A message from Adam Morgan, M.D. (Laboratory Medical Director | SSM Health St. Mary’s Hospital - Madison) ...

STI testing updates Notification Date: 5/30/2025 Effective Date: 6/2/2025

Based on feedback to simplify specimen source selection, new orderables for ThinPrep sources for STI testing has been built. 
ThinPrep sources will be removed from the current CT/NG and TV orderables.
No changes have been made to the HPV test orderable.

Ordering Information

Please direct questions or comments to:

Rachel Bosserman, PhD, D(ABMM)
Clinical Microbiologist
SSM Health St. Mary's Hospital - Madison
608-258-6393

Please communicate to colleagues and staff in your area accordingly.

Thank you,

Adam Morgan, M.D.

Laboratory Medical Director

Pathology, SSM Health St. Mary’s Hospital Madison

700 South Park Street

Madison, WI 53715

Phosphorus Critical Value Change Notification Date: 4/7/25 Effective Date: 5/15/25

   Assistant Laboratory Medical Director, Chemistry
   SSM Health St. Mary’s Hospital Madison
   Office: (608) 258-6914
   molly.gurney@ssmhealth.com

A message from Adam Morgan, M.D. (Laboratory Medical Director | SSM Health St. Mary’s Hospital - Madison) ...

Legionella DFA (LAB06390) to be discontinued Notification Date: 3/13/25 Effective Date: 3/18/25 SUBJECT: Effective 3/18/25, Legionella DFA testing will no longer be performed at St. Mary’s Madison, Microbiology Laboratory. The preferred diagnostic tests for Legionella are: Legionella urine antigen test (LAB06351) Culture Legionella (LAB04045) of lower respiratory secretions.  Please direct questions or comments to:     Amanda Martinez, MLS (ASCP)     Microbiology Manager, St. Mary’s Madison     608-258-5977     Amanda.Martinez@ssmhealth.com Please communicate to colleagues and staff in your area accordingly. Thank you, Adam Morgan, M.D. Laboratory Medical Director Pathology, SSM Health St. Mary’s Hospital Madison 700 South Park Street Madison, WI 53715 Office: (608) 258-6914

STI Testing on ThinPrep specimens Notification Date: 3/7/2025 Effective Date: 3/10/2025 SUBJECT: STI testing will be available on ThinPrep specimens Effective 3/10/25, STI testing for Chlamydia + N. gonorrhoeae (LAB15225) and Trichomonas Vaginalis (LAB15226) can be performed on ThinPrep specimens. The STI testing must be ordered prior to Cytology processing and will not be allowed as an add-on test, due to the risk of nucleic acid contamination. Please direct questions or comments to:     Amanda Martinez, MLS (ASCP)     Microbiology Manager, St. Mary’s Madison     608-258-5977     Amanda.Martinez@ssmhealth.com Please communicate to colleagues and staff in your area accordingly. Thank you, Adam Morgan, M.D. Laboratory Medical Director Pathology, SSM Health St. Mary’s Hospital Madison 700 South Park Street Madison, WI 53715 Office: (608) 258-6914

A message from Adam Morgan, M.D. (Laboratory Medical Director | SSM Health St. Mary’s Hospital - Madison) ...

Rotavirus antigen, feces Bordetella pertussis / parapertussis Notification Date: 2/27/2025 Effective Date: 2/27/2025 SUBJECT: Performing Lab updates Rotavirus antigen, feces (LAB04117) will be sent to ARUP. Order Lab Miscellaneous – ARUP Test Code 0065088. Turnaround time is 24 hours + transit time If a faster turnaround time and/or testing for multiple gastrointestinal viruses is needed, order the Gastrointestinal Pathogen Panel by PCR (LAB10921). Bordetella pertussis / parapertussis (LAB14300) on nasophareyngeal swabs will be performed at St. Mary’s Madison. Nasopharyngeal aspirates, BALs, Nasal swabs, and throat swabs will continue to be sent to ARUP. Please direct questions or comments to:     Amanda Martinez, MLS (ASCP)     Microbiology Manager, St. Mary’s Madison     608-258-5977     Amanda.Martinez@ssmhealth.com Please communicate to colleagues and staff in your area accordingly. Thank you, Adam Morgan, M.D. Laboratory Medical Director Pathology, SSM Health St. Mary’s Hospital Madison 700 South Park Street Madison, WI 53715 Office: (608) 258-6914

Chlamydia trachomatis/Neisseria gonorrhoeae (CT/NG), Trichomonas vaginalis (TV), and HPV testing Notification Date: 11/20/2024 Effective Date: 12/3/2024 SUBJECT: Neisseria gonorrhoeae/Chlamydia trachomatis, Trichomonas vaginalis, and HPV  testing at St. Mary’s Madison On December 3rd, St. Mary’s Madison Microbiology Laboratory will update testing strategies for Chlamydia trachomatis/Neisseria gonorrhoeae (CT/NG), Trichomonas vaginalis (TV), and HPV.  The orderable codes have changedfor CT/NG and TV testing to CHLAMYDIA AND N. GONORRHOEAE NAA [LAB15225] and TRICHOMONAS VAGINALIS NAA [LAB15226]. There will also be a change in collection devices for CT/NG and TV testing (Roche collection devices required); Aptima tubes will no longer be accepted. Testing will be performed daily Monday-Friday. HPV testing previously performed at Fond du Lac will now be routed to Madison. Video: Endocervical Swab Specimen Collection with the cobas PCR Media Dual Swab Sample Kit.mp4 Vagnial Swab Specimen Collection with the cobas PCR Media Uni Swab Sample Kit.mp4 Vaginal Swab Specimen Collection with the cobas PCR Media Dual Swab Sample Kit.mp4 Please communicate to colleagues and staff in your area accordingly. Thank you, Adam Morgan, M.D. Laboratory Medical Director Pathology, SSM Health St. Mary’s Hospital Madison 700 South Park Street Madison, WI 53715 Office: (608) 258-6914

SARS-COV-2 (Antigen) Hospital Discharge Screen Notification Date: 7/17/24 Effective Date: 7/18/24 SUBJECT: SARS-COV-2 (Antigen) Hospital Discharge Screen is discontinued SITE: St. Mary’s Hospital – Madison The COVID-19 Discharge Antigen Test was implemented on March 7th, 2023, in response to Skilled Nursing Facilities requiring COVID-19 screening prior to admission. This test was used for discharge screening only, not for preadmission testing, preprocedural testing, or diagnosis. Many Skilled Nursing Facilities have now relaxed these requirements, reducing our test utilization. As a result, Laboratory, and the Infection Prevention Committee have elected to discontinue this assay. It will be removed from all order and preference lists effective 07/18/2024. The Antigen Hospital Discharge Screen used a different collection kit than the continuing PCR test. Please discard all collection kits labeled for the discharge screen test. If a COVID-19 test is required for discharge, please order SARS-COV-2 (COVID-19) RAPID PCR LAB13674. Please direct questions or comments to:      Nyssa Sheridan, MS, MLS (ASCP)      Microbiology Technical Specialist, St. Mary’s Madison Microbiology      608-258-6756      nyssa.sheridan@ssmhealth.com Please communicate to colleagues and staff in your area accordingly. Thank you, Adam Morgan, M.D. Laboratory Medical Director Pathology, SSM Health St. Mary’s Hospital Madison 700 South Park Street Madison, WI 53715 