Biochemistry Reception 071 917 4142 Main Laboratory 071 917 4590 Endocrinology 071 917 4141 Fax 071 917 4658 Biochemistry Blood Sample tube guidelines The sample tubes that are predominantly used in Biochemistry are as follows; Vacuette Serum Tube The wall of the VACUETTE® Serum tubes have a special coating of microscopic silica particles to activate the coagulation process. Serum gel tubes contain an inert barrier gel that is present in the bottom of the tube. During centrifugation the barrier gel moves upward to the serum - clot interface, where it forms a stable barrier separating the serum from fibrin and cells. VACUETTE® Serum Tubes with Gel improve the serum yield and enable serum to be left in the primary tube. Vacuette Lithium Heparin Tube The wall of the VACUETTE® Heparin tubes is coated with spray-dried lithium, ammonium or sodium heparin. The additives are anticoagulants, which block the coagulation cascade and prevent coagulation of the blood sample. Plasma gel contain an inert barrier gel that is present in the bottom of the tube. During centrifugation the barrier gel moves upward to the plasma - cell interface, where it forms a stable barrier separating the plasma from cells. VACUETTE® Plasma Tubes with Gel improve the plasma yield and enable plasma to be left in the primary tube. Vacuette Flouride Oxalate Tube Both sodium fluoride and iodoacetate are used in VACUETTE® Glucose Tubes as glycolysis inhibitors to preserve glucose when combined with an anticoagulant such as EDTA, potassium oxalate or heparin. The tubes are suitable for determining glucose and lactate. Vacuette EDTA Tube
Random ( only for paedriatrics) Universal NB wil only be accepted for paedriatric patients Send to lab immediately after collection. Calcium : Creatinine ratio is calculated. CEA Blood Serum (Red top tube) <5.0 ng/ml Reference for non smokers Should not be used as a screening test. CA-15.3 Blood Serum (Red top tube) 0 – 31.3 U/ml Weekly CA-19.9 Blood Serum (Red top tube) 0 - 27 U/ml Weekly CA-125 Blood Serum (Red top tube) 0 - 35 U/ml Weekly Carbamazepine Blood Serum (Red top tube) 4 - 12 ug/ml Therapeutic range Weekly Chloride Blood Serum (Red top tube) 96 - 108 mmol/L See report for paediatric ranges Daily or STAT samples <1hr Cholesterol Blood (Red top tube) < 5.2 mmol/L (Fasting) Daily HDL Cholesterol Blood Serum (Red top tube) >1.45 mmol/L (Male) >1.68 mmo/L (Female) Daily LDL Cholesterol Blood (Red top tube) 0 – 2.59 mmol/L Daily Cortisol Blood Timed Serum (Red top tube) Morning 0700-1000hrs 171 – 536 nmol/L Afternoon 1600-2000hrs 64 – 327nmol/L Note: Due to Circadian rhythm of Cortisol levels, in serum and plasma, sample collection time must be noted.
Short Synacthen Investigation; investigation of suspected adrenal insufficiency Adrenal insufficiency is excluded by a rise in cortisol >200nmol/L and a 30 min >600nmol/L. Baseline and post Synacthen cortisol values do not apply to women on oral contraceptives Low dose overnight dexamethasone suppression test; Investigation of suspected Cushing Syndrome: A normal response is suppression of cortisol at 0900hrs to <50nmol/L. Failure to suppress is indicative of Cushing’s syndrome. C-Reactive Protein Serum (Red top tube) < 5 mg/L Daily Creatine Kinase Blood Serum (Red top tube) <190 IU/L (m) <167 IU/L (f) See report for paediatric ranges Daily or STAT samples <1hr Creatinine Serum (Red top tube) or Plasma (Green top tube) 62-106 umol/L (M) 44-80 umol/L (F) See report for paediatric ranges or STAT samples <1hr Creatinine Clearance Blood and Urine Serum (Red top tube) and Universal or 24H container 80 - 100 mls/min Blood & 24 hr collection of urine. Blood sample should be taken during the urine collection period. CSF Protein CSF Universal 0.2 - 0.4 g/L Contact Laboratory STAT sample <1hr CSF Glucose CSF Universal 2.5 - 4.7 mmol/L Oligoclonal banding CSF and Blood Universal and Serum (Red top tube) tube Unique specimens for Biochemistry. Send Blood sample with CSF. Digoxin Blood Serum (Red top tube) 1.2 - 2.6 nmol/L Specimen should be taken at least 6 hours after lasr oral dose. Weekly Electrophoresis Blood Serum (Red top tube) See report form Fortnightly EMU or 24H 24Hr container EMU- full morning void or complete 24h colledtion Ferritin Blood Serum (Red top tube) 6m – 15yr 7-140 ug/L Daily
M 16 -60yr 30-400 ug/L F 16-60yr 15 -150 ug/L M/F 60-90yr 15-650 ug/L Folate Blood Serum (Red top tube) 3.1 – 20.5 ng/ml Daily FSH Blood Serum (Red top tube) Follicular phase 3.0-8.1 mIU/ml Mid-cycle peak 2.6-16.7 mIU/ml Luteal phase 1.4-5.5 mIU/ml Post Menopausal 26.7-133.4 mIU/ml Males 1.0-11.9 mIU/ml Gamma GT Blood Serum (Red top tube) <60 U/L (Male) <40 U/L (Female) Daily or STAT samples <1hr Glucose Blood Fluoride EDTA; Adult grey top or Paediatric yellow top tube. Fasting: Adults,<60y 4.1-5.9mmol/l 60-90y 4.6-6.4mmol/l >90y 1hr PP <7.8mmol/l 2hrPP <6.7mmol/l Criteria for diagnosing DM 1) Incidental glucose >11.1mmol/l or 2) Fasting glucose or 3) 2hr post oral GTT, glucose conc. >11.1mmol/l. or STAT samples <1hr Haemochromotosis Blood 2 EDTA (purple top tube) Presence or absence of mutation Fortnightly Haemoglobin A1c Blood EDTA (purple top tube) or Fluoride EDTA mmol/mol. No diabetic range Weekly
IgG IgA IgM Blood Serum (Red top tube) IgG (Adult) 7-16g/L IgA (Adult) 0.7-4.0 g/L IgM (Adult) 0.4-2.3g/L See report for paediatric ranges Serum protein electrophoresis is done in conjunction with immunoglobulin for technical reasons. Weekly Iron Serum (Red top tube) 11 - 28 umol/L (m) 6.6 - 26 umol/L (f) See report for paediatric ranges Lactate Blood Fluoride EDTA; Adult grey top or Paediatric yellow top tube. 0.5 – 2.2 mmol/L On ice and transported to laboratory immediately Daily LDH Blood Serum (Red top tube) 240 - 480 U/L Daily or STAT samples <1hr LH Blood Serum (Red top tube) Follicular phase 1.80-11.78 mIU/ml Mid-cycle peak 7.59-89.08 mIU/ml Luteal phase 0.56-14.00 mIU/ml Post Menopausal 5.16-61.99 mIU/ml Males 0.57-12.07 mIU/ml Daily Lithium Blood (Red top tube) Therapeutic ranges 0.6-1.2 mmol/L Potentially Toxic at > 1.5 mmol/L Specimen should be taken 12 hours post dose Weekly Magnesium (Red top tube) Adults, <60y 0.66 - 1.07 mmol/L 60-90y 0.66-0.99 mmol/L See report for paediatric ranges Daily or STAT samples <1hr
>90y 0.70-0.95 mmol/L Microalbumin Creatinine Ratio Random Random < 2.26 g albumin/ mol creatinine Daily Microalbumin Excretion Rate 24hr Urine Bottle < 30 mg / 24hr Daily NT-Pro BNP Blood (Red top tube) Refer to interpretation on report Daily Oestradiol Serum (Red top tube) Follicular phase 77 – 921 pmol/L Mid-cycle peak 139 - 2382 pmol/L Luteal phase 77- 1145 pmol/L Post Menopausal < 103 pmol/L On HRT < 528 pmol/L Males 40-161 pmol/L Weekly Osmolality Blood Serum (Red top tube) 280 300 mOsm/Kg (adult) 265-275 mOsm/Kg (neonate) Weekly Urine Random 50 - 1250 mOsm/Kg Weekly Paracetamol Blood Serum (Red top tube) Therapeutic range 10-30 mg/L Daily Phenobarbital Blood Serum (Red top tube) 15 - 40 ug/ml Therapeutic Weekly Phenytoin Blood Serum (Red top tube) 10 - 20 ug/ml Therapeutic range Weekly Phosphate Blood Serum (Red top tube) 0.87 - 1.45 mmol/L See report for paediatric ranges Daily or STAT samples <1hr 24H Urine 24H Urine Container 10 - 42 mmol/24H
