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Laboratory Services

General Information, Test Spotlight

Influenza Testing Update: April 2022

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:

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

 

TEST INFORMATION

Test name Epic code Interface EMR Code CPT Code
 Influenza PCR  LAB3255 11594 87502
 Influenza Rapid Antigen  LAB2111530 11208 87804 x4
April 15, 2022 by
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
Microbiology

Herpes Simplex Virus PCR Update

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.

Continue Reading

April 4, 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
Advanced Technology Laboratory, Molecular Diagnostics

Test Discontinuation: MTHFR C677T

MTHFR C677T [LAB7390], the methylenetetrahydrofolate reductase mutation analysis, is being discontinued as an obsolete test.

The American College of Medical Genetics (ACMG) and American College of Obstetricians and Gynecologists (ACOG) have determined that MTHFR C677T testing has minimal clinical utility. Current testing recommendations indicate that this test should not be ordered as part of a routine evaluation for thrombophilia or adverse pregnancy outcomes. Continue Reading

February 28, 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