INTRODUCTION
The Microbial Immunology Unit performs infectious disease serology. Various serologic procedures are performed for a variety of bacterial, parasitic, and viral agents except for HIV. HIV (Human Immunodeficiency Virus) is performed in the Virology Unit. Hepatitis serology is only performed for county health departments and Georgia Department of Public Health agencies. Tests not performed in the Public Health Laboratory can be forwarded to CDC, if the submitter requests the testing.
SPECIMEN COLLECTION/LABELING/REQUISITION FORM
Collection Using Universal Precautions, and standard venipuncture technique, collect approximately six milliliters of whole blood (for serum) in a red top tube (no additive), labeled with patient’s identifier (name, first and last, or number), data, and name of the submitter. Use a marker that will not fade, smear, or run during transportation. Use proper size needle (large enough to prevent hemolysis of the red blood cells) for the vein location and age of the patient. Allow blood specimen to clot, at least 30 minutes undisturbed, at room temperature, and transport, or place in the refrigerator for transporting. Collect blood specimens in, or transfer them to, non-breakable, leak resistant tubes. Specimens should be transported as soon as possible, do not hold over 7 days. Specimens over 14 days old are unacceptable. Many of the procedures we perform are not approved for use with plasma. Therefore, please submit only serum or whole blood without anticoagulants, not plasma.
Collect cerebrospinal fluids (CSF) according to proper hospital procedure. CSF contaminated with blood or grossly contaminated with bacteria is unacceptable.
Labeling All specimens must be labeledwith patient identification (name or number), in acceptable testing condition, and accompanied by a completed requisition form. If the form is not specific for one test or a set of tests, the specific testing requested must be hand- written in the proper area, e.g., “viral serology” is not acceptable, the specific agent, e.g., “CMV”, must be clearly requested. Failure to provide proper patient information may result in testing delays.
Requisition Form:
UseForm #3583 for all tests performed by the Microbial Immunology Unit. There is a single requisition form for all tests performed in the Georgia Public Health Laboratory. Hepatitis B
testing is performed for the (Department of Public Health facilities and county health departments only). Completely fill out the form and include the following information:
1. Unique patient identifier (name or number).
2. TEST(S) REQUESTED (Please check only the corresponding box for
test(s) requested). 3. Date specimen collected.
4. Submitter’s name, address and code number, where applicable. 5. For hepatitis the reason for testing, e.g., routine, or prenatal.
6. Any information the submitter needs for patient identification, e.g., chart number, address.
7. The date of onset of illness, if applicable.
8. Race, sex, and age, where applicable, e.g., hepatitis testing.
SHIPMENTOF SPECIMENS
Use outfit #0500, available from Laboratory Services and Supply, 404-327-7920, and follow the specific instructions below. For HCV Viral Load testing please use outfit 502.
Routine specimens may be mailed at room temperatures overnight or delivered cold to the laboratory by courier. HCV Viral Load should be sent frozen by overnight courier.
Shipping Instructions for USPS and Couriers:
Place the tubes of blood in protective, leak resistant, doubled-walled containers, e.g., aluminum and cardboard box, for transport. Wrap the requisition form around the inner (aluminum) can, secure with a rubber band and place in the outer container. If a screw-cap outer container is used, the screw-cap must be secured with tape or the Postal Service will return it for taping. Up to 50 milliliters of blood may be transported in one package (U.S. postal regulations). Therefore, an individual tube of blood may be placed in the metal can, with the requisition form secured to the outside by a rubber band, and several aluminum cans placed in one cardboard box for transporting.
Shipping Instructions for Courier Services Only:
Tubes of blood may be placed in leak proof biohazard bags. Wrap brown absorbent material around the tube, then secure with a rubber band. Place the requisition form in the sleeve located on the outside of the bag.
REPORTINGAND INTERPRETATION OF RESULTS
Table 1 summarizes the interpretation of results for all serological tests performed in the Microbial Immunology Unit. The turnaround time after receipt of the specimen depends on the testing methodology and the frequency of testing. The frequency of testing depends on the demand for a specific test. Several tests are performed daily, while others are performed weekly. The turn-around time for specimens referred to CDC depends on CDC’s schedule, which varies from laboratory to laboratory.
UNACCEPTABLE SPECIMENS
1. Spinal fluid obviously contaminated with bacteria or blood;
2. All specimens:
Not approved for testing by the indicated method, e.g., plasma for RPR. Grossly hemolyzed, lipemic, turbid, or contaminated.
Over 14 days old. Broken in transit.
Insufficient quantity for testing. No identification on specimen.
Name on the tube and form does not match.
The submitter will be notified of all rejected specimens. Most serologic services are
available to both the public and private sectors. However, hepatitis B testing is limited to the public health care providers, and not available to the private providers.
HCV VIRAL LOAD TESTING