Potassium Blood (Red top tube) or Plasma (Green top tube) 3.5 - 5.1 mmol/L < 1 month 3.5 – 5.5 mmol/L daily or STAT samples <1hr Urine Random / 24hr Refer to report Daily Progesterone Serum (Red top tube) Follicular phase < 0.3 - 0.9 nmol/L Luteal phase 3.8 - 50.6 nmol/L Post Menopausal < 0.3 - 0.6 nmol/L First Trimester 8.9 - 468 nmol/L Second Trimester 71.5 - 303 nmol/L Third Trimester 88.8 - 771 nmol/L Males <0.64 nmol/L Weekly Prolactin Blood Serum (Red top tube) Female ng/ml Male 3.46-19.40 ng/ml Daily Protein Blood Serum (Red top tube) 66 - 87 g/L Daily or STAT samples <1hr 24H Urine 24H Urine Container < 0.14 g/24H Daily Urine Random Protein : Creatinine ratio is calculated PSA (Total) (Red top tube) Age related range ng/ml See report form Daily 0 - 50 yrs 50 - 60 yrs 60 - 70 yrs > 70 yrs PTH Blood EDTA (purple top tube) 15 - 65 pg/ml Transport immediately to lab Weekly Rhuematoid factor Blood Serum (Red top tube) 0-14 IU/ML Daily Salicylate Blood Serum (Red top tube) Therapeutic range <300 mg/L Daily
Sodium Blood Serum (Red top tube) or Plasma (Green top tube) 133 - 145 mmol/L See report for paediatric ranges Daily or STAT samples <1hr Random 50 - 200 mmol/L Daily Sweat Test Collected by Medical Scientist, must arrange with Biochemistry Lab ext 4590 in advance. A value below 60 mmol/l is unlikely to be associated with cystic fibrosis. Values above 90mmol/l support a diagnosis of cystic fibrosis. Cystic fibrosis should not be diagnosed on conductivity measurement alone. Confirmation should be sought using sweat chloride or genotyping. Intermediate values between 60 and 90 mmol/l require further investigation by sweat chloride and/or genotyping. Per appointment only, please call Biochemistry on ext 4590 to arrange Testosterone Blood Serum (Red top tube) Male: 18-50 yrs 4.94 – 32.0 nmol/L Weekly T4 (Free) (Red top tube) 9.0 - 19.0 pmol/L Daily Total Iron Binding Capacity Blood Serum (Red top tube) 40.8 – 76.6 umol/L Daily Transferrin saturation Blood Serum (Red top tube) 25- 30% Daily Triglyceride Blood Serum (Red top tube) < 2.26 mmol/L Fasting specimen Daily Troponin T Hs Blood Serum (Red top tube) <14 ng/L Analysis on E170 Haemolysed samples unsuitable Daily
Urine 5HIAA 24hr 24hr Urine collection in acidified VMA bottle Beaumont Urine - Bence Jones (UPE) Early Morning Random Urine (for screening) / 24hr Urine collection (known cases)- plain bottle Biomnis Creatinine 24hr 24hr Urine collection - plain bottle Biochemistry, SUH Urine Calcium (UCA) 24hr 24hr Urine collection in acidified Calcium bottle Biochemistry, SUH Urine Calcium-Creatinine ratio (UCCR) Paediatrics only – random urine -send to lab immediately post collection. Biochemistry, SUH Urine Catecholamines / VMA / Metanephrines 24hr Urine collection in acidified Catecholamines bottle (available from Lab) Random sample for Paediatrics only. Beaumont Urine Citrate (CIAU) 24hr 24hr Urine collection - plain bottle –Send to lab immediately post collection Biomnis Urine Copper 24hr 24hr Urine collection - plain bottle Biomnis Urine Cortisol (24UC) 24hr 24hr Urine collection - plain bottle Biomnis Creatinine / Creatinine Clearance (CRCL) 24hr 24hr Urine collection - plain bottle NB. Blood sample must accompany urine for estimation of clearance Biochemistry, SUH Urine Cystine Adult Early morning fasting sample,10mls must be on ice Biomnis Paed Random Urine on ice (add 1 drop 5%thiomercel) Temple St Metabolic screen ( Phos/Uric acid/Calcium) 24hr 24hr Urine collection - plain bottle and 24hr Urine collection in acidified Calcium bottle (available from Lab) Biochemistry, SUH Urine Microalbumin/creatinine ratio MCR Random Biochemistry, SUH Microalbumin Excretion Rate 24hr Urine Collection – plain bottle Biochemistry, SUH Urine Myoglobin (MYUS) 24hr / random 24hr Urine collection - plain bottle / random sample. Biomnis Mucopolysacharides Random urine with 1 drop of 5% Thiomersal added Willink Manchester Urine Organic Acids Urine must be on ice Temple St
Beaumont Hospital Dublin 9, Beaumont Hospital P.O. Box 1297 Beaumont Road Dublin 9 Ireland Toxicology (01) 809 2673/5 Telephone enquiries 09:00 - 17:00 GMT Birmingham, City Hospital Biochemistry Dept (TPMT) Dr Jonathan Berg Clinical Biochemistry Department City Hospital Dudley Road Birmingham B18 7QH Tel. No. 0121 507 5353 Fax 0121 507 5290 E Mail Jonathan.Berg@swbh.nhs.uk Biomnis Laboratories Ltd. Three Rock Road, Sandyford Business Estate, Sandyford, Dublin 18, Ireland. Results and Test Enquiries 1800 252966 Telephone enquiries 09:00 - 17:30 GMT Web link; main website CytoGenetics Crumlin Crumlin Molecular Genetics National Centre for Medical Genetics, Our Lady’s Hospital for Sick Children Crumlin Dublin 12 Ireland Cytogenetic enquiries 01-409 6970 Molecular Genetics Crumlin Crumlin Molecular Genetics National Centre for Medical Genetics, Our Lady’s Hospital for Sick Children Crumlin Dublin 12 Ireland Molecular Genetic enquiries 01-409 6733 Genetic Medicine St Mary’s Hospital 6 St Mary’s Hospital Oxford Rd ManchesterM13 9WL Genetic Medicine Tel 0161 276 6506
Fredreich Ataxia Refer to QPulse for detailed bench instructions Free Light chains Serum Print lastest PE result and attach to FLCR request form Refrigerated University Hosp, Galway Fructosamine Refrigerated Biomnis G6PD DO NOT SPIN 2ml EDTA whole blood Refrigerated Biomnis Gabentine Serum preferably on ice Frozen <4hrs Biomnis Galactose-1-Phosphate Uridyl transferase GALT Refer to QPulse for detailed bench instructions Gastrin Serum must be on ice Frozen <1hr Biomnis Glucagon EDTA Aprotinin tubes (small pink tube in cold rm,do not send in shute) must be on ice Separate into plain tube Frozen <1hr Biomnis Growth Hormone Serum preferably on ice Frozen <4hrs If haemolysed credit with HU-PR University Hosp, Galway Growth Hormone (when part of Newcastle screen ONLY) Refer to QPulse for detailed bench instructions Gut Hormone 1 EDTA Aprotinin (small pink tube in cold rm,do not send in shute) must be on ice Separate into plain tube Frozen <1hr Biomnis Gut Hormone Profile (glucagon/pancreatic polypeptide/vasoactive intestinal polypeptide/ Gastrin) 3 EDTA Aprotinin tubes (small pink tube in cold rm,do not send in shute) + 1 Serum must be on ice Frozen <1hr Biomnis Haemochromotosis DO NOT SPIN 2 EDTA + Consent form Refrigerate In house Heriditary Non Polyposis Colorectal Cancer (Lynch syndrome) Refer to QPulse for detailed bench instructions Homocysteine (cardiovascular events) Fasting Serum/ Plasma (clinical details MUST be provided) must be on ice Frozen <1hr Biomnis Homocystine (Homocystinuria) Fasting Plasma (clinical details MUST be provided) must be on ice Frozen <1hr Biomnis
