Rubella Virus IgG Antibody Titer

CERNER / EPIC MNEMONIC: RUB IGG
POE DESCRIPTION: RUBELLA VIRUS IGG AB TITER; RUBELLA IGG; RUB IGG
CPT CODE:

86762-90

TURNAROUND TIME:

 5-7 working days

CONTAINER TYPE:

 Red top tube - 4 mL or SST Tube

SPECIMEN REQUIREMENTS:

 2.0 mL blood (1.0 mL serum)

REJECTION CRITERIA:

Grossly hemolyzed, grossly lipemia

MINIMUM VOLUME:

 0.5 mL blood (0.1 mL serum)

REFERENCE RANGE:

See Quest Diagnostics - Search Test Code 802

TEST SYNONYM(S):Rubella Antibody Screen

RPR

CERNER / EPIC MNEMONIC: RPR
POE DESCRIPTION: RPR
CPT CODE:

86592

DAYS PERFORMED: Routine and Stats: Performed once daily on first and second shift.
TURNAROUND TIME: 1 day
CONTAINER TYPE:

Red top tube - 4 mL or SST

SPECIMEN REQUIREMENTS:

4 mL blood (2 mL serum)

REJECTION CRITERIA: Any hemolysis, chylous serum.
MINIMUM VOLUME: 2 mL blood (1 mL serum)
REFERENCE RANGE: Nonreactive
LIMITATIONS OF TEST: Positive tests are considered to be presumptive evidence of syphilis. The titer will fall over 6-8 months if the disease is adequately treated. Due to the nonspecificity of the test, false positives (FP`s) may occur. However, all reactive sera are confirmed by performing an MHA-TP test. FP`s of less than 6 months duration occur with measles, chickenpox, viral pneumonia, upper respiratory infections, pregnancy, and after receipt of a smallpox vaccination. Usually reactivity disappears spontaneously within a few days or weeks. Chronic FP`s (over 6 months) can be associated with SLE, metastatic carcinoma, rheumatoid arthritis, serum protein abnormalities, rheumatoid factors, and narcotic addiction. Reactive tests due to related treponemal infections will also occur. A falsely negative test can sometimes be seen because of a prozone effect (1-2% of patients with secondary syphilis). In late syphilis, the RPR may be nonreactive in 20-30% of cases. In suspected cases of late syphilis, the MHA-TP should be requested.
METHODOLOGY: Nontreponemal agglutination screening test
ADDITIONAL INFORMATION: In untreated syphilis, reactive sera are found in the chancre stage, 70% after 1 week, and 90% after 3 weeks. In the secondary stage, the RPR should be reactive 100% of the time, decreasing to 90% in the tertiary stage. In the latent stage and a month to 2 years after successful treatment, the RPR may become nonreactive. The titer of antibody will vary from patient to patient; there is no direct relationship between the amount of reagin and the severity of disease. All specimens determined to be reactive will be confirmed by MHA-TP testing. Patients from whom reactive results are obtained are reported to the City of Chicago Board of Health. This is mandated by law.
TEST SYNONYM(S):Rapid Plasma Reagin Test; Syphilis Screening Test

Rubella Virus IgM Antibody Titer

CERNER / EPIC MNEMONIC: RUB IGM
POE DESCRIPTION: RUBELLA VIRUS IGM AB TITER; RUBELLA IGM; RUB IGM
CPT CODE: 86762
DAYS PERFORMED: Monday-Friday
TURNAROUND TIME: 1-7 days
CONTAINER TYPE: Red top Vacutainer® tube or SSTTM tube
SPECIMEN REQUIREMENTS: Blood (serum)
REJECTION CRITERIA: Excessive hemolysis, gross contamination of specimen, chylous serum, improper storage of specimen, inappropriate specimen container, insufficient specimen volume.
MINIMUM VOLUME: 5 mL blood (1 mL serum)
HANDLING INSTRUCTIONS: Specimen should be transported as soon as possible. When transportation is delayed, refrigerate.
REFERENCE RANGE: No Rubella IgM antibody detected
METHODOLOGY: Enzyme-linked immunosorbant assay (ELISA)
REFERRAL LABORATORY: Commercial Laboratory
ADDITIONAL INFORMATION: This test is used as an aid in the diagnosis of acute Rubella infection in all patients including neonates. Confirmation of primary Rubella virus infection can be made from a single serum specimen. IgM antibody is present in neonatal serum following congenital infection and increases during the period from birth to 6 months of age. Detection of Rubella specific IgM indicates active infection or recent exposure. Active or recent infection is also demonstrated by a four-fold or greater increase in IgG titer between acute and convalescent sera.

Rapid Helicobacter pylori Urease Test

CERNER / EPIC MNEMONIC: C HPYLORI
POE DESCRIPTION: CU HELICOBACTER PYLORI UREASE
CPT CODE: 87081
TEST INFORMATION: The test detects urease enzyme activity in gastric mucosal biopsy specimens which is usually indicative of the presence of Helicobacter pylori.
DAYS PERFORMED: Daily, 24 hours
TURNAROUND TIME: 2 hours, if test is positive at the time of receipt in the laboratory. Final reports will be issued 24 hours after receipt of the specimen in the laboratory.
CONTAINER TYPE: Selective Rapid Urea medium (available from the Clinical Microbiology Laboratory); sealed sterile container.
SPECIMEN REQUIREMENTS: Gastric mucosal biopsies either inserted in the Selective Rapid Urea medium or transported in sterile saline.
REJECTION CRITERIA:

Inappropriate specimen container, expired Selective Rapid Urea medium, mislabeled/unlabeled specimen.

