Browsing Tag

Surgery

General Information, Microbiology

Influenza Antigen Testing (December 2024)

Influenza prevalence fluctuates seasonally, and case numbers are currently increasing throughout West Michigan. The onset of “flu season” varies year-to-year though typically begins its upswing in the month of December. It is important for providers to have an awareness of influenza prevalence (in addition to other respiratory viruses) to help guide when influenza testing should be pursued.

The use of point of care (POC) antigen testing reduces both the cost to the patient and turn-around-time as compared to lab-based molecular methods. POC antigen tests are typically available for COVID-19, influenza A/B, and as a COVID-19/influenza A/B combination test. During warmer months when influenza prevalence is negligible yet COVID-19 may be circulating, a COVID-only antigen test may be helpful for diagnosis. As influenza increases into colder months, a COVID-19/Influenza A/B combo test would act as a screen for both viruses.

POC 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 POC result if influenza is still suspected and if the result will impact clinical decision making. Influenza PCR may be ordered as a standalone test (LAB3255) or as a part of a panel alongside COVID-19 and RSV (LAB1230746).

 

Test Information

  • Influenza PCR Epic Code: LAB3255, Interface EMR Code: 11594, CPT Code 87502
  • COVID-19, Influenza A/B, RSV PCR Epic Code: LAB1230746, Interface EMR Code: 1230746, CPT: 0241U

 

Contact/Resources

Local Infection Prevention Team

Michigan Department of Health and Human Services

 

December 24, 2024 by
General Information, Hemostasis/Coagulation

Reference Range Updates Coagulation Laboratory

Effective December 2, 2024 at 08:00 AM, Corewell Health West Laboratory Coagulation Department will be updating the reference range for several assays. The following will be impacted by these changes:

APTT testing for the BCS XP analyzers will be updating to 22.0 – 27.0 seconds.

This will include the following tests:

Effective December 2, 2024 at 08:00 AM, the Corewell Health West and South Coagulation Departments will be updating the reference range of the Fibrinogen Level (LAB 314) to 190-450 mg/ dL.

Questions may be directed to the Coagulation Laboratory using the Contact Us link above.

November 27, 2024 by
Test Utilization

Influenza Testing Update: April 2024

This winter, West Michigan influenza infections peaked in February 2024 and significantly declined throughout March and April 2024. 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 antigen testing (e.g. Sofia instrument)
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

April 30, 2024 by
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

Continue Reading

June 30, 2023 by
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.

May 15, 2023 by
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

March 31, 2023 by
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.

August 25, 2022 by