The supply of the Sofia Strep Test Kits (ITM-1052057) has returned to a stable level allowing the system to migrate back to this Strep Test kit solely. Please note once the remaining supply of the alternative strep test kit (Cardinal – ITM-1157857) is depleted, the item will be inactivated.
Due to this change, please ensure competencies are up to date for the Sofia Strep test kit.
Procedure Reference #17340, #24118.
Test Information:
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.
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 name | Epic code | Interface EMR Code | CPT Code |
| Influenza PCR | LAB3255 | 11594 | 87502 |
| Influenza Rapid Antigen | LAB2111530 | 11208 | 87804 x4 |
Self-collected vaginal swabs may be used for testing as opposed to provider-collected swabs. Self-collected swabs are supported by current clinical guidelines as recent studies have shown their equivalence, if not superiority, in quality and their association with increased patient satisfaction.
NOTE: Self-collection must still take place in a healthcare setting and is not approved for at-home collection.
Test manufacturer supply chains continue to be disrupted due to COVID-19. Currently, there is a shortage of supplies for the Group B Streptococcus PCR test. Orders for this PCR test may continue to be placed, however, the SHRL Microbiology Department will perform a culture method until PCR supplies are available with appropriate charging and a reporting comment indicating that the culture was performed. The PCR test is normally resulted within 24-48 hours of specimen receipt in lab, whereas the culture method turnaround time may be 48-72 hours. An update will be posted when these PCR supplies are received, however, there may continue to be intermittent supply issues for this test. Additional test information can be found here.
As of January 13, 2020, the Spectrum Health Microbiology Laboratory will switch any viral culture orders placed on cutaneous or mucocutaneous lesion specimens to molecular PCR testing as the preferred diagnostic method.
Please refer to these documents for specimen collection information and appropriate ordering codes:
Effective May 18, 2020, Spectrum Health Regional Laboratory is pleased to be offering in-house COVID-19 serology testing, with initial availability 1,000 tests per day.
What is Serology Testing?
• Serology testing measures the body’s immune response to COVID-19 infection in the form of antibody production against the SARS-CoV-2 virus.
• There is a single COVID-19 serology order available in Epic, however, the Spectrum Health laboratory performs two versions of antibody testing to increase specificity and avoid reporting false positive results. An initial screen will be used to measure total antibody (IgA, IgM, and IgG), and positives will be confirmed by a second method that is specific to IgG.
• Specificity is critical when the expected prevalence in a community is low. This serology testing is not expected to cross-react with other circulating coronaviruses that cause the common cold.
• A positive IgG result indicates previous infection with COVID-19, but does not indicate immunity or protection against future infection.
• This test should not be used to detect acute COVID-19 disease. Symptomatic patients suspected to have acute COVID-19 infection should be tested using a molecular assay.
• Whether positive or negative for the presence of COVID-19 antibodies, serology testing results do not support easing of behaviors such as social distancing, wearing masks, or hand hygiene.
Click on images for printable pdf version.
Overview
Clinical guidelines no longer recommend serologic testing as a method for the diagnosis of H. pylori infection. Rather than IgG serology testing, other non-invasive testing methods such as H. pylori stool antigen and urea breath tests may be used to both diagnose and monitor response to therapy for H. pylori infection. In anticipation of an increase in stool antigen testing, currently a reference lab send-out test, Spectrum Health Regional Laboratory (SHRL) will be implementing this test as of October 29, 2018. By offering this test in-house, results will typically be available one day faster than present state.
On June 27th, the name of the current order “Respiratory (non-sputum) Culture without Gram stain” will change to “Throat Culture Comprehensive.” All other specimen collection details and culture workup will remain the same. Given the fact that there are currently several similarly named tests, this change is being made to reduce confusion regarding test selection and to clarify acceptable specimen types.