HANDLING INSTRUCTIONS: Specimen should be transported as soon as possible. When transportation is delayed, leave at room temperature.
REFERENCE RANGE: No Helicobacter pylori detected
LIMITATIONS OF TEST: An improperly transported specimen may not yield an accurate result. A false positive reaction could result should the medium become contaminated with an alternative urease-producing microorganism. A false negative reaction could result from an insufficient number of microorganisms present in the biopsy material.
METHODOLOGY: Urease reaction in conventional culture medium.
LAST UPDATED:

5-19-2014

TEST SYNONYM(S):CLOtest

Respiratory Virus PCR

CERNER / EPIC MNEMONIC:

RESVIRPCR

CPT CODE:

83900, 83901 x 6

TEST INFORMATION:

This test is used to detect the presence of RNA from Influenza A, Influenza B, Respiratory Syncytial Virus, Parainfluenza viruses 1, 2, 3 and 4, Adenovirus, Entero/Rhino Virus and Human Metapneumo Virus.

DAYS PERFORMED:

Monday through Saturday during  respiratory virus infection season

TURNAROUND TIME:

24- 48 hours

SPECIAL INSTRUCTIONS:

Specimen must be received by the Clinical Microbiology Laboratory no later than 6:00am on the day of testing for same day result.

CONTAINER TYPE:

Nasopharyngeal swabs and throat swabs should be placed in M4 viral transport media.  Nasopharyngeal aspirates, nasopharyngeal washes, or bronchoalveolar lavage should be placed in a sterile container.

SPECIMEN REQUIREMENTS:

Nasopharyngeal swab, nasopharyngeal aspirate, nasopharyngeal washes

REJECTION CRITERIA:

Inappropriate specimen, improper collection, inappropriate specimen container, improper storage, unlabeled specimen, mislabeled specimen.

MINIMUM VOLUME:

1 ml

HANDLING INSTRUCTIONS:

Specimens should be transported to the laboratory as soon as possible.  When transportation is delayed, refrigerate the specimen

REFERENCE RANGE:

This assay will be reported as 'RNA detected', 'No RNA detected' for each viral target.

LIMITATIONS OF TEST:

A negative result does not exlude the possibility of respiratory virus infection since very low levels of infection or sampling error may cause a false negative result.  The assay does not detect respiratory viruses other than those listed above.

METHODOLOGY:

Polymerase Chain Reaction with detection by Luminex technology

LAST UPDATED:

6-3-2014

Respiratory Syncytial Virus and Antigen

CERNER / EPIC MNEMONIC:

RSV AG

POE DESCRIPTION: RSV ANTIGEN DETECTION
CPT CODE: 87420; 87252
CDM NUMBER:

 

TEST INFORMATION:

The test includes a direct screening test for RSV antigen.

DAYS PERFORMED:

Daily; RSV Ag performed during respiratory viral season

TURNAROUND TIME:

1 day

CONTAINER TYPE: Viral transport medium
COLLECTION:

Introduce 3-7 cc sterile saline into the patient''''s posterior nasal cavity and immediately aspirate the fluid via vacuum suction and Leuken''''s trap. Specimens must then be placed into the viral transport medium (available from the Clinical Microbiology Laboratory).

SPECIMEN REQUIREMENTS: Nasopharyngeal washes and secretions
REJECTION CRITERIA: Inappropriate specimen container, specimen NOT submitted in viral transport medium, specimen NOT refrigerated during transport, excessive delay in transport.
MINIMUM VOLUME: 1 mL
HANDLING INSTRUCTIONS: Specimen should be transported as soon as possible. When transportation is delayed, refrigerate. Keep specimen cold and moist. Do NOT freeze specimen.
REFERENCE RANGE:

No RSV antigen detected

LIMITATIONS OF TEST: Respiratory syncytial virus is extremely labile.
METHODOLOGY:

Direct antigen detection: chromatographic immunoassay

LAST UPDATED:

6-3-2014

TEST SYNONYM(S):Rapid RSV Ag; Respiratory Synctial Virus Antigen

Rotavirus Antigen

CERNER / EPIC MNEMONIC: ROTAVIR AG
POE DESCRIPTION: ROTAVIRUS ANTIGEN
CPT CODE: 87425
DAYS PERFORMED: Daily
TURNAROUND TIME:

1 day

CONTAINER TYPE: Sealed plastic feces container, no preservative; sealed sterile or nonsterile clean container
COLLECTION: Liquid stool is the preferred specimen.
SPECIMEN REQUIREMENTS: Fresh stool
REJECTION CRITERIA: Specimen on outside of container, inappropriate specimen, specimen submitted in a preservative, specimen contaminated with water and/or urine, inappropriate specimen container, specimen submitted on a diaper or tissue paper, insufficient specimen volume, specimen containing interfering substances (i.e. castor oil, bismuth, Metamucil?, barium). Only one specimen will be accepted per day unless purged samples are required to be submitted.
MINIMUM VOLUME: 1 mL liquid stool
HANDLING INSTRUCTIONS: Specimen should be transported as soon as possible. When transportation is delayed, refrigerate.
REFERENCE RANGE: No Rotavirus antigen detected
LIMITATIONS OF TEST: The test result is reported as negative or positive only; quantitation is NOT provided.
METHODOLOGY:

Chromatographic immunoassay

ADDITIONAL INFORMATION:

If the specimen yields an initial negative result, repeat testing may be warranted if the patients` condition is consistent with infection. Submit the repeat specimen 24 hours after the initial submission.

LAST UPDATED:

6-3-2014

TEST SYNONYM(S):Rotavirus Antigen Screen; Rotavirus EIA