Latest News

  • Notification of change in service for the diagnosis of H Pylori Infections

    Notification of change in service for the diagnosis of H Pylori Infections

    Item Author Joanne Duffy

    The laboratories at HEFT are changing the way we diagnose H. pylori infections. Urease breath tests (UBT) and blood tests (helicobacter serology) will no longer be available from our laboratories with immediate effect. These tests are being replaced with a Stool Antigen Test (SAT).

    Guidance released in 2012 on the management of H. pylori (Management of Helicobacter pylori infection—the Maastricht IV/ Florence Consensus Report) indicates that the SAT is equivalent to UBT in terms of diagnostic performance and does not require a hospital appointment like UBT. Helicobacter serology is also not recommended by updated PHE guidelines for most patients (PHE H. pylori guideline).

    The stool antigen is reliable for both diagnosis and post eradication testing, provided the patient has avoided PPIs for 2 weeks and antibiotics for 4 weeks prior to sample collection.

    A stool sample is required and samples must arrive in the laboratory within 48 hours of collection. Patients should be advised to bring the properly labelled stool sample in a blue topped sample pot (picture below) to the GP surgery or laboratory reception as soon as possible after collection, ideally same day or next morning.

    If you have any queries relating to this notice, please do not hesitate to contact us:

    Duty Biochemist:

    Telephone: 0121 424 2000 (Bleep 2506)

  • Notification of Assay Change: Vitamin D

    Item Author Joanne Duffy

    We are changing our Vitamin D method to the Abbott Total 25OH-Vitamin D method from Monday 16th January 2017. This is to allow us to process more rapidly the very large number of requests for vitamin D.

    Reference ranges and specimen requirements will not change.

    The circulating form of vitamin D is hydroxylated colecalciferol (vitamin D3). Most patients with vitamin D deficiency are also treated with vitamin D3, but a small number of patients are given ergocalciferol (vitamin D2) instead. Since the Abbott method cannot detect vitamin D2 in equimolar concentrations (up to 50% under-recovery), those given ergocalciferol will require their serum vitamin D levels to be measured using the mass spectroscopy method.

    The mass spectrometry method can be requested for patients on D2 using ICE requesting. If ICE requesting is not available, please use the clinical details section to document this or alternatively request “VITDMS” in the tests request section.

    All paediatric samples will be run on the mass spectrometer due to the smaller sample volume requirements on this method.

    The new abbott Vitamin D assay is awaiting accreditation and will be assessed by UKAS against ISO 15189 standards at our next annual inspection.

    For further information about vitamin D and the methods we offer please visit the test database. If you have any queries relating to this notice, please do not hesitate to contact us: Duty Biochemist: 0121 424 2000 (Bleep 2506)

  • Dual Liquid Swabs for MRSA Screening (Heart of England Trust Only)

    Dual Liquid Swabs for MRSA Screening (Heart of England Trust Only)

    Item Author Craig Webster

    The PHE microbiology laboratory at Heartlands is no longer able to process dual liquid swabs for MRSA screening if two swabs are left in the sample tube.

    To perform a dual emergency MRSA screen, swab the patient's nostrils with the pink swab; put the swab into the tube and rotate the swab against the side of tube to release the sample into the liquid. Do not break off the pink swab into the tube - remove and discard the pink swab after the sample has been added to the liquid. The white swab used for the patient's groin should still be broken off and left in the tube.

    Full instructions for using Dual Liquid Swabs for MRSA Screening can be found under "infection control" then "MRSA" on the HEFT intranet: http://intranet_1/infectioncontrol/MRSA%20Dual%20Swab%20Poster%20May15.pdf

  • Troponin testing in suspected ACS patients at HEFT

    Troponin testing in suspected ACS patients at HEFT

    Item Author Craig Webster

    The Trust guidance on Cardiac Troponin testing has been revised in line with the European Society of Cardiology guidance.

    This process will be in place from 10th October 2016 and will be subject to audit. The trust uses gender specific Troponin results – for Males <34ng/l and for Females <16ng/l are considered to be within normal range.

    The main change is that patients with chest pain >6hrs ago, and remaining pain free during their hospital attendance, will only require a single troponin in order to exclude an ACS. If the hs-TnI is undetectable, risk stratification is also favourable and the patient is pain free then the patient can be considered for discharge with arrangements for outpatient investigation if appropriate.

    Paired troponin samples should still be sent at 0h and 3h for patients with onset of chest pain within the last 6 hrs or with ongoing chest pains whilst in hospital.

    The ICE requesting system will incorporate a prompt box to ask clinicians to clearly specify if the request is for a single or paired troponin. There will also be a reminder message on the results screen of the Troponin results.

    The flowchart below summarises this change and is a reminder of the role troponin plays in the suspected ACS pathway. 

     

  • Faecal Calprotectin and Local IBS Guidelines

    Item Author Emma Evans

    Faecal Calprotectin (FCAL) is a protein that is released into the intestines in excess when there is any inflammation. Many people with irritable bowel syndrome (IBS) have unnecessary invasive hospital investigations before their condition is diagnosed. Use of FCAL testing may lead to a reduction in the number of investigations being requested for people with a high likelihood of an IBS diagnosis. This will:

    • Improve the patient experience for those with IBS and reduce the number of patients undergoing invasive procedures within secondary care.

    • Reduce outpatient referrals into secondary care.

    • Increase the numbers accessing rapid diagnosis for IBS/IBD.

    • Improve pathways for the management of IBS.

    • Provide a structured programme to aid decision making in primary care.