Browsing Tag

Pulmonary

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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Hematology

Result Reporting Change of Nucleated Cells in Cerebrospinal Fluid (CSF) Counts

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.

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General Information, Microbiology

New Test: Varicella Zoster Virus (VZV) PCR, Swab

Effective February 10, 2022, Spectrum Health Regional Laboratory will offer Varicella Zoster Virus (VZV) PCR testing on swab specimens collected from cutaneous and mucocutaneous lesions (e.g. anorectal, genital, nasal, ocular, oral, skin, urethral).

PCR is the test method of choice for the diagnosis of VZV infection due to its enhanced sensitivity and speed as compared to traditional viral cultures, which should no longer be used for VZV detection. Continue Reading

Chemistry, Education & Training, Main lab

Test Update: AST and ALT

Go Live Date delayed to 3/3/2022

Go-Live Date: 3/2/2022

Due to new instrumentation at Spectrum Health Blodgett Hospital Laboratory (BIRL) and to standardize across the Spectrum Health system, we will be adopting new tests for AST and ALT. The difference between our current test and this new test is the addition of the co-factor pyridoxal phosphate (Vitamin B6). The new test is the recommended test of the International Federation of Clinical Chemistry and ultimately will provide our patient population more accurate AST and ALT results. We did not adopt the new test in the past because it came with logistical and stability issues that made its use in the lab difficult. The new instrumentation we obtained has solved some of these concerns.

Historically, if patients had a Vitamin B6 deficiency, their AST and ALT levels may have been falsely lower than the true values. This decrease was due to the lack of endogenous co-factor causing a slower reaction rate when we tested the patient sample. After we implement the new test across the system, you may notice an increase in your patient’s AST and ALT results. This increase may be evidence that your patient had some degree of Vitamin B6 deficiency. If you were trending results, we recommend you establish a new baseline with the new test versions. The lab has been changed slightly in EPIC to prevent trending between the two test versions, since the results may not be able to be correlated if your patient had a Vitamin B6 deficiency. Continue Reading

Chemistry, General Information, Immunochemistry

Test Update: Rubella IgG Antibody Testing

On January 24th, 2022 Rubella Antibody, IgG, Serum (LAB496) and Rubella IgG Antibody Quantitative (LAB3544) will be combined as LAB496 and moved to the Immunochemistry laboratory due to reagent constrains with the current vendor.

Testing will be available Monday-Friday with a turn-around-time of 1-3 days. Results will be reported qualitatively as Immune or Not Immune.  If quantitative results are needed, please fax Immunochemistry at 616-267-2771 or call 616-267-2770. Continue Reading

Molecular Diagnostics

Cystic Fibrosis (CF) Carrier Screen Discontinued

Effective February 1, 2022, the Cystic Fibrosis (CF) Carrier Screen test, which includes the 23 common variants for cystic fibrosis recommended by ACOG/ACMG, will be discontinued as an orderable test at Spectrum Health Laboratory.

The recommended replacement test is the Cystic Fibrosis Mutation Analysis (Test ID: CFP) offered by Mayo Clinic Laboratories, a 106-variant panel which includes the recommended 23 common variants.

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General Information, Hematology

Test Update: Cell Count with Differential, Body Fluid

Beginning Tuesday, January 4, 2022, Spectrum Health Laboratories will include an automated neutrophil (PMN) count on Cell Count with Differential, Body Fluid (LAB210) orders for peritoneal body fluids.   This component will be displayed in Epic as an absolute PMN count, body fluid.

• The absolute PMN count in the peritoneal fluid is calculated by multiplying the total nucleated cell count by the percentage of PMNs in the differential.

• This calculation aids in the diagnosis of spontaneous bacterial peritonitis (SBP).

• The diagnosis of bacterial peritonitis is established by a positive peritoneal fluid bacterial culture and an elevated peritoneal fluid absolute PMN count (≥250 cells/uL).

• Epic will automatically calculate the absolute PMN count in peritoneal body fluids based on the manual differential data.

• This component ONLY calculates for Cell Count with Differentials (LAB210) on PERITONEAL BODY FLUIDS Continue Reading