Effective June 1, 2026, Corewell Health Microbiology Laboratory in Southeast Michigan is updating specimen collection criteria for body fluid specimens. Microbiology will no longer accept red top vacutainer tubes as a collection device for body fluids (i.e. synovial fluid, pleural fluid, peritoneal fluid, etc). Collection criteria information has been updated in Corewell’s Lab Test Directory to reflect this change. Test order for body fluid cultures is LAB2111016 (aerobic culture) and commonly accompanied by LAB233 (anaerobic culture).
Surgery
Effective Date: September 3, 2025
The MRSA Screen PCR [LAB1231076] detects the presence or absence of colonization with methicillin-resistant Staphylococcus aureus (MRSA) and may be used to guide antimicrobial prophylaxis decisions. To improve and standardize test utilization across all Corewell Health regions, the following restrictions will be added to this test order:
- Ordering will be restricted to one test every 7 days.
- An indication for ordering must be provided for each order. Acceptable indications are:
- Pneumonia
- Skin and soft tissue (use for non-purulent infections)
- Surgical prophylaxis
Studies have shown that there is minimal utility in re-testing within 2 weeks as MRSA conversion rates are low and the PCR negative predictive values remain high for at least 14 days after initial testing.
Absence of nasal colonization with MRSA cannot be used to reliably rule out MRSA infection in scenarios other than those listed above.
Test Information
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
- Resources: https://www.michigan.gov/flu/resources
- Surveillance information: https://www.michigan.gov/flu/surveillance
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:
- aPTT Direct Thrombin Inhibitor (LAB1230880) (APTT-DTI)
- Mixing Studies, aPTT (LAB326)
- APTT (LAB325)
- APTT Heparin Neutralization (LAB3377)
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.
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:
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 |
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.
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.
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.
