Laboratory Medicine Updates - April 4, 2005

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.

Test Name

Code

Components

 

Test Name

Code

Components

Drug Allergen Panel

DRUG

Penicilloyl G

 

Mold Allergen Panel

MOLDR

P. notatum

Penicilloyl V

 

C Herbarum

Ampicilloyl

 

T rubrum

Amoxicilloyl

 

A fumigatus

Adult Food Allergen Panel

FOODA

Egg

 

Candida albicans

Peanut

 

A alternata

Soybean

 

H halodes

Milk

 

Nut Allergen Panel

NUT

Peanut

Carrot

 

Hazel Nut

Wheat

 

Brazil Nut

Pediatric Food Allegen Panel

FOODP

Egg

 

Almond

Peanut

 

Pecan Nut

Soybean

 

Cashew Nut

Milk

 

Pistachio

Wheat

 

Pine Nut

Grass Allergen Panel

GRASS

Bermuda Grass

 

Walnut

Timothy Grass

 

Coconut

Indoor Allergen Panel

INDOOR

D pteronyssinus

 

Pollen Allergen panel

POLLEN

Swt Vernal Grass

D. farinae

 

Bermuda Grass

Cat Dander

 

Cocksfoot

Dog Dander

 

Maple/Box-Elder

Cockroach

 

Pecan / Hickory

Meat Allergen Panel

MEAT

Pork

 

Birch

Beef

 

Mt Juniper/Cedar

Turkey

 

Oak

Chicken

 

Lamb's Quarters

Mini Allergen Screen Panel

MINI

D pteronyssinus

 

Common Pigweed

D. farinae

 

Sheep Sorrel

Cat Dander

 

Giant Ragweed

Dog Dander

 

False Ragweed

Bermuda Grass

 

Mugwort

Timothy Grass

 

English Plantain

Cockroach

 

Tree Allergen Panel

TREE

Maple/Box-Elder

A alternata

 

Sycamore

Pecan / Hickory

 

Cottonwood

Oak

 

White Ash

Elm

 

Pecan / Hickory

Common Ragweed

 

Birch

English Plantain

 

Mt Juniper/Cedar

Weed Allergen Panel

WEED

Common Ragweed

 

Oak

Lamb's Quarters

 

Elm

Common Pigweed

 

 

 

 

Sheep Sorrel

 

 

 

 

Mugwort

 

 

 

 

English Plantain

 

 

 

 

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.

 

Alphabetical by Test Name

TEST NAME

Code

 

TEST NAME

Code

 

TEST NAME

Code

A alternata

AM6

 

D pteronyssinus

AD1

 

Pecan / Hickory

AT22

A fumigatus

AM3

 

D. farinae

AD2

 

Pecan Nut

AF201

Almond

AF20

 

Dog Dander

AE5

 

Penicilloyl G

AC1

Amoxicilloyl

AC6

 

Egg

AF1

 

Penicilloyl V

AC2

Ampicilloyl

AC5

 

Elm

AT8

 

Pine Nut

AF253

Banana

AF92

 

English Plantain

AW9

 

Pistachio

AF203

Barley

AF6

 

False Ragweed

AW4

 

Pork

AF26

Beef

AF27

 

Giant Ragweed

AW3

 

Potato

AF35

Bermuda Grass

AG2

 

Green Beans

AF315

 

Rice

AF9

Birch

AT3

 

H halodes

AM8

 

Rye

AF5

Brazil Nut

AF18

 

Hazel Nut

AF17

 

Salmon

AF41

C Herbarum

AM2

 

Honey Bee

AI7

 

Scallop

AF338

Candida albicans

AM5

 

Lamb's Quarters

AW10

 

Sheep Sorrel

AW18

Carrot

AF31

 

Latex

AK82

 

Shrimp

AF24

Cashew Nut

AF202

 

Lentils

AF235

 

Soybean

AF14

Cat Dander

AE1

 

Lobster

AF80

 

Strawberry

AF44

Chicken

AF83

 

Maize

AF8

 

Sunflower

AW204

Clams

AF207

 

Maple/Box-Elder

AT1

 

Swt Vernal Grass

AG1

Cockroach

AI6

 

Milk

AF2

 

Sycamore

AT11

Cocksfoot

AG3

 

Mt Juniper/Cedar

AT6

 

T rubrum

AM205

Coconut

AF36

 

Mugwort

AW6

 

Timothy Grass

AG6

Codfish

AF3

 

Oak

AT7

 

Tomato

AF25

Common Pigweed

AW14

 

Oat

AF7

 

Tuna

AF40

Common Ragweed

AW1

 

Oyster

AF290

 

Turkey

AF284

Common Wasp

AI3

 

P notatum

AM1

 

Walnut

AF256

Cottonwood

AT14

 

Paper Wasp

AI4

 

Wh Face Hornet

AI2

Crabs

AF23

 

Pea

AF12

 

Wheat

AF4

Cranberry

AF341

 

Peanut

AF13

 

White Ash

AT15

 

 

 

 

 

 

Yellow Hornet

AI5

 

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

 

Quantitative Results
( kU/L)

Level of Allergen Specific Antibody

Semi-Quantitative Results
(Specific IgE Class)

< 0.35

Absent or undetectable

0

0.35 to < 0.7

Low

1

0.7 to < 3.5

Moderate

2

3.5 to < 17.5

High

3

17.5 to < 50

Very high

4

50 to < 100

Very high

5

100 and larger

Very high

6

 

 

 

 

 

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).