University of Virginia Health System

Medical Laboratories

“Quality You Expect, Service You Deserve”

LABORATORY MEDICINE UPDATE

April 4, 2005

Swabs for Anaerobic Cultures

Anaerobic culture of tissue, sterile body fluids and aspirates collected from a site of infection provides a much higher yield of clinically useful information than anaerobic culture of swabs taken from these sites.  Therefore, as of June 1, 2005 , swabs will no longer be accepted for anaerobic culture.  When considering patient outcomes, swabs are substandard specimens because they sample only a limited portion of the infected area and are a significant source of culture contamination with surrounding flora.  As such, they decrease the utility of culture results and may lead to inappropriate antimicrobial therapy when contaminants are reported.  In addition, the anaerobic transport system currently in use is glass and subject to breakage in the pneumatic tube system, compromising the integrity of the specimen and posing a risk to staff.   The appropriate materials to submit for culture when anaerobes are suspected as a cause of infection are as follows: 

1.  Aspirates: should be submitted in a sterile black top tube (preferred), or a capped syringe from which the needle has been removed.
2.  Sterile body fluids: preferably in sterile black top tubes. 
3.   Tissue: submitted in a sterile urine cup. 

When an anaerobic culture is ordered, a gram stain and culture for aerobic organisms is automatically performed. 

Beginning April 1, 2005 , the following comments will be attached to culture results from specimens submitted on swabs: 

“Specimen received on swab.  Results may not be reliable.  For maximum sensitivity submit, tissue, fluid or needle aspirate”

and

“Swabs of sterile body fluids, tissues and wounds will no longer be accepted for anaerobic culture beginning June 1, 2005 .”

Allergy Testing (RAST Testing)

The Davis Laboratory began performing Allergy Testing (RAST Testing) using the Pharmacia UniCap system on March 24, 2005 .  Working with UVa allergists, the following panels have been developed to test for the most common allergens and, where applicable, local flora and fauna.

In addition to these panels, individual allergens may be ordered, with the following available in the Davis Laboratory.  Additional allergens are also available and should be written on the outpatient test request form.

Results will be reported in kU/L with the reference interval of <0.35 kU/L.  The following table demonstrates the interpretation of results:

Laboratory Relocation Update

The Anatomic Pathology Laboratories will be moving to the third floor of the Hospital Expansion Building at the end of April.  This relocation will consolidate Cytology, Special Tissues and Surgical Pathology laboratories and will relocate all medical staff offices now located in the Old Medical School building.  Electron Microscopy and Surgical Pathology East will remain in their present locations.

The consolidation of Anatomic Pathology provides the labs with an opportunity to improve specimen processing and introduce automation for improved efficiency of workflow and staffing.  The new location will also allow for more effective interaction with the staff, residents, fellows and faculty.

Autopsy Services will relocate to the ground level of the Hospital Expansion Building and includes an additional autopsy room designed for infectious disease cases.  This new suite prevents the need to shut down services for 24 hours for decontamination due to suspected prion diseases.   

All phone numbers and contacts for these services will remain the same. 

The move date for the Core Lab, Microbiology, and Molecular Diagnostics Laboratory has been postponed due to construction delays.  We are now looking at mid-May as the earliest time we will be able to move operations over to the new site. 

Nonetheless, there is much activity going on to prepare for the move.  The building itself is nearing completion, with the flooring being laid and the cabinetry being installed. The construction crew is working closely with the railroad and boring company to complete installation of the pneumatic tube system that will connect the laboratory building to the main hospital.  A firm relocation date cannot be set until the tube system is installed and tested. 

Plans are also underway to enhance lab services as we prepare for the move to the new site, including: implementation of a combined Chemistry Immunoassay platform that will improve turnaround times for most STAT and routine chemistry testing.  Hemoglobin A1c will also be added to the Core Laboratory menu.  We continue to look for opportunities that improve test availability as we introduce new technology and consolidate services. 

We sincerely appreciate everyone’s patience and support throughout the planning and construction process and we will continue to issue updates as they are received.  

For additional information or questions regarding any of the upcoming relocation please contact Cavell Kopetzky in Medical Laboratories Administration at 434-243-2649 (email: cak3w@virginia.edu).