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.
Emergency Medicine
Microalbumin/Creatinine, Random Urine Result Comment Update
Effective January 4, 2023, the process for reporting the Microalbumin/Creatinine ratio was changed for situations where one of the results, microalbumin and/or creatinine, is below or above the assay’s analytical measuring range (AMR).
Albumin Reagent Conversion
Corewell Health Laboratories (formerly Spectrum Health) has utilized the Bromcresol Purple (BCP) method for the measurement of albumin concentration in serum, plasma, and serous body fluids for well over 20 years. The test principle consists of a reaction where the BCP binds selectively with albumin, causing a color change that is measured photometrically. A vast majority of labs across the country, including reference labs such as Mayo Medical Laboratories, utilize an alternative method for albumin measurement that consists of Bromcresol Green (BCG) instead of BCP. To align with the majority of institutions this size, and to be included in a larger peer group for proficiency testing purposes, Corewell Health Laboratories – West, has been transitioning to BCG for the measurement of albumin over the last few weeks.
Corewell Health Laboratory (Grand Rapids) Coagulation laboratory is pleased to announce a change to our von Willebrand factor (VWF) activity test. The historical test von Willebrand ristocetin cofactor (LAB335) will be retired and replaced by von Willebrand factor activity (VWF activity, LAB1230904) on January 17, 2023.
New Tests: Trichomonas PCR, Mycoplasma genitalium PCR, and STI Panel (Alinity)
New Test Announcement
Corewell Health Advanced Technology Laboratory is pleased to announce the addition of Trichomonas, Mycoplasma Genitalium (Mgen), and STI Panel testing on the Alinity m platform.
As of 1/5/2023, Trichomonas vaginalis (TV) and Mycoplasma genitalium (MG) STI tests are available using the Alinity m collection kit and a panel which includes the above plus Chlamydia trachomatis (CT) and Neisseria gonorrhoeae (NG).
All four tests may be run on one urogenital sample, saving cost and time, and reducing human error.
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 testing (e.g. Sofia instrument) to have improved performance. The use of rapid antigen 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. Rapid antigen 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 antigen result if influenza is still suspected and if the result will impact clinical decision making.
Starting November 29th, 2022, Corewell Health West, Hematology Laboratories will begin reporting absolute counts for white blood cell (WBC) manual differentials, in addition to relative (percentage) counts. The WBC differential count determines the number of each type of white blood cell present in the blood. It can be expressed as a percentage or as an absolute value. Of these, the absolute value is much more important than the relative value, given that clinically relevant WBC elevations and declines are defined by their absolute numbers, not by their relative proportions, and there is potential for error if this conversion is performed outside the laboratory.
Effective immediately, the following Regional Hospital Laboratories have the 4-Plex (COVID-19, Influenza A, Influenza B, RSV) test available for ordering and testing:
- Big Rapids Hospital Laboratory
- Blodgett Hospital Laboratory
- Gerber Hospital Laboratory
- Ludington Hospital Laboratory
- Pennock Hospital Laboratory
- Reed City Hospital Laboratory
- United/Greenville Hospital Laboratory
- Zeeland Hospital Laboratory
Test Update: Chlamydia and Gonococcus Testing (Alinity m)
Effective October 31, 2022, the Advanced Technology Laboratory’s Molecular Diagnostics Department will accept oropharyngeal and rectal swab specimens as testing sources for Chlamydia and Gonococcus testing using the Alinity m multi-Collect Kit. This specimen type is FDA approved on the Alinity m platform.
NOTE: Specimens collected on patients under the age of 14 or collected for Child Protective Services, will still be sent out to a reference laboratory.
Beginning October 1, 2022, Spectrum Health Laboratory will update the current Chlamydia and Gonococcus testing using Abbott multi-Collect kit and Abbott m2000 platform to the Abbott Alinity m multi-Collect kit and Alinity m platform. This platform update will include an orderable name change and change in collection materials.