Laboratory Medicine Updates - 1/31/2001
University of Virginia Health System
"Quality You Expect, Service You Deserve"
LABORATORY MEDICINE UPDATE
January 31, 2001
Change In Blood Culture Bottles
Beginning in February or March, 2001, the company who supplies blood culture bottles will be replacing them with bottles containing a new generation of media. The actual replacement date is dependent on the existing bottle inventory. The color of the bottles will change and will be evident as follows:
The aerobic blood culture bottle, formerly a gray bottle, will change to blue. It will have a blue top and label and will be labeled SA Aerobic Bottle.
The anaerobic bottle, formerly a purple bottle, will change to a slightly different shade of purple. The bottle will be labeled SN Anaerobic Bottle.
These bottles will be available from the hospital storeroom and will not require any change in the way they are currently ordered or used.
Rapid test for Influenza A & B
The laboratory will begin testing for Influenza A & B by an enzyme immunoassay in the next few weeks. When a virus culture screen for Influenza A & B is ordered during "flu season" (November 1 through March 31), the laboratory will perform the rapid antigen screen for Influenza A & B. If the rapid tests are negative, a culture will be performed.
Arrangements are now being made to establish the test in the ordering pathways and an announcement of when it is actually available will be distributed as soon as it is available.
Cryptococcal Antigen Test
The MIS pathway for ordering and / or viewing results for the Cryptococcal Antigen Test has changed. Now, you must enter the Microbiology pathway and then select the appropriate specimen type. Although spinal fluid is the optimum specimen for suspected meningitis, blood is acceptable.
MIS PATHWAY ADDITIONS
In addition to gastric fluids, MIS ordering pathways have been added to order pH on ileostomy and miscellaneous fluids. These pathways can be found under "non-blood", "non-urine" specimen types.
NEW 7 ML PINK TOP PLASTIC TUBE FOR BLOOD BANK
A new 7 mL plastic blood collection tube has been approved for Blood Bank specimens. It will available the week of February 5, 2001. The new tube has a PINK top and contains a slightly different formula of EDTA than does the traditional purple top tube. This new tube should be used for submitting specimens to the Blood Bank. Although a new 3 mL plastic lavender top tube is being introduced at the same time, only the 7 mL pink top tube is appropriate for Blood Bank orders, as this much whole blood is typically required to complete the requested testing.
The introduction of these new pink top tubes does not change the current BB labeling requirements.
NEW 3 ML LAVENDER TOP PLASTIC TUBE
A new 3 mL lavender top plastic blood collection tube will be available the week of February 5, 2001. This tube will replace the 3 mL lavender top glass tube currently in use. Continue using the 3 mL glass tube until all supplies are exhausted.
THINPREP PAP TEST NOW AVAILABLE
The UVA Cytology Laboratory is pleased to announce the availability of the ThinPrep Pap test to all clinicians. The ThinPrep Pap Test is a liquid-based methodology that can serve as a replacement for the conventional Pap smear in screening for abnormalities of the uterine cervix. It can reduce or eliminate many of the technical limitations of the conventional Pap smear, such as poor fixation, mechanical distortion, and excess blood/ inflammation. Studies have also shown increased detection rates for cervical abnormalities (LGSIL, HGSIL) when using this technology.
The clinical implementation of the ThinPrep Pap Test requires unique collection materials and a short instructional session on collection methods. The cellular sample is taken from the cervix/endocervix or vagina and placed directly into a preservative solution. The slides are then prepared in the laboratory using a special processing instrument. Clinicians will no longer need to make direct smears.
The ThinPrep Pap Test has an increased cost over the conventional Pap smear, primarily due to the expense of the collection/processing kits. However, most major insurance providers, including QualChoice, Blue Cross/Blue Shield and Medicare, have recognized the benefits of the thin prep test and have agreed to offer appropriate reimbursement.
For additional information on this new service, on obtaining supplies or on arranging instructional sessions, contact our Customer Service Department at 924-LABS (434-924-5227).
CHRONIC GRANULOMATOUS DISEASE SCREENING
The Medical Laboratories now offer a new screening assay for Chronic Granulomatous Disease. This new assay, performed by flow cytometry, replaces the Nitroblue tetrazolium assay. The test requires one lavender top tube containing EDTA. The specimen must be sent to the laboratory STAT. The test is orderable in MIS for inpatients. Outpatient requests can be submitted on a Clinical Pathology Laboratory Request Form. A neutrophil oxidative burst index of 30 or greater is considered to be normal.
ALTERNATIVE PRIMIDONE TESTING
Reagents for the measuring Primidone are not available from Abbott Laboratories until further notice. Consequently, all requests for Primidone and Primidone/Phenobarbital analysis will be sent to American Medical Laboratories, our reference laboratory. Result turnaround time is two days Monday through Friday.
FRACTIONATED BILE ACID ASSAY NOT AVAILABLE
Due to a national shortage of reagents required for the Fractionated Bile Acid Assay, this test will not be available until further notice.