Microbiology and Molecular Pathology Laboratories

Effective Monday, March 14th, 2011, all requests for respiratory virus testing will be performed by PCR. The laboratory is experiencing a high volume of testing currently, and respiratory virus antigen testing is demonstrating poor sensitivity (high false negative rate).

Results will be reported the same day for specimens received by 2:30 pm Monday- Friday. Results will be reported the same day on the weekend for specimens received by Noon.

Please use EPIC order: MICROBIOLOGY: RESPIRATORY LAB5840
   Select appropriate source (see additional information below)
   Select Virology order: RESPIRATORY VIRUS PCR

Questions concerning testing can be directed to Aaron Bossler, MD, PhD (ext. 4-9566), Stacey Klutts, MD, PhD (ext. 6-2990), or Dan Diekema, MD (ext. 4-5626).


Information on Specimen Collection

1. Nasopharyngeal swab: Collect using the flexible minitip flocked swab (Hospital Stores #33595). Measure the distance from the patient's nostril to the nasopharynx (half the distance from nostril to base of the ear) and hold the swab at that location. Do not advance the swab beyond that point. Gently insert the swab along the base of one nostril (straight back, not upwards) and continue along the floor of the nasal passage until reaching the nasopharynx. Rotate swab 2-3 times and hold in place for 5 seconds. Place swab in tube containing viral transport medium. Break off the excess length of swab at the score mark to permit capping of the tube.



2. Nasopharyngeal wash/aspirate:
• Assemble equipment:
• Sterile specimen trap
• Personal Protective Equipment (gloves, surgical mask, eye protection)
• Appropriate size suction catheter (8 fr for infants/children, 10/12 fr for adults)
• Normal saline vial
• Wall suction
• Bag or cup of ice for specimen transport to laboratory
• Place patient with the head tilted slightly back.
• With sterile gloved hand, insert suction catheter into the patient's nose to the depth of the nasopharyngeal area (beyond the turbinates). Do not remove catheter until end of procedure (see picture below).
• With the non-sterile gloved hand, instill approximately 1-2 mL normal saline outside the catheter.
• Apply suction to aspirate nasopharyngeal secretions.
• Above steps may need to be repeated to obtain 1 mL sample in specimen trap.
• Remove catheter from patient. With specimen trap still in-line, rinse catheter with remaining saline to clear secretions.
• Specimens transported by tube system must be transferred from trap to a leak-proof sterile container (be sure the lid is tightly secured).

Detection of influenza (A, B, and novel H1N1), adenovirus, respiratory syncytial virus (RSV), metapneumovirus, and parainfluenza virus (types 1, 2, and 3) is performed using reverse transcription real-time PCR.