Free/total homocysteine (kidney problems) to QPulse for detailed bench instructions Huntingtons disease Refer to QPulse for detailed bench instructions 17 Hydroxyprogesterone Serum Refrigerated Biomnis Hydroxyproline Lithium Heparin must be on ice Frozen <1hrs Biomnis IG subclasses serum Refrigerated University Hosp, Galway IGE/ RAST Serum + suspected allergens specified on request form Refrigerated University Hosp, Galway IGF 1 Serum preferably on ice Frozen <4hrs Biomnis IGF 1 BP3 Serum preferably on ice Frozen <4hrs Biomnis Imuran Lithium Heparin whole blood preferably on ice Do NOT spin Frozen <4hrs Biomnis Inhibin Serum preferably on ice Frozen <4hrs Biomnis Insulin preferably on ice,haemolysed samples unsuitable Frozen <4hr centrifuged immediately Biomnis Insulin tolerance test Serum preferably on ice Growth hormone to Galway (if haemolysed, credit with HU), Cortisol and Glucose result included University Hosp, Galway Iodine Serum Refrigerated Biomnis Ionised Calcium gas analyser in ICU/ AE - venous sample JAK 2 mutation Haematology referral test. Karotyping (chromosome analysis) DO NOT SPIN 2 x Lithium Heparin & Consent form Adults - Refrigerated Biomnis <5yrs - Refrigerated Crumlin Ketones Urine (20 mls universal) / 2 Lithium Heparin,send to Biochemistry reception immediately.Record Glucose result with request for BHB (3 hydroxybutyrate( BHB))Spin 1 lithium Hep and freeze (Acetoacetate(AOA)) 2nd Lithium hep-take 2ml blood add to PCA tube (4ml percholric acid),centrifuge 5mins,freeze supernatant. Biomnis
Mitrochondrial DNA Refer to QPulse for detailed bench instructions Mucopolysaccharides Refer to QPulse for detailed bench instructions Myoglobin / Urine Refrigerated Biomnis Myosin genetic test Refer to QPulse for detailed bench instructions Newcastle Screen to protocol in Referral folder in Biochemistry reception for further detail) 5 lithium hep,5 serum,1 Aprotinine,1 EDTA,2 Flouride Oxalate,Urine and Gutherie card Refer to QPulse for detailed bench instructions Biomnis / Temple St Nickel Refrigerated Biomnis Nitrazepam Serum preferably on ice Frozen <4hrs Biomnis Olanzapine Serum preferably on ice Frozen <4hrs Biomnis Oligioclonal band Serum + CSF Refrigerated, include CSF Glucose / CSF protein University Hosp, Galway Oxalate Serum must be on ice Frozen <1hrs Biomnis Oxycarbamezepine Serum must be on ice Frozen <1hrs Biomnis Pancreatic polypeptide 1 EDTA Aprotinin tube pink tube in cold rm,do not send in shute) must be on ice Separate into plain tube Frozen <30mins Biomnis Pierrre Robin Syndrome (chromosome analysis) Refer to QPulse for detailed bench instructions Phenyalanine Lithium Heparin,plasma Refrigerated Tem Porphyrin Screen 2 EDTA (DO NOT SPIN), 1 Lit Hep, 1 Fecal sample, 1 24hr urine collection Protect all from light Protect from light,spin Lit Hep,take 100ml aliqout from urine collection St Pradar Willi Syndrome Molecular genetics Refer to QPulse for detailed bench instructions Primidone Serum preferably on ice Frozen <4hrs Biomnis Pro- Insulin Serum preferably on ice Frozen <4hrs Biomnis
Anti- glutamic acid decarboxylase Abs - GAD Serum JRH, UK Anti Histone Abs Serum Biomnis Anti IA2 antibodies – Anti tyrosine phosphatase Abs Send URGENTLY to Lab. Must be FROZEN within 4 hr. Collect date and time must be specified on request form. Biomnis Anti IgA antibodies JRH, UK Anti-insulin antibodies Send urgently to Lab. Must be FROZEN within 4 hr. Collect date and time must be specified on request form. Biomnis Anti-intrinsic factor antibodies - AIF Serum Biomnis Anti-islet cell antibodies Serum Biomnis Anti Liver Kidney Microsomal Abs - LKM Biomnis Anti Myelin Associated Glycoprotein Abs- MAG Abs Serum JRH, UK Anti-muscle-specific kinase antibodies- MUSK Serum JRH, UK Anti Microsomal Abs - See Abs Anti-mitochondrial antibodies Serum Biomnis Anti MOG, Anti myelin oligodendrocyte glycoprotein ab Serum JRH, UK Anti-neuromyelitis optica Abs – NMO Abs (aquaporin 4) Serum Biomnis Anti N-methyl-D-aspartate receptor antibodies - NMDA JRH, UK Anti-nuclear Abs - ANA Serum Biomnis Anti-neuronal Abs (Hu, Yo, Ri, CV2, Amphiphysin, Ma1, Ma2) Serum Biomnis Anti-neutrophil cytoplasmic antibodies - ANCA Serum GUH Anti-parietal cell Abs Biomnis Pituitary Antibodies Serum Biomnis Anti Proton Pump Abs Serum Biomnis
Immunology Referral Laboratories: Laboratory Address Contact details Institute of Molecular Medicine John Radcliffe Hospital (JRH) Headington Oxford OX3 9DS United Kingdom Tel: 0044 1865 741166 Biomnis Laboratories Ltd. Three Rock Road, Sandyford Business Estate, Sandyford, Dublin 18, Ireland. Results and Test Enquiries 1800 252966 Telephone enquiries 09:00 - 17:30 GMT Web link; main website Galway University Hospital Galway University Hospital Newcastle Road Galway Telephone enquiries 09:00 - 17:00 GMT Results and Test Enquiries 091 524765 / 524222 ext 4418 Immunology Dept Royal London & St Barts Hospital Immunology, 2nd floor Pathology & Pharmacy building 80 Newark Street, Whitechapel, London, E1 2ES Tel: 0044 2032460279 Immunology Laboratory, St James’s Hospital St James' Hospital James street, Dublin 8 (01) 416 2928 or (01) 416 2034
K3EDTA K3EDTA for blood haematology determinations. Tube inversions prevent clotting. Invert 8-10 times. Sodium Citrate For coagulation determinations. Tube inversions prevent clotting. MUST be filled to Black arrow. Serum Clot Activator Tube inversions ensure mixing of clot activator with blood. For Serum specimens Haematology Routine Test Menu Test Specimen type Additional Information Turn-Around-Time * Full Count EDTA x 1 One specimen is sufficient for FBC and ESR when filled to mark. 1 hour stat 3 hrs routine 24hrs GP specimens Erythrocyte Sedimentation Rate EDTA x 1 For ESR analysis on paediatrics- 2 paediatric specimens required. 1 hour stat 3 hrs routine 24hrs GP specimens Reticulocyte Count EDTA x 1 Can be added on to FBC specimen. 1 hour stat 3 hrs routine 24hrs GP specimens Coagulation Screen (on Heparin or Heparin & Warfarin) NaCit x 1 Specimen must be filled to the arrow on the tube <1 hour stat 3hrs Routine 8 hrs GP INR (on Warfarin) x 1 Specimen must be filled to the Black arrow on the tube <1 hour stat 3hrs Routine 24 hrs GP Fibrinogen NaCit x 1 Can be added on to Coag specimen. Specimen should be as fresh as possible <4hrs <1 hour stat Dimers NaCit x 1 Can be added on to Coag specimen if specimen is within 4 hrs of phlebotomy <1 hour stat 3hrs Routine 4 hrs GP Haptoglobins Serum x 1 48 Hours * Turn Around Time applies to Stat/Urgent specimens after they are received in Haematology Laboratory. Haematology In-House Special Tests
