M. tuberculosis Complex Detection and Rifampin Susceptibility - 1/3/2017
Effective Jan. 3
rd, 2017 - please order
M. tuberculosis Complex Detection and Rifampin Susceptibility by PCR - ARUP whenever a direct specimen screening for
M. tuberculosis is intended.
Message from Henry D. Slosser, MD. on Respiratory Panel by PCR - for rapid
identification of upper respiratory viruses and bacteria
Effective May 2nd, 2016, the FilmArray Respiratory Panel will be done in-house
The FilmArray Respiratory Panel (RP) is a multiplexed nucleic acid test
intended for use with FilmArray systems for the simultaneous qualitative
detection and identification of multiple respiratory viral and bacterial
nucleic acids in nasopharyngeal swabs (NPS) obtained from individuals
suspected of respiratory tract infection.
The following upper respiratory viruses and bacteria are detected:
- Coronavirus 229E
- Coronavirus HKU1
- Coronavirus NL63
- Coronavirus OC43
- Influenza A (with subtyping for hemagglutinin genes H1, H1-2009 and H3)
- Influenza B
- Human Metapneumovirus
- Parainfluenza Virus 1
- Parainfluenza Virus 2
- Parainfluenza Virus 3
- Parainfluenza Virus 4
- Respiratory Synctial Virus
- Bortadella pertussis
- Chlamydophila pneumoniae
- Mycoplasma pneumoniae
Testing summary is as follows:
||FilmArray™ Respiratory Panel (RP)
||Nasophyarynegeal (NP) swab specimen should be collected according to standard
technique and immediately placed in viral transport media (VTM)
||0.3 mL of Nasopharyngeal Swab collected and placed in viral transport media (VTM).
|Ordering in Cerner
||Respiratory Panel by PCRFilmArray
Testing performed: 0700 - 20:00 daily
Results from graveyard set up will be reported by 0700 daily
|Result Turn-Around Time
||1.5 hour (completion of panel)
Effective immediately, Hemoglobin Electrophoresis and Direct Measurement
LDL will be sent to Reference Lab ARUP. The Lipid Panel contains Total
Cholesterol, Triglycerides, Direct Measurement HDL, Calculated LDL and VLDL.
Message from Dr. Henry D. Slosser on Testing of Uncommon Organisms
To ensure quality patient care, uncommon organisms which are not routinely
identified and tested for susceptibility will be sent immediately to a
referral lab. The ordering physician will be notified of the isolate being
sent out along with an expected turn-around time for results.
We describe here a recent case which supports our hospital’s laboratory
policy on the testing of uncommon organisms.
SV is a morbidly obese 62 year old female who presented with sepsis secondary
to possible community-acquired pneumonia and left lower extremity cellulitis.
Two sets of blood cultures grew gram positive bacilli which was later
identified as Corynebacteriumamycolatum/striatum and initially reported
to be sensitive to penicillin but subsequently changed to resistant to
penicillin upon further evaluation of results. Concerns regarding the
penicillin susceptibility results prompted a request for repeat speciation
and susceptibility testing to be performed at a referral laboratory. Results
were available after 3 and 5 days respectively. In contrast to in-house
results, the species identified at the referral laboratory was Corynebacterium
striatum/simulans with a higher level of resistance to penicillin and
ceftriaxone than was reported in-house.
Corynebacterium spp. is a common colonizer of the skin and mucous membranes
and rarely causes invasive infection. Thus, speciation of the organism
and susceptibility testing is not routinely performed in house. The discrepancy
in speciation and susceptibility results between the in-house laboratory
and the referral laboratory illustrated in this case has the potential
to negatively affect treatment outcome. Thus, our current policy of sending
test requests for uncommon organisms immediately to a referral laboratory
helps to ensure timely reporting of reliable results to guide appropriate
Message from Dr. Henry D. Slosser on ordering Ketones
Due to the continuing nation-wide production problems with the Acetest
tablets used for ketone body testing, we are again unable to perform the
test. In order to provide a test that measures ketones, we will temporarily
send the specimens to ARUP for quantitative beta-hydroxybutyric acid testing.
- Specimen requirements
- How you place the order for ketones
- The order for ketones will be mapped to beta-hydroxybutyric acid, and sent to ARUP.
- Turn-around time will be 1-3 days.
- To view results in EMR, you’ll need to access the Chemistry group
of Laboratory Tests, and select Beta-Hydroxybutyric Acid. The reports
will include an explanatory comment.
You also have to option of ordering beta-hydroxybutyric acid directly.
If you have any questions or concerns, please contact Karen Watkins (Manager,
Clinical Laboratory, x5780), or Kiem Injo (Hematology Lead CLS, x5720).
Bone Marrow Microbiology Culture
For consideration of bacterial, fungal or mycobacterial cultures, bone
marrow will be processed as “blood” and placed into the Bactec
blood culture vials. The blood cultures vials will support the growth
and detection of most entities that could be associated with infection
in bone marrow (Brucella, Cryptococcus neoformans, Histoplasma capsulatum,
Requesting a bone marrow culture without specific indication is discouraged.
Laboratory Orderable Test Index