The Enteric Pathogens PCR test performed by Spectrum Health Laboratory may be used to detect common pathogenic bacteria and viruses in stool collected from individuals with symptoms of gastrointestinal infection. Specifically, this test detects Campylobacter, Salmonella, Shigella, Vibrio, Yersinia enterocolitica, Norovirus, Rotavirus, and the Shiga toxin virulence factor. Effective August 17, 2022, Spectrum Health’s Epic EMR will contain new ask-at-order questions to help improve the clinical decision support and appropriate utilization of this testing.
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Family Medicine
As of July 19, 2022, in alignment with recommendations from the Center for Disease Control and Prevention (CDC) the reference range for blood lead testing has been updated from 5 mcg/dL to 3.5 mcg/dL.
This applies to both: Lead, Blood Level [LAB98] and Lead Screen Filter Paper [LAB2111119].
In addition, at this time the low end of reporting for Lead Screen Filter Paper [LAB2111119] has increased from 1 mcg/dL to 2 mcg/dL.
Compliance & Safety, Education & Training, Microbiology
Update: Swabs for Cultures without a Source and Order
Effective May 9th, 2022, Spectrum Health Laboratory’s Microbiology Department will no longer be preemptively setting up cultures on swabs without a source and order, when received on Thursdays through Sundays and Holidays. Note: The specimen will still be held, but cultures will not be set up in anticipation of the order.
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 |
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.
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.
Go Live Date delayed to 3/3/2022
Go-Live Date: 3/2/2022
Due to new instrumentation at Spectrum Health Blodgett Hospital Laboratory (BIRL) and to standardize across the Spectrum Health system, we will be adopting new tests for AST and ALT. The difference between our current test and this new test is the addition of the co-factor pyridoxal phosphate (Vitamin B6). The new test is the recommended test of the International Federation of Clinical Chemistry and ultimately will provide our patient population more accurate AST and ALT results. We did not adopt the new test in the past because it came with logistical and stability issues that made its use in the lab difficult. The new instrumentation we obtained has solved some of these concerns.
Historically, if patients had a Vitamin B6 deficiency, their AST and ALT levels may have been falsely lower than the true values. This decrease was due to the lack of endogenous co-factor causing a slower reaction rate when we tested the patient sample. After we implement the new test across the system, you may notice an increase in your patient’s AST and ALT results. This increase may be evidence that your patient had some degree of Vitamin B6 deficiency. If you were trending results, we recommend you establish a new baseline with the new test versions. The lab has been changed slightly in EPIC to prevent trending between the two test versions, since the results may not be able to be correlated if your patient had a Vitamin B6 deficiency.
Compliance & Safety, Education & Training, General Information
Appropriate Labeling for Shared Specimen – COVID-19 & FLU AB PCR
To provide efficient and safe testing for patient specimens, please review the following information when sending COVID-19 PCR and Influenza A/B PCR testing in the same encounter to Spectrum Health Laboratories.
Two labels will be available for this testing. Labels must be fixed so that
• The test and patient information are shown
• The barcode may be easily scanned by Lab staff or instruments
When this is not done correctly, Laboratory staff removes the labels and re-fixes or re-prints it, which obstructs workflow, causes delays, and could result in patient information being peeled off. With patient safety and efficient testing being two of the Lab’s top priorities, it is vital that specimens arrive in such a way as to best accomplish both.