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General Information

General Information, Microbiology, Test Utilization

Discontinuation of Placenta Microbiology Cultures

As of April 12, 2022, Spectrum Health Laboratory will no longer add microbiology cultures to placental tissues received based on paper requisition forms.

Viral and bacterial cultures from placental tissue are rarely clinically beneficial and are no longer the gold standard diagnostic approach due to the relative insensitivity of culture methods.

If viral studies are desired (possible indications could include known CMV exposure with positive IgM or intrauterine fetal demise at < 28 weeks), then molecular testing is the recommended diagnostic approach. HSV and CMV PCR tests may be ordered in Epic.

• Herpes Simplex 1/2 Qualitative PCR, Tissue (LAB1230413)

• Cytomegalovirus (CMV) Qualitative PCR, Tissue (LAB1230291)

Bacterial cultures are challenging to interpret since they typically grow normal genital flora and histopathological analysis used to diagnose acute chorioamnionitis correlates poorly with growth from bacterial placenta cultures. If indicated, culture and PCR tests may be ordered in Epic.

• Tissue Culture (LAB2111173)

• Metamycoplasma hominis, Molecular Detection, PCR, Varies (LAB848)

• Ureaplasma species, Molecular Detection, PCR, Varies (LAB848)

Placenta tissues sent to the lab in formalin are not acceptable for PCR or culture orders.

April 11, 2022 by
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

March 31, 2022 by
Education & Training, General Information

Reminder: Fasting Tests

Several tests performed by Spectrum Health Laboratories and our Reference Laboratories (Mayo Clinic Lab) require or recommend fasting.

Please check the Lab Catalog prior to sending your patient to a draw site or sending a patient’s specimens to the lab. Help remind patients to arrive fasting if fasting tests are required.

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. Some tests also require no alcoholic beverages for 24-48 hours prior to testing.

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

Results may be inaccurate if fasting was not done prior to the test and may lead to improper diagnosis or treatment. Testing will need to be repeated if patient was not fasting properly before testing.

List of fasting tests

March 4, 2022 by
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

February 9, 2022 by
General Information

Supply Update: UTM with Swab

The following NEW items are available at the Spectrum Health Distribution Center.

ITM-1140078 – Viral Transport Media with Nasopharyngeal Swab (NP, UTM)

ITM-1186125 – Viral Transport Media with Flocked Swab (UTM)

Spectrum Health and Spectrum Health Medical Group providers, please order via Workday. Independent and non-SH providers please order via the Laboratory Supply Form.

ITM-1140078 has replaced ITM-1140814 – Saline Swab Kit for Covid Nasopharyngeal collection. ITM-1186125 is recommended for Nares (Nostril) collection. Please reference the Laboratory Catalog for more information on specimen collection containers for COVID testing.

Continue Reading

February 9, 2022 by
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

January 19, 2022 by