020-2021 winter season. However, influenza has now returned and case numbers are 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

December 16, 2021 by
Advanced Technology Laboratory, General Information, Main lab, Test Utilization

Outpatient Respiratory Viral Testing

Spectrum Health Lab has noticed an increase in outpatient orders for Respiratory Pathogens by Film Array [LAB3359].  This may be due to a shortage of supplies for some Point of Care (POC) testing platforms.  Film Array is typically used for emergency and high acuity patients and therefore has a high cost that may not be covered by most patients’ insurance.  To lesson out of pocket costs for your patients, please order the below for RSV, COVID, or Flu testing. Continue Reading

November 11, 2021 by
Main lab, Microbiology, Test Utilization

Influenza Testing Reminder

The mitigation strategies enacted during the COVID-19 pandemic to reduce the spread of this virus have also impacted the transmission of other respiratory viruses. Influenza is typically prevalent during the winter months (December through March), however, influenza cases were essentially non-existent during the 2020-2021 season and influenza is not currently circulating in our community.

In the absence of circulating influenza activity, it is recommended to use the most sensitive diagnostic test in order to obtain accurate and actionable results. Influenza antigen testing (e.g. Sofia instrument) is not appropriate at this time. 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

Low Influenza
prevalence		 High influenza
prevalence
Recommended order Influenza PCR (LAB3255) Influenza Rapid Antigen (LAB2111530)
or
Influenza PCR (LAB3255)

TEST INFORMATION

Test name Epic code Interface EMR Code CPT Code
 Influenza PCR  LAB3255 11594 87502
 Influenza Rapid Antigen  LAB2111530 11208 87804 x4
September 16, 2021 by
Microbiology, Test Spotlight, Test Utilization

Stool Ova & Parasite Exam: New Order Criteria

Effective September 15, 2021, Spectrum Health’s Epic will contain new ask-at-order questions to help improve clinical decision support and appropriate utilization of stool ova and parasite (O&P) testing. O&P testing may be used to diagnose several parasitic infections, though the staining of stool smears and their microscopic review is very labor intensive for laboratories. Historically, O&P testing has been widely ordered for patients with diarrhea, however, there are now other testing options able to detect the most common pathogens associated with community-acquired diarrhea. While Enteric Pathogens PCR and Giardia/Cryptosporidium testing is more appropriate for the identification of common bacterial/viral and parasitic pathogens, respectively, O&P testing should be reserved for patients with specific exposure or immune status criteria.

The Pharmacy and Infectious Disease Stewardship Committee has endorsed the following order criteria for O&P testing. If any of these criteria are met, then then order can be placed.

♦ Past foreign residence or recent foreign travel followed by at least 2 weeks of diarrhea.

♦ Immunocompromised status.

♦ Unexplained microcytic anemia or peripheral eosinophilia.

♦ Unique exposure (daycare, MSM, waterborne outbreak, etc.)

Note: If no criteria are met, cancel the order and consider Giardia/Cryptosporidium Screen (LAB258) or Enteric Pathogens PCR testing (LAB3618).

Please direct question to the Contact Us link above.

 

TEST INFORMATION

Ova and Parasites, Complete – Epic: #LAB9550, Interface Code #50033, CPT #87328, 87329, 87177, 87209

Enteric Pathogens by PCR – Epic #LAB3618, Interface Code #55078, CPT #87506

Giardia/Cryptosporidium Screen – Epic #LAB258, Interface Code #50025, CPT #87329, 87328

 

September 15, 2021 by
Advanced Technology Laboratory, General Information, Main lab

Update: COVID-19 Swab Supplies

If you are collecting COVID-19 swabs in your office or clinic, please order and collect using the saline swab kits (“liquid media” or “wet collection”) instead of the tube with no liquid media (“dry collection”).

• Liquid media swab kits will provide a faster turn-around time.

• Dry collection kits supplies are low.

Please refer to the COVID-19 PCR test in the Lab Catalog for the most up-to-date information on COVID-19 collection.

• COVID-19 PCR Swab – LAB1230607

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April 8, 2021 by