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.
Infectious Disease
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.
COVID-19 Test Update for Regional Hospital Lab Clients
Effective Tuesday, September 27, 2022, the following laboratories will be going live with the GeneXpert Xpress for COVID-19 testing: Big Rapids, Gerber, Ludington, Pennock, Reed City, United, and Zeeland.
Please ensure your sites are stocked with the correct collection devices listed below in preparation of the changeover.
Effective September 21, 2022, the resulting options for the following Hepatitis lab result components will be updated from “Positive”/”Negative” to “Reactive”/”Nonreactive”. Any additional current resulting options, such as “Equivocal” or “See Comment”, will remain available. This will only affect applicable tests that have not yet been resulted.
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:
TEST INFORMATION
Test name | Epic code | Interface EMR Code | CPT Code |
Influenza PCR | LAB3255 | 11594 | 87502 |
Influenza Rapid Antigen | LAB2111530 | 11208 | 87804 x4 |
As of April 5th, 2022, Herpes Simplex viral PCR testing will transition from being performed in the Spectrum Health Molecular department to the Microbiology department. There are no changes to the acceptable specimen sources for this test (cerebrospinal fluid and blood plasma specimens). Benefits of the new Microbiology testing method include:
• The new test method (DiaSorin Simplexa® HSV PCR) is FDA-cleared for testing spinal fluid specimens with a validated modification for testing plasma specimens. The prior method was a lab-developed test for both specimen types.
• Especially for pediatric patients, collecting sufficient specimen volumes can sometimes be challenging. The new method requires a minimum of 0.05 mL specimen per run whereas the prior method required 0.2 mL specimen.
• The frequency of testing will increase from typically one run per day to testing being performed at several times each day.