University College Hospital, Galway University College Hospital Newcastle Road Galway Telephone enquiries 09:00 - 17:00 GMT Results and Test Enquiries 091 524765 / 524222 ext 4418 Bristol H+I Laboratory NHS BT, 500 North Bristol Park Northway Filton Bristol BS34 7QH Dr Jeff 00441179217536 Elaine Griffin 00441179217532 Haematology Referral Tests Test name Specimen type Information Referral lab TAT Anticardiolipin antibodies Serum x 1 Immunology UCHG 2-3 weeks Anti Factor Xa Na Citrate plasma x 2 Should be received in lab within 1 hour of phlebotomy. Sample should be taken 4 hours post dose of LMWH. Details and dose of low molecular weight heparin (LMWH) should be stated on request form and time of administration. Haem Lab UCHG (adults), OLCHC (children <16 yrs old) 2 weeks BCR ABL (Molecular Analysis of Leukaemia) For Chronic Myeloid Leukaemia (CML) or disorders (MPD) EDTA Peripheral blood or BM in RPMI Samples should be in afternoon before 16:00 Ensure sample is accompanied with fully completed and signed PATH-HAEM-EXT-14 Cancer Molecular for molecular analysis Cancer Molecular Diagnostics (CMD)St. James' Hospital 14-21 working days
Cytogenetics BM in RPMI with heparin for Leuk/MDS BM in RPMI with in EDTA for CLL BM smears for Multiple Myeloma All samples must be accompanied by a fully completed and signed PATH-HAEM-EXT-5 NCMG Cytogenetics request form. Samples should be taken in afternoon and received in the laboratory before 16:00 Division of Cytogenetics, National Centre for Medical Genetics, Our Lady's Children's Hospital, Crumlin, Dublin 12.(NCMG) Results available approx 6 months. Urgent referrals may have a preliminary FISH result within 4 days Chimerism testing PB/BM 9ml of peripheral blood in EDTA (3 samples) or 1-3ml of bone marrow in RPMI (1:3 dilution) Samples should be taken in afternoon and received in the laboratory before 16:00 Ensure sample is accompanied with fully completed and signed PATH-HAEM-EXT-14 Cancer Molecular Diagnostics-Request for molecular analysis Cancer Molecular Diagnostics, Central Pathology Laboratory, St James's Hospital, Dublin 8. Usually within 14-21 working days. CD3 (cells), CD4 (T Helper), CD8 (T Cytotoxic), CD19 (B cell), CD16/56 (NK cells). 3ml blood in EDTA X 2 Take sample 2 pm Contact lab prior to sending samples as it must arrive in referral laboratory within 24 hours of phlebotomy. Time and date of collection must be on form. Immunology Lab, St. Hospital Dublin 8 5 working days Factor Assays Na citrate x 6 Send samples Mon-Fri. Ensure delivered to laboratory within 4 hours post phlebotomy and during routine hours St James's Hospital. For patients <16 yrs send to OLCHC Crumlin 6-8 weeks Factor inhibitor test Na citrate x 2 Send samples Mon-Fri. Ensure delivered to laboratory within 4 post phlebotomy and during routine hours NCHCD St James's Hospital. For patients <16 yrs send to OLCHC Crumlin 4 weeks Factor V Leiden 1 x EDTA Note: Factor V Leiden testing is only carried out on patients with an abnormally reduced APCR result Biomnis 8 days
Hb- electrophoresis 1 X EDTA Advise to request Ferritin test also. Biomnis 5-7 days HIT screen (Heparin Induced Serum x 2 & NA citrate x 2 Must have a pre-test probability score of 4 or more & must be accompanied by a clinician completed PATH-HAEM-EXT-1 SJH HIT request form. Send samples Mon-Thurs. Ensure delivered to laboratory within 4 hours post phlebotomy and during routine hours NCHCD SJH Up to 2 weeks HLAB27 (HLA 27 genotype) EDTA x 2 Biomnis 2 Hereditary Spherocytosis (EMA) EDTA sample > 0.5ml Contact laboratory to discuss prior to taking specimen as must be received by referral laboratory within 18-24 hours Adults- St James Special Haematology Lab <16 yrs Crumlin Haematology Lab 1 week (this includes CD19) BM in RPMI specimens Peripheral blood (~3ml EDTA) Must be accompanied by completed PATH-HAEM-EXT-15 UCHG Request for Specialised Haematology Tests Patient details on sample must be HANDWRITTEN Haematology Lab., UCHG/SJH 2-5 days JAK2 EDTA x 2 PB samples / BM in RPMI Send with a fully completed and signed CMD form CMD SJH 14-21 days Leucocyte Adhesion Deficiency (CD 18/ CD 11) EDTA x1 sample Contact laboratory to discuss prior to taking specimen as must be received by referral laboratory for testing <5 hrs post phlebotomy and requires prior arrangement with referral lab before phlebotomy. (Specialist test not all staff trained) Immunology Lab St James Hospital 5 days Lupus anticoagulant Na citrate x2 samples Ensure delivered to laboratory within 4 post phlebotomy and during routine hours Biomnis 2 weeks
Unlabelled / Mislabelled samples Sample not processed. Report issued stating that unlabelled sample received and This sample deviated from Pathology Labelling Policy. Requesting clinician was contacted by the laboratory and informed of requirement to rectify labelling error and complete Declaration Form for Inadequately Labelled Specimens. Nature of deviation stated ie Unlabelled samples or Mislabelled samples. CSF samples Blood Culture samples Unrepeatable samples Unrepeatable specimens-refer to sample deviation acceptance policy in Introduction section of this manual. Requesting Clinician is required to complete form: PATH-GEN-FRM-3 Declaration form for inadequately labelled samples and correct labelling error in person before samples may be processed. Samples with no clinical details or inappropriate clinical details provided on request form ( including antibiotic assays) Sample not processed. Any samples received without accompanying appropriate clinical details will also be rejected with the following comment “No (or inappropriate)clinical details provided. Sample not processed. Relevant clinical information is necessary in order to allow interpretation of test results. Samples will be held for 48 hours and processed if relevant clinical details are provided” ICU samples NICU RDU samples Haematology/ Oncology patients Diabetic patients Any sample that cannot be easily repeated e.g. tissue, CSF, aspirates, cultures, BALs, biopsies. MRSA/VRE screens (including CSU urines from known MRSA carriers) Consultant Urologist Pregnancy Relevant clinical information is necessary in order to allow choice of relevant tests and interpretation of test results. If clinical information is subsequently provided, this is recorded on the report and the sample is processed. Specimens with no requesting doctor or location Specimen not processed. Rejected with following comment ‘’ ‘’ No details of requesting doctor given on form. Specimen not processed. ‘’ Putting samples up to historic events on the Laboratory Information System (LIS), may breach confidentiality.
Specimen request form does not have a location and location cannot be determined from PCN/requesting doctor. Specimen not processed. Rejected with following comment ‘’No patient location details given on form. Specimen not processed. Putting samples up to historic events on the Laboratory Information System (LIS), may breach confidentiality. Old Samples: Samples >48 old Or Date of collection not stated on request form or sample Such samples will not be processed. Samples will be rejected with the comment: “Specimen >48 hours old. Unsuitable for analysis. According to best practice, specimens should be transported and processed as soon as possible. Delays of >48 are undesirable and may yield false negative or misleading results. Advise repeat specimen if clinically indicated.” Faeces At this target organisms may not have survived and processing such samples may yield false negative or misleading results. Inappropriate antibiotic therapy can result from working up poor quality samples. No information available regarding storage or transport conditions to submission to laboratory. Sample Quality/Quantity: Specimens submitted in a non-sterile or an incorrect container/swab. Leaking Sample Insufficient specimen received. Sample not processed. Report issued with comment, specimen received in a non standard non sterile container. Sample not processed. Report issued with comment, Leaking sample received unsuitable for analysis. Sample not processed. Report issued with comment, Insufficient Unrepeatable samples (Samples may be processed with a suitable comment appended to the report) N/A N/A A non-sterile container may lead to a contaminated sample and misleading results. A leaking container may lead to a contaminated sample and misleading results. N/A
Manual Microscopy WBC <20 x 106/L AND epithelial cells or amorphous deposit present. Automated Cell Count WBC <40 x 106/L AND ≥1+ epithelial cells present. obscured by Amorphous Deposit or Epithelial Cells Automated Cell WBC <40 x 106/L AND no bacteria present. Sample not cultured. A report will be issued with the microscopy result and a comment stating “Culture not performed on this sample due to low white blood cell count and the presence of epithelial cells/amorphous deposit.” Sample not cultured. A report will be issued with the microscopy result and a comment stating “Poor quality sample as evidenced by large amounts of epithelial cells and/or amorphous deposit……Advise repeat specimen if clinically indicated.” Sample not cultured. A report will be issued with the microscopy result and a comment stating “Culture not performed on this sample due to absence/low cells and absence/low levels of bacterial cells on urine cytometry. Evidence has shown that significant growth does not occur on culture in these instances.’’ Neutropaenic Haem/Onc patients ICU/NICU/RDU pts Suprapubic aspirates Suprapubic catheter >100 RCC in male patients, elderly females, pregnancy or anybody where there is not a reasonable explanation for a high RCC. Proteinuria in pregnancy Pyelonephritis Majority of such samples cultured yield mixed growth of contaminating organisms (mixed skin flora or mixed enteric organisms) Culture not performed due to high likelihood of contamination Evidence has shown that significant growth does not occur on culture in these instances. Faecal samples: (Routine culture) Samples received from in-house patients that Such samples will not be processed for routine culture unless specifically N/A Yield of routine enteric pathogens is low in these instances.
Multiple requests,( Two samples received) SEPARATE samples required. MRSA: Screens from community (including nursing Repeat MRSA screens received within 7 days MRSA: Axilla and/or groin swabs received Such samples will not be processed. A report will be issued with the comment “Sample not processed. MRSA screens from the community will only be processed in the following circumstances: if clinical details indicate patient is for admission to hospital, if clinical details indicate screening is required as part of pre-operative assessment, or if requested by Infection Prevention and Control.” Such samples will not be processed. A report will be issued with the comment “Duplicate MRSA screen received within ‘? days.’ Please submit repeat screening swabs at weekly intervals.” Swabs not cultured. Report issued with comment, Axilla and groin swabs are not part of routine MRSA screening procedure in Sligo University Hospital. If clinical details indicate patient is for admission to hospital If clinical details indicate screening is required as part of assessment If requested by Infection Prevention and Control N/A If the screen is for another hospital e.g. pre-op patient Recommended by SARI Infection Prevention and Control The Control and Prevention of MRSA in Hospitals and in the Community. Ireland:Health Protection and Surveillance Centre, 2005. MRSA protocol. Axilla and groin swabs are not part of routine MRSA screening procedure in Sligo University Hospital.
Microbiology Samples: Due to the instability of bacteria over time and the processing undertaken for some samples, it is advisable that requesting additional on submitted samples are made as close to date of collection of sample as possible. Please phone relevant section in Laboratory with additional request. Requestor will be advised as to feasibility of carrying out additional tests requests. An additional form/specimen may be required. Serology Samples: The time limit for testing blood samples for various antibodies / antigens is variable. If additional testing is required by the clinician on a sample previously received, please contact the Serology Laboratory to investigate the feasibility of using the initial specimen for analysis. Storage of Examined Samples Storage of Samples ID Specimen Description Storage Requirement Storage Location Minimum Retention Period 1 Serum ( In house Serology tests ) Serum (Antibiotics and Referral tests) Aliquot kept at -40oC Primary tube kept at 20C – 80C Serology - freezer Serology Specimen Fridge 2 years 7 days 2 Body fluids, aspirates, 20C – 80C Microbiology Cold Room 48 hours after release of reports 3 Urine Specimens 20C – 80C Microbiology Cold Room 48 hours after release of reports 4 Faeces 20C – 80C Microbiology Cold Room 48 after release of reports 5 CSF Aliquot kept at -850C Microbiology Freezer 6 Stained Slides: CSF and Blood Culture films AAFB films 180C – 250C for all stained slides Microbiology Microscopy room Blood Culture Room 7 days release of report
Norovirus (small round structured virus) Intra-Uterine Infection Toxoplasma gondi* Cytomegalovirus* Rubella virus* Parvovirus B19* Varicella Zoster Virus* (VZV) Serum/ Clotted Blood Organ donors Hepatitis B & C viruses Human Immunodeficiency Virus (HIV) Cytomegalovirus* (CMV) Toxoplasma gondii * Human T-Lymphotropic Virus* (HTLV) Syphilis (Treponema pallidum) Serum/ Clotted Blood Pleurodynia Coxsackie Group B viruses* Stool/ Viral Throat Swab or Pleural Pericarditis/ Myocarditis Coxsackie Group B viruses* Stool/ Viral Throat Swab or Pleural Fluid Coxiella burnetii *(Q Fever) Chlamydia Group* Mycoplasma pneumoniae* Clotted Blood Lymphadenopathy & Glandular fever Monospot Epstein Barr virus* (EBV) Cytomegalovirus *(CMV) Toxoplasma gondii* Serum/ Clotted Blood Paraparesis T-Lymphotropic Virus* (HTLV) Serum/ Clotted Blood Enterovirus* (Coxsackie Echo) Stool Conjunctivitis Adenovirus* Herpes Simplex (HSV) Enterovirus* (Coxsackie Echo) Eye swab in viral transport media Chlamydia trachomatis* Eye swab in chlamydia transport Stomatitis Herpes Simplex Virus *(HSV) Enterovirus *(Coxsackie Echo) Swab in viral transport media Serum/ Clotted Blood Stool/ Throat Swab
Acanthamoeba PCR * Specimen Type 1. Corneal Scrapings in sterile universal container. or 2. Aqueous tap of ocular in sterile universal container. Sample Container Sterile universal container. Sample collection/ preparation Corneal scrapings and intraocular fluids will be collected by an ophthalmic surgeon: sterile needles may be used to aspirate or scrape material, and sterile scalpel blades to scrape material. Volume/Quantity As much corneal scraping as possible. A minimum volume of 1ml is required for intraocular fluids and pus exudates. Safety Requirements Ensure sterile universal containers are and closed correctly. Place in a sealed plastic specimen bag with request form in the pouch, ready for transport to the laboratory. Ensure contact lens containers are leak-proof and closed correctly. Place in a sealed plastic specimen bag with request form in the pouch, ready for transport to the laboratory. Time Between Collection and Processing Transport as soon as possible, hold at ambient temperature. Sample Quality N/A Special Requirements N/A Turnaround Times 1 Month Comments Referred to external laboratory for PCR. Bartholins cyst fluid Specimen Type Bartholins cyst fluid Sample Container Sterile universal container Sample collection/ preparation 1. Disinfect skin with chlorhexidine preparation. 2. Using a sterile needle and syringe, aspirate fluid from ducts. 3. Transfer sample into sterile universal container. Volume/Quantity 5 ml volume (minimum >1ml) Safety Requirements Do not submit sample in needle and syringe. Time Between Collection and Processing Transfer to the laboratory as quickly as possible, preferably within a few hours of the sample been taken. If delivery to the laboratory is delayed, specimens should be refrigerated. Sample Quality The volume of the specimen influences the transport time that is acceptable. Larger volumes of purulent material maintain the viability of anaerobes for a longer period of time. The recovery of anaerobes is compromised if the transport time exceeds 3 hours.
