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Surgery

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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Education & Training, General Information, Histology

Best Practices for Small Tissue Material

Tissue specimens less than 0.1cm may yield insufficient results if submitted for Tissue Pathology. To make the best use of diagnostic tissue material please follow the below guidelines:

Biopsy Size Order Code Test Preservative
<0.1cm LAB2111263 Fine Needle Aspiration (FNA) Cytology *CytoLyt solution
>0.1cm LAB8 Tissue Pathology 10% Formalin

*Place entire specimen in CytoLyt. Do not attempt to make smears from specimen.

Please contact the Corewell Health Pathology Department at (616)267-2622 Mon-Fri, 8am-5pm, or the Corewell Health Laboratory Call Center at (616)774-7721, 24/7 to speak with a Pathologist.

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

General Information

Positive COVID-19 PCR Communications

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.

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
Chemistry, Test Spotlight

Reminder: Folate Test and Fasting

Folate (aka Folic Acid) is a test that requires the patient to be fasting in order for the results be accurate. Results are falsely elevated if the patient is not fasting.  Spectrum Health Laboratories recently updated our system to hard stop a test from being collected if the patient is not fasting. Please remind your patients to fast 8 hours prior to having their blood drawn.

Spectrum Health Laboratories recommends:

• No caloric or caffeine intake for 8-12 hours prior to testing. Do not eat or drink anything except normal amounts of plain water. This also includes no smoking, chewing gum, candy, cough drops, etc.

• Take normal dosages of medications unless the provider has instructed otherwise.

Click here for a list of tests the require or recommend fasting. Continue Reading

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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