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Pediatrics

Test Utilization

Influenza Testing Update: April 2024

This winter, West Michigan influenza infections peaked in February 2024 and significantly declined throughout March and April 2024. 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 antigen testing (e.g. Sofia instrument)
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

Chemistry

Anion Gap Reference Range Update

Effective February 7, 2024, at 7:30 AM, Corewell Health West Laboratories will go live with a new reference range for the calculated Anion Gap (AG). The AG reference range will be adjusted to align with recent reference range studies.

The following will be the new normal reference ranges for AG:

Anion Gap: 5 – 14 mmol/L

 

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Immunochemistry, Main lab

Update in Testing Platform – Immunochemistry

As of January 26, 2024, for the following tests, the testing platform has changed from EliA Fluorescence Enzyme Immunoassay (FEIA) from Thermofisher to Multiplex Flow Immunoassay from Biorad. Please review the lab catalog for any changes to collection information or reference ranges.

• Anti-dsDNA Antibody
• Cyclic Citrullinated Peptide (CCP) Antibody
• Celiac Antibody Cascade
• Tissue Transglutaminase Antibody
• Gliadin Antibodies Continue Reading

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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General Information

Outpatient Lab Draw Site Updates

Effective Monday, October 2, 2023, the Outpatient Lab Draw Sites in Kent, Ottawa, and Muskegon counties (excluding the Zeeland Hospital and Gerber Hospital sites) will begin a new process for walk-in patients.

Registration staff will begin informing the patient of their wait times based on the scheduling template available for that site for that day. This will allow the patient to make an informed decision on whether to wait, come back at a later time, or schedule an appointment time that works best for them. Patients choosing to schedule, may schedule for any available sites, times and dates in MyChart, or they may schedule with the registrar for the next 24-48 hours.  (Note: lab staff does not have the ability to schedule patients.)

Additionally, at this time, Blodgett Outpatient Lab is temporarily closed until further notice. Sites closest to Blodgett are the Integrated Care Campus at 426 Michigan St NE, 4100 Lake Drive, and Integrated Care Campus at 2750 East Beltline, or patients may visit Find a Doctor | Corewell Health to find a lab location nearest to them.

 

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