Special Requirements N/A Turnaround Times 2-4 Days Comments Biopsy, Tissue, Bone and Prosthetic Devices Specimen Type Biopsy, Tissue, Bone and Prosthetic Devices Sample Container Sterile universal container (Do not add formaldehyde, as this will kill any bacteria present) Sample collection/ preparation The optimal time of collection is before antimicrobial therapy where possible. Specimens are collected according to local practice. If sterile saline is used to keep small quantities of tissue moist please indicate on label any additive e.g. 5mls sterile saline. Volume/Quantity As large a sample as possible should be sent. Safety Requirements Ensure sterile universal containers are leak-proof and closed correctly. Place in a sealed plastic specimen bag with request form in the pouch, ready for transport to the laboratory. Time Between Collection and Processing Specimen should arrive in the laboratory as soon as possible after collection. Tissue samples must not dry out; if sample size is small then some drops of sterile saline may be added but this must be indicated on the specimen container. If a in transport or processing is anticipated, the specimen should be refrigerated. Sample Quality Tissue Samples for Microbiology received in formalin will not be processed. Special Requirements N/A Turnaround Times 2-4 Days Comments Tissue samples for Enterovirus PCR can be done by arrangement with the NVRL. SUH microbiology laboratory must be contacted when considering such requests. Cultures Specimen Type Venous blood is appropriate for most micro-organisms, however, if disseminated fungal infection is suspected than arterial blood may be submitted. Sample Container Paediatric/Neonate A single paediatric yellow top bottle. Adult One Aerobic bottle (blue top)
Comments Indicate antimicrobial therapy on ordering requisition. Separate swabs in appropriate transport media are needed for the diagnosis of viral and Chlamydia infections. If Chlamydia infection is suspected, please contact Serology laboratory beforehand to obtain chlamydial transport swab. Break the swab into this medium and replace top. Faeces Faeces - Routine Specimen Type Faeces – Routine culture (Salmonella, Shigella, Campylobacter and E. coli O157:H7); Adenovirus/Rotavirus* & Cryptosporidium. Faecal Occult Blood (FOB). Sample Container Sterile Universal Container. Sample collection/ preparation Collect specimen as soon as possible after onset of symptoms. Specimen may be passed into a clean, dry, disposable bedpan or similar container and transferred into a sterile container (see above) using the spoon. The specimen is unsatisfactory if there remains any residual soap, detergent or disinfectant in the pan. Volume/Quantity 1-2g (spoonful) is sufficient. If more than one specimen is received on the same day, only one specimen per patient per day will be processed. Please submit multiple separate faeces samples if multiple tests are requested e.g.Culture & C.Diff & Norovirus Safety Requirements Please do not fill to the brim. Ensure that the lid of the container is firmly closed. Ensure sterile universal containers are and closed correctly. Place in a sealed plastic specimen bag with request form in the pouch, ready for transport to the laboratory. Time Between Collection and Processing Stool specimens should arrive in the laboratory as soon as possible. If a delay is unavoidable, specimen should be refrigerated in a designated refrigerator or in a designated part of a refrigerator not close to medicines or food. Sample Quality N/A Special Requirements N/A Turnaround Times 2-5 Days Comments Please note that this laboratory employs a cost-effective approach to the diagnosis of infectious diarrhoea. Not all specimens are examined for every pathogen. It is therefore important that clinical details or suspected diagnoses are included on the request form.
Sample collection/ preparation Inner ear: Sample must be acquired using aseptic technique. Follow protocols outlined by your health care facility for this sample type. Outer ear: Use a moistened swab to remove any debris or crust from the ear canal. Obtain sample by firmly rotating swab in the outer canal. Volume/Quantity One specimen is sufficient in the case of all swabs. Safety Requirements Ensure the swab is returned fully to the transport medium case and correctly closed. Place in a sealed plastic specimen bag with request form in the pouch, ready for transport to the laboratory. Time Between Collection and Processing Specimens should arrive in the laboratory within 24hrs of collection. In the event of any delays, store swab at 4oC. It is possible for coliforms to multiply in transport after a few hours at room temperature causing a significant change in culture results. Sample Quality N/A Special Requirements N/A Turnaround Times 2-5 Days Comments Where possible specimen collection should occur before antimicrobial therapy and always when pus or exudate is present. Respiratory syncytial and parainfluenza viruses have been isolated from middle ear effusions and may have a role in the aetiology of otitis media especially in children. Use a Green or Pink top viral culture swab if indicated. Mycotic infection of the ear is a superficial, chronic or subacute infection of the external auditory canal. Fungal infection accounts for two to ten percent of cases of otitis externa, and most frequently occurs after treatment of bacterial infection. Superficial infection with Candida spp occurs more commonly in patients who use hearing aids. For investigation of fungal infection, scrapings of material from the ear canal are preferred although swabs can also be used. Swab Specimen Type Nasal. Sample Container Bacterial Culture: Blue agar transport swab. Viral Swab (Pink or Green Top)
with relevant clinical details for test to be processed. Bartonella henselae* Clotted Blood Test currently suspended Bordatella pertussis antibodies* Clotted Blood Relevant Clinical details provided & discussion with Consultant Microbiologist required. No relevant clinical details provided or no discussion with Consultant Microbiologist./ Please contact Consultant Microbiologist with relevant clinical details for test to be processed. Chlamydia trachomatis (CT) / Neisseria gonorrhea (GC) PCR * Urine specimen Endocervical swab Urethral Swab Eye Swab Rectal Swab Throat Swab Urine and swabs for CT/GC PCR should be received in a (Urine or Swab) Aptima collection device that is in date provided by the Serology Laboratory. Urine sample received in a universal container must reach Serology Lab within 24 hrs of collection so that it can be transferred to a Aptima Urine Collection device. Specimen collect date and time must be provided. The level of urine in the Aptima collection device must be between the two black indicator lines on the tube. For Swabs: Discard cleaning swab (WHITE shafted swab) after use. Specimen collection swab (BLUE shafted swab) ONLY must be put in Aptima transport tube Expired Aptima collection device received unsuitable for analysis No Collect date and time provided on Universal urine container. Unable to establish if it is < 24 hrs since collection or Urine sent in primary universal container > 24 hours of collection. Urine sample does not fall between the guidance markers on the collection device and is unsuitable for analysis Swab unsuitable for analysis if shafted & blue shafted swabs OR white shaft swab only are received in Aptima transport tube For all of the above: Advise submit repeat specimen. Chloramphenicol levels * Clotted Blood Relevant Clinical details provided & prior discussion with Consultant Microbiologist required. No relevant clinical details provided or no discussion with Consultant Microbiologist./
Please contact Consultant Microbiologist with relevant clinical information for test to be processed. CMV DNA * EDTA whole blood Urine Specimen collect date and time must be provided on request form . EDTA sample must be received in Laboratory, separated and frozen within 24 hrs of venepuncture. samples must be frozen ASAP. Laboratory must be contacted. Incorrect sample received - Clotted Blood unsuitable for analysis - EDTA Blood samples required Specimen date and collect time NOT provided. Sample received in laboratory > of venepucture For all of the above: Advise submit repeat specimen Clostridium tetani antibodies * Clotted Blood Relevant Clinical details provided & prior discussion with Consultant Microbiologist required. No relevant clinical details provided or no discussion with Consultant Microbiologist./ Please contact Consultant Microbiologist with relevant clinical details for test to be processed. Corynebacterium diphtheriae antibodies * Clotted Blood Relevant Clinical details provided & prior discussion with Consultant Microbiologist required. No relevant clinical details provided or no discussion with Consultant Microbiologist./ Please contact Consultant Microbiologist with relevant clinical details for test to be processed. Coxiella burnetti (Q fever) antibodies * Clotted Relevant Clinical details provided & prior discussion with Consultant Microbiologist required. No relevant clinical details provided or no discussion with Consultant Microbiologist./ Please contact Consultant Microbiologist with relevant clinical details for test to be processed. Cryptococcus Serology * Clotted Blood Relevant Clinical details provided & prior discussion with Consultant Microbiologist required. No relevant clinical details provided or no discussion with Consultant Microbiologist./ Please contact Consultant Microbiologist with relevant clinical details for test to be processed.
Dengue antibodies * Clotted Blood Relevant Clinical Details including details of foreign travel and prior discussion with Consultant Microbiologist required. No relevant clinical details provided or no discussion with Consultant Microbiologist./ Please contact Consultant Microbiologist with relevant clinical details for test to be processed. B Abs * Clotted Blood Relevant Clinical details provided & prior discussion with Consultant Microbiologist required. No relevant clinical details provided or no discussion with Consultant Microbiologist./ Please contact Consultant Microbiologist with relevant clinical details for test to be processed. Echinococcus antibodies * (Hydatid Cyst / Cystercercosis Ab) Clotted Blood Relevant Clinical details provided & prior discussion with Consultant Microbiologist required. No relevant clinical details provided or no discussion with Consultant Microbiologist./ Please contact Consultant Microbiologist with relevant clinical details for test to be processed. Epstein-Barr PCR * EDTA whole blood Specimen date and collect time MUST be indicated on request form. EDTA samples must be received in Laboratory, separated and frozen within 24 hrs of venepuncture. Incorrect sample received - Clotted Blood unsuitable for analysis. EDTA Blood samples required Specimen date and collect time NOT provided. Sample received in laboratory > 24hrs of venepucture. For all of the Advise submit repeat specimen Gentamicin Clotted Blood Specimen Collect Time/ Focus of infection/ Dose Schedule/ when last dose was given must be provided on request form Inadequate clinical information provided- Timing of sampling, dose administered, dose frequency and focus of infection must be specified. Results uninterpretable without the above information/ Sample will be held and processed if relevant details are provided.
Hepatitis C RNA EDTA Whole Blood or Clotted Blood Specimen collect date and time must be indicated on request form. Specimen must be sent to the Serology Lab Urgently so that it can be centrifuged, aliquoted and frozen within 6 hrs of venepuncture. The Serology laboratory must be contacted before blood is taken and specimen must reach laboratory before 4pm. Specimen date and collect time NOT provided or or specimen received in laboratory > 6 hours from venepuncture. Sample not received and frozen within 6 hours of venepuncture./ Advise submit repeat specimen HCV genotype * EDTA Whole Blood or Clotted Blood Specimen collect date and time must be indicated on request form. Specimen must be sent to the Serology Lab Urgently so that it can be centrifuged, aliquoted and frozen within 6 hrs of venepuncture. The Serology laboratory must be contacted before is taken and specimen must reach laboratory before 4pm. Specimen date and collect time NOT provided or specimen received in laboratory > 6 hours from venepuncture Sample not received and frozen within 6 hours of venepuncture./ Advise submit repeat specimen HIV Viral load * EDTA whole blood Specimen collect date and time must be indicated on request form. Two EDTA samples must be received centrifuged and frozen within 6 hours of venepuncture. Laboratory must be contacted before blood is taken. Specimen date and collect time NOT provided or specimen received in laboratory > 6 hours from venepuncture. Sample not received and frozen within 6 of venepuncture./ Advise submit repeat specimen Hepatitis B Viral Load * EDTA Whole Specimen collect date and time must be indicated on request form. Specimen must arrive in Serology Urgently so that it can be centrifuged, aliquoted and frozen within 6 hrs of venepuncture. The Serology laboratory must be contacted before blood is taken and specimen must reach laboratory before 4pm. Specimen date and collect time NOT provided or specimen received in laboratory > 6 hours from venepuncture. Sample not received and frozen within 6 hours of venepuncture./ Advise submit repeat specimen Legionella * Urine Blood samples unsuitable for testing. Urine sample required. Incorrect sample received. Blood sample received, Unsuitable for analysis,/ Advise submit Urine sample. Urine
PAEDIATRIC SAMPLES: If submitting 2 ml microtubes please provide 1 tube per investigation Test/ Profile Specimen Type Additive required Volume Required/ ml Type Special Requirements Turnaround Times Amoebic Serology * Blood None 5.0 Red top vacuette serum tube Only accepted following prior consultation with Consultant Microbiologist. 18-24 days Antibiotic assays See under individual antibiotic assays Antenatal Screen/ Rubella, Syphilis, HBsAg, HIV ** Blood None 5.0 Red top vacuette serum tube 2- 6 days Amikacin levels * Blood None 5.0 Red top vacuette serum tube Site of infection, Dose schedule, When last dose was given, must be clearly indicated on form. Prior discussion with Consultant Microbiologist required. Amikacin is assayed in Biomnis Laboratory 2 days for phoned report Anti-DNAse B * Blood None 5.0 Red top vacuette serum tube Only accepted following prior consultation with Consultant Microbiologist. 18-24 days titre (ASOT) None 5.0 Red top vacuette serum tube Useful for the investigation of A Beta- haemolytic Streptococcal infection or post- streptococcal disorder e.g. rheumatic fever. 1 – 3 days Aspergillus precipitans * None 5.0 Red top vacuette 13 – 18 days
serum tube Avian allergans * Blood None 5.0 Red top vacuette serum tube 13 – 21 days Bartonella henselae antibodies */ Cat Scratch Disease None 5.0 Red top vacuette serum tube Test currently suspended Bordatella pertussis antibodies * Blood None 5.0 Red top vacuette tube Only accepted following prior consultation with Consultant Microbiologist. 18-24 days Borrellia burgdorferi antibodies (Lyme Disease)* Blood None 5.0 Red top vacuette tube 13 – 18 days Brucella screen * Blood None 5.5 Red top vacuette serum tube 7-14 days Chlamydia trachomatis (CT) PCR * Samples requested for CT investigations will also be tested for Neisseria gonorrhoeae (GC) Urethral Swab Swab Eye Swab Throat swab Rectal Swab specimen None Not relevant Swab/ APTIMA collection device kits Available from Serology Lab Details on specimen collection for combined CT and GC testing are included in the APTIMA collection device kits 7-14 days Chlamydia CFT assay (Non STD, respiratory) Discontinued, NVRL in conjunction with labs in the UK has been unable to obtain control antigens for Chlamydia for use in the CFT assay. Chloramphenicol levels * Blood None 5.5 Red top vacuette serum tube Only accepted following prior consultation with Consultant Microbiologist. 3 – for phoned result
Clostridium tetani antibodies * Blood None 5.5 Red top vacuette serum tube Only accepted following consultation with Consultant Microbiologist. 18-24 days Coeliac Screen Blood None 5.5 Red top vacuette serum tube Supplementary testing sent to Immunology UCHG if Anti tTG is positive on initial screening. 2-5 days for screen Corynebacterium diphtheriae antibodies * Blood None 5.5 Red top vacuette tube Only accepted following prior consultation with Consultant Microbiologist. 18-24 days Coxiella burnetti (Q fever) antibodies * Blood None 5.5 Red top vacuette serum tube Only accepted following prior consultation with Consultant Microbiologist. 18 - 24 days Cryptococcus Serology * Blood None 5.5 Red top vacuette serum tube Only accepted following prior consultation with Consultant Microbiologist. 24 days Cytomegalovirus (CMV) antibodies * None 5.5 Red top vacuette tube 7-12 days Cytomegalovirus (CMV) DNA CMV PCR * Blood Urine K EDTA 4.5 Purple top vacuette EDTA tube Serology Lab must be notified before sending samples. Specimen collect date and time must be provided on request form. Samples must be received in Laboratory, separated and frozen within 24 hrs of venepuncture. Please send to laboratory immediately as sample must be sent frozen to referral lab 10 – 18 days
None Sterile Universal Dengue Antibodies * Blood None 5.5 Red top vacuette tube Only accepted following prior consultation with laboratory. Please provide clinical details including comprehensive travel history 18-24 days Echinococcus antibodies (Hydatid Cyst / Cystercercosis Ab) * Blood None 5.5 Red top vacuette serum tube Only accepted following consultation with Consultant Microbiologist. 18-24 days Epstein-Barr Virus (EBV) antibodies * Blood None 5.5 Red top vacuette serum tube 7 – 12 days Epstein-Barr Virus PCR EBV DNA * Blood K EDTA 4.5 Purple top vacuette EDTA tube Serology Lab must be notified before sending samples. Specimen collect date and time must be provided on request form. Samples must be received in Laboratory, separated and frozen within 24 hrs of venepuncture 10 – 21 days Farmers lung screen * Blood None 5.5 Red top vacuette serum tube 10 – 24 days Gentamicin levels *** Blood None 5.5 Red top vacuette serum tube Site of infection, Time blood was collected, Dose schedule, When last dose was given, must be clearly indicated on request form. See HSE Intranet/ SUH homepage/ hyperlink to ‘Guide to Antimicrobial Use in SRH’ 3-6 hours Results outside therapeutic ranges are phoned to ward during routine day. All tests performed On Call are phoned to ward
Group B streptococcal PCR Blood K EDTA 4.5 adult 1.5 paed Purple top vacuette EDTA tube Please state on request form if patient was on antibiotic before taking sample, Clinical details, Date of onset of symptoms If sample received in referral lab before 11 AM preliminary verbal report can be issued same day. Haemophilus influenzae b antibodies (HIB) * Blood None 5.5 Red top vacuette serum tube 15-24 days Haemophilus PCR * Blood K EDTA 4.5 adult 1.5 paed Purple top vacuette EDTA tube Please state on request form if patient was on antibiotic before taking sample, Clinical details, Date of onset of symptoms If sample received in referral lab before 11 AM preliminary verbal report can be issued same day. Hepatitis A IgM (Acute infection) *** None 5.5 Red top vacuette serum tube 2 – 6 days Hepatitis A IgG (Immunity/ Past infection) * None 5.5 Red top vacuette serum tube 7 – 14 days Hepatitis B surface antigen *** (HBsAg) Acute Infection ** Blood None 5.5 Red top vacuette serum tube 2 – 6 days (PTWIP) Anti-HBs *** (Hepatitis B Immunity/ Vaccination) Blood None 5.5 Red top vacuette serum tube Please provide vaccination history. For information on HBV vaccine schedule/ post vaccination testing refer to Immunisation Guidelines at - Chapter 9 Hepatitis B 2 - 6 days Anti-HB core (Evidence of past infection) * Blood None 5.5 Red top vacuette serum tube 7 – 12 days
Hep B markers: HBeAg, Anti Hep B core specific IgM Blood None 5.5 Red top vacuette serum tube 7 – 12 days Hepatitis B viral load, HBV DNA * Blood KEDTA 4.5 Purple top Vacuette EDTA tube Specimen collect date and time must be provided on request form. Samples must be received in Laboratory, separated and frozen within 24 hours of venepuncture and Serology Lab notified before blood is taken. 10 – 21 days Hepatitis C serology *** ** None 5.5 Red top vacuette serum tube 2 – 6 days (PTWIP) Hepatitis C Ag * Blood None 5.5 Red top vacuette serum tube 5-12 days HCV Genotype * KEDTA OR None 4.5 5.5 Purple top Vacuette EDTA tube Red top vacuette serum tube Specimen collect date and time must be provided on request form. Samples must be received in Laboratory, separated and frozen within 24 hours of venepuncture and Serology Lab notified before blood is taken. 10 – 24 days HCV PCR/ load * Blood KEDTA OR None 4.5 5.5 Purple top Vacuette EDTA tube Red top vacuette serum tube Specimen collect date and time must be provided on request form. Samples must be received in Laboratory, separated and frozen within 24 of venepuncture and Serology Lab notified before blood is taken. 10 – 24 days
Leptospiral screen * Blood None 5.5 Red top vacuette serum tube 10 – 18 days Measles antibodies (IgM + IgG) * Blood None 5.5 Red top vacuette serum tube 10 – 18 days antibodies * Blood None Paed 1.5 (0.2-0.5 ml serum) Red top vacuette tube Variable, 2 – 6 months Monospot (Glandular fever) Blood None 5.5 Red top vacuette serum tube 1.-3 days Mumps antibodies (IgM + IgG) * Blood None 5.5 Red top vacuette serum tube 10 – 18 days Mycoplasma pneumoniae antibodies * Blood None 5.5 Red top vacuette serum tube NVRL will test Mycoplasma IgM for patients under the age of 20. For patients >/= 20 years old prior discussion is required with Consultant Microbiologist as these samples are sent, to UK for analysis 10 – 18 days Neisseria meningitidis PCR * Blood K EDTA 4.5 adult 1.5 paed Purple top vacuette EDTA tube Please on request form if patient was on antibiotic before taking sample, Clinical details, Date of onset of symptoms If sample received in referral lab before 11 AM preliminary verbal report can be issued same day. Parvovirus B19 serology * Blood None 5.5 Red top vacuette serum tube 10 – 18 days Pneumococcal antibodies * Blood None 5.5 Red top vacuette serum tube Only accepted following prior consultation with Consultant Microbiologist 15-24 days
Pneumococcal PCR * Blood K EDTA 4.5 adult 1.5 paed Purple top vacuette EDTA tube Please state on request form if patient was on antibiotic before taking sample, Clinical details, Date of onset of symptoms If sample received in referral lab before 11 AM preliminary verbal report can be issued same day Polyomavirus (JC, BK) * CSF Urine None 5.5 Red top vacuette serum tube Sterile Universal Specimen collect date and time must be provided on request form and sample. Sample must be received and frozen within 24 hours of venepuncture. sample must be frozen within 24 hrs of collection 10-24 days Rubella IgG*** Blood None 5.5 Red top vacuette serum tube 2-6 days Rubella IgM * Blood None 5.5 Red top vacuette serum tube 7-12 days Staphylococcal antibodies * Blood None 5.5 Red top vacuette serum tube Test currently suspended Schistosomal antibodies * (Primarily screened on in microbiology) None 5.5 Red top vacuette serum tube Only accepted following prior consultation with Consultant Microbiologist 15-24 days Syphilis *** screen (Treponema pallidum) ** Blood None 5.5 Red top vacuette serum tube 2-6 days Teicoplanin level (Trough) * Blood None 5.5 Red top vacuette serum tube Site of infection, Dose schedule, When last dose was given, must be clearly indicated on form. Only accepted following 3– 7 days for phoned result
prior consultation with Consultant Microbiologist Tobramycin Level * None 5.5 Red top vacuette serum tube State dose schedule, when last dose was received, Tobramycin is assayed in St Vincent’s Hospital 2 – 4 days for phoned result Toxocaral antibodies * Blood None 5.5 Red top vacuette tube 15-24 days Toxoplasma screen * Blood None 5.5 Red top vacuette serum tube 7-12 days Vancomycin levels *** None 5.5 Red top vacuette tube Site of infection, Collect time of sample, Dose schedule, When last dose was given, must be clearly indicated on request form. See HSE Intranet/ SUH homepage/ hyperlink ‘Guide to Antimicrobial Use in SRH’, 2 hrs Results outside therapeutic ranges are phoned to ward during routine day. All tests performed On Call are phoned to ward Varicella Zoster Virus (VZV) *** antibodies ** Blood None 5.5 Red top vacuette serum tube 2-6 days Viral Screen Blood None 5.5 Red top vacuette serum tube Please provide relevant clinical details.Tests analysed by NVRL are based on clinical information supplied on original Laboratory request form. Clinical team in NVRL can be contacted at 01 7164418 if advice is required 7-12 days West Nile Virus * Blood None 5.5 Red top vacuette serum tube Only accepted following prior consultation with Consultant Microbiologist 10- 18 days Widal test Discontinued. Does not meet criteria for diagnostic test. No longer available in this country. Yersinia antibodies * Blood None 5.5 Red top vacuette Test discontinued. The recommended method for the diagnosis of suspected Yersiniosis is the