Dear Healthcare Provider,
The information contained here may be very important to your practice. Please take a moment to review this document.
Antinuclear Antibody Testing Panel Updates
September 15, 2020
Alverno Laboratories is pleased to offer new Antinuclear Antibody testing panels, as well as updated report formatting for the existing testing panels. The changes reflect input from our clinicians and review of current guidelines with a goal to increase transparency of test method and reflex testing. Please see page 2 for details.
Change in Urine Culture Organism Identification Protocol
September 2020
The Central Laboratory Microbiology Department will no longer differentiate E. coli from Shigella species for non-lactose fermenting gram negative rods identified by the MALDI-TOF system in urinary isolates. If clinically indicated, confirmatory testing can be requested by calling the Central Laboratory Microbiology Department. Please see page 3 for details.
BTNP Specimen Handling Update
September 2020
Due to the short stability of the BTNP analyte, Alverno Laboratories requires plasma only for all specimens transported to the Central Lab. Please separate EDTA samples within 7 hours of collection and send the refrigerated plasma aliquots. The Central Lab will no longer accept whole blood specimens. Please refer to Alverno’s Collection Manual for all specimen handling instructions
Supply Ordering
September 2020
Effective October 1, 2020, the link to the printable order form will no longer appear on Alverno’s website. The online order form will need to be utilized to place supply orders moving forward.
Antinuclear Antibody Testing Panel Updates
September 15, 2020
Alverno Laboratories is pleased to offer new Antinuclear Antibody testing panels, as well as updated report formatting for the existing testing panels. The changes reflect input from our clinicians and review of current guidelines with a goal to increase transparency of test method and reflex testing. Antinuclear Antibody (ANA) testing will be offered via two different methodologies: Multiplex Flow Immunoassay (“bead-based” testing or Bio-Plex®) or Immunofluorescence Assay (IFA) using HEp-2 cells.
Three options are available using the Multiplex Flow Immunoassay: 1) a display of antigens only if one of the tested beads exceeds an instrument-defined cutoff, 2) a display of antigen titers irrespective of the cutoff of the individual antigen bead results, and 3) a new panel that will focus on the display of antigens specific to the diagnosis of Scleroderma.
Two options are available using the IFA method: 1) IFA alone with standard titer and pattern reporting or 2) IFA with a reflex to Multiplex Flow Immunoassay for a titer ≥ 1:80.
Per guidelines, ANA testing is intended for diagnostic use only, is of limited clinical utility in monitoring disease course and must be correlated with the clinical presentation.
Change in Urine Culture Organism Identification Protocol
September 2020
The Central Laboratory Microbiology Department will no longer differentiate E. coli from Shigella species for non-lactose fermenting gram negative rods identified by the MALDI-TOF system in urinary isolates.
If clinically indicated, confirmatory testing can be requested by calling the Central Laboratory Microbiology Department.
The Bruker MALDI-TOF system utilized for primary identification methods cannot differentiate E. coli from Shigella species.
Conventional overnight identification panels are required to confirm isolate identification of non-lactose fermenting gram negative rods identified by the MALDI-TOF system as E. coli/Shigella species.
E. coli is the most common cause of urinary tract infections.
Therefore, the College of American Pathologists (CAP) recommends that clinical laboratories do not routinely need to differentiate Shigella species from E. coli in urinary isolates, unless prompted to do so by the clinical team managing a patient with the following risk factors:
- Urinary tract infections occurring via ascending retrograde transmission from the gastrointestinal tract of colonized or symptomatic patients
- Urinary tract infections secondary to bacteremia in neonates
- Malnourished children
- Immunosuppressed (AIDS) patients