First quarter 2024. The Lab Medicine Update is a collaboration between the UVA Medical Laboratories and the UVA Clinical Laboratory Stewardship Subcommittee. Feedback on the LMU? Contact Jim Harrison (james.harrison@virginia.edu).
Chlamydia/Gonorrhea PCR 24 hr TAT for Labor & Delivery patients ↑
Because of a shortage of erythromycin ointment used for neonates, the Clinical Microbiology laboratory has implemented a new PCR test for Chlamydia and Gonorrhea with a reduced turn-around time (24hrs). This testing is currently available ONLY for the Labor and Delivery unit, and requires a different collection device. The new testing and collection devices will be rolled out to other areas of UVA Health over the next 4 months. Detailed instructions for specimen submission from L&D are available.
New Mayo sendout test for CMV resistance ↑
A new test for CMV resistance, "CMV Resistance: Ganciclovir, Foscarnet, Cidofovir" with the Mayo test code JFCMVR is available to order from the Epic menu and replaces the previous test "CMV Drug Resistance, Next Generation Sequencing." The new test is expected to improve turnaround times.
Clinical flow cytometry laboratory update ↑
The clinical flow cytometry laboratory will transition to new flow cytometry instruments and panels for leukemia/lymphoma assays (Flow Cytometry Immunophenotyping, LAB2554) on Monday, February 26, 2024. This change will improve the efficiency of the clinical flow laboratory and will position us for future transition to more sophisticated flow cytometry analyses. You will see changes in the formatting of the flow cytometry summary section of the flow cytometry reports and minor changes in the panel of antigens evaluated. The test name/number and ordering process remain the same (specimen source and clinical history requested at time of order). Please reach out to Elizabeth Courville (Medical Director of the Clinical Flow Cytometry Laboratory) if you have questions or concerns.
Foundation Medicine tests now orderable in Epic ↑
Tests from the Foundation Medicine referral laboratory have been integrated into the UVA Epic orderables list. The tests can be selected and ordered within Epic; a portal order is no longer required. Results will report into Epic when complete. A Tip Sheet is available on how to correctly place a Foundation Medicine Epic order.
New online referral test request form available ↑
An online form for submitting requests for review and approval of new "send-out" tests and reference laboratories is now available on the UVA Medical Laboratory Web site. UVA LIPs may use the form to request new reference testing or referral laboratories. The contents of the form are submitted to the Medical Laboratory and the Laboratory Stewardship Committee for review. This form should be used to request tests prior to use in patients. Questions related to the immediate or emergent use of non-approved tests for specific patients should not use this form and should be addressed to the Medical Laboratory leadership or on-call pathologists. The form is available under the "Laboratory Tests" tab, "Referral Lab Testing," "New Sendout Test or Referral Lab Request Form." It includes instructions for completion and submission.
Standardization of LDL-c calculation ↑
On January 3rd, 2024, the calculation for low-density lipoprotein cholesterol (LDL-c) will be changed to standardize calculation across the UVA Health System. After this change, the calculation for LDL-c on lipid panels will match across UVA University Hospital and Prince William, Haymarket, and Culpeper hospitals. This change is part of the ongoing effort to standardize test results across the UVA Health System to provide the same care no matter where the patient engages with us. The LDL-c equation will match the most common equation used, the Friedewald equation, which calculates LDL-c as LDL-c = Total-c – HDL-c – Triglycerides/5.
Fentanyl added to urine drug screen testing ↑
In consultation with the Medical Toxicology service and the department of Pathology, the Toxicology Laboratory is adding Fentanyl to the following urine drug screens:
- Drugs of Abuse Modified (LAB2020)
- Drugs of Abuse Full (LAB677)
- Urine Contract Med Screen (LAB3701)
The screening assay is calibrated to detect fentanyl when the quantitation is >1.0 ng/mL and should detect synthetic analogs of fentanyl. Any urine sample that screens positive for fentanyl will be reflexed to Fentanyl Confirmation (LAB6241) for an additional charge. Please contact Lindsay Bazydlo, Ph.D., director of the laboratory if you have any questions at LAL2S@uvahealth.org.
Anti-Fungal Drug testing schedule update ↑
The Toxicology Laboratory will increase Anti-Fungal Drug testing (Itraconazole, Posaconazole, Voriconazole) to twice weekly on Monday and Thursday. Samples need to be in the laboratory by 9:00 am for same-day testing. Samples received after 9 am will be analyzed on the next day of testing.