08/25/11
CLOSTRIDIUM DIFFICILE TESTING
Parkview Health Laboratories began performing Clostridium difficile testing by a molecular method on August 9, 2011. This new method has 95-98% sensitivity and specificity. The Laboratory will be following the 2010 Clinical Practice Guidelines of Society for Healthcare Epidemiology of America (SHEA) and Infectious Diseases Society of America (IDSA) . Due to the need for further client education and policy review, the following recommendations for testing will be put into place in September 25, 2011.
1. Due to the higher sensitivity, one specimen will be tested in a 7 day period. There is no longer a
clinical need for testing X 3.
2. Patients must be symptomatic. Only specimens that conform to the container shape will be
tested. Formed stool specimens will be rejected.
3. No "test of cure" specimens should be submitted. Patients may remain positive for long periods
without symptoms.
4. This test is not FDA approved for colonoscopy specimens. Specimens collected during
colonoscopies will be sent to a referral laboratory for testing.
Until that time, all specimens, with the exception of those collected during colonoscopy, will be tested.
Please note that due to the increased sensitivity of this test, patients may test positive for an indefinite time period. More information can be found on the 2010 Clinical Practice Guidelines at: http://www.jstor.org/stable/10.1086/651706For questions, please contact Phyllis Bonner, MT (ASCP), Microbiology Lead, at extension 373-9491, or Craig McBride, MD, Medical Director, at extension 373-3656.
08/02/11
Methadology changes for Clostridium Difficile Testing
Beginning August 8, 2011, Microbiology will be changing to a molecular method for the diagnosis of Clostridium difficile infection. (CDI) Molecular methods are more accurate with a 95-98% sensitivity/specificity in contrast to the current EIA technology which is between 50-80%. The new method detects both A+B+ and A-B+ toxin producing strains of Clostridium difficile. As a result of the increased accuracy with the new DNA method, the following recommendations will also go into effect:
1) One specimen will be tested in a 7 day period. No X3 orders will be accepted.
2) Patients must be symptomatic. Only specimens that conform to the container shape will be tested. Formed stool specimens will be rejected.
3) No "test of cure" specimens should be submitted. Patients may remain positive for long periods without symptoms.
4) This test is not currently approved for colonoscopy specimens.
After 8-8-11, any orders for the current EIA methodology will be converted to the new method. Testing will be performed 7 days per week with at least one run per shift. For questions, please contact Phyllis Bonner, MT (ASCP), Microbiology Lead, at extension 373-9491, or Craig McBride, MD, Medical Director, at extension 373-3656.
06-30-11
Announcement
It is with great pleasure to announce that Parkview Health Central Laboratory at 328 Ley Road is relocating to the new Parkview Regional Medical Center (PRMC) on the Parkview North campus, effective November 17, 2011.
The move to PRMC will allow Parkview Health Laboratories to consolidate laboratory testing to better improve its services to physicians and their patients.
Additional information, such as mailing address, phone and fax numbers announced with future communications. We are looking forward in continuing to provide excellent laboratory services to our patients and clients at our new location in the very near future.
04-25-11
Utilization of Reference Laboratories
Parkview Health Laboratories is continuing to lean processes, increase efficiency, and reduce costs associated with send out testing to outside reference labs. Reference labs are selected with medical staff approval based on quality, methodology, cost effectiveness and turnaround time. Special requests may be denied if testing needs can be met more cost effectively at an approved laboratory. Specific reference laboratory requests will only be guaranteed if accompanied by requisition and shipping supplies from desired laboratory. Please contact Dr. Wan at extension 33650 with any questions.
Change in Susceptibility Reporting
Due to a recall from the bioMerieux company, which produces the Vitek susceptibility cards, you may notice the absence of piperacillin/tazobactam (Zosyn®) susceptibility data. The Parkview microbiology department has begun suppressing the automated reporting of Zosyn for several bacterial isolates including: E. coli, Pseudomonas, Morganella, Proteus, and several others. To supplement the missing data in hospitalized patients, manual alternative Zosyn susceptibility testing will be automatically performed for all Pseudomonas and Morganella isolates and for other Gram-negative isolates that are resistant to cefazolin. Additional manual testing will be performed as requested.
If you have further questions, please contact Craig McBride, MD (Pathologist, ext. 33656), Phyllis Bonner, MT (Microbiology Lead Technologist, ext. 39491) or Shannon Matsko, PharmD (Infectious Diseases Clinical Specialist Pharmacist, ext. 33432).
03-01-11
Change in testing formats calls for a change in Specimen Types
Infectious Mononucleosis Screen has changed to a waived test. Specimen requirements as of March 4, 2011. Preferred sample 0.3 mL whole blood in Lavendar Top tube (EDTA plastic vial) refrigerated for up to 24 hours.
Beginning 3-28-11, the specimen requirement for a Quantitative Ethylene Glycol will change. The new requirement is 4.0 mL whole blood collected in a gray-top tube (sodium fluoride potassium oxalate).
To better conform to World Health Organization standards, TSH testing will be consolidated to the laboratory's Siemens Centaur testing platform beginning 4-4-11. After this date, plasma will no longer be an acceptable specimen. Please collect a serum separator tube for all TSH tests. Questions can be directed to Dr. Wan, Medical Director, at 373-3660.
01-20-11
Lab Draw Site at 328 Ley Road to close effective March 15.
The Parkview Laboratory at 328 Ley Road will be relocating to the Parkview North Campus as part of the Parkview Regional Medical Center. In preparation for that move, the laboratory drawing site at the Ley Road location will be closing effective March 15, 2011. We are notifying all patients that have used the 328 Ley Road location within the past 6 months and providing them with information regarding alternate draw sites. At this time, 328 Ley Road will continue to be the collection/drop off site for Semen Analysis. Home Health agencies may also continue to drop off samples at 328 Ley Road. This will not change until the rest of the laboratory relocates later this year.
01-03-11
LAB CUMULATIVE REPORTS TO CHANGE JANUARY 11, 2011:
The cumulative style lab report, which is used in Access Anywhere for Inpatient, Outpatient and ER lab reports, will be updated. Currently, hematology and chemistry results print in a horizontal fashion. While this old style was good for trending a single lab result across multiple days, it was difficult when trying to view a series of lab results for one particular day. The NEW and IMPROVED lab cumulative report is a single column vertical style. The lab results will go down the page, instead of across. Hematology results, for example, will group together, in chronological order, followed by chemistry results, in chronological order, etc. Trending of individual lab results is available in GE Centricity (Carecast). Please contact Alice Friedt, Director of Laboratories, with questions. (373-9443).
12-22-10
Effective on December 22, 2010, the adult reference range for CK and LD will change.
The CK range will be: Males 21-224 U/L, Females 10-175 U/L.
The LD range will be 107-230 U/L.
These changes are necessary due to a change in the manufacturer's reagent.
For questions or concerns, please contact Dr Xiaoying Wan at 260-373-3660.
12/15/10
As of January 1, 2011, the American Red Cross blood services will no longer prepare volume-reduced platelet products for transfusion to neonates. Whole blood derived platelets are the recommended product of choice because manipulation of platelets during the volume-reduction process can lead to platelet activation and a suboptimal clinical response. A 10 mL/Kg transfusion of whole blood derived platelets has the potential to raise the platelet count of a 1 Kg infant by 100,000 platelets/uL. Please direct any question to Craig McBride, MD, Pathologist at 373-3656.
Beginning September 20, 2010, the reference ranges and diagnostic comments for Troponin I testing are being revised. See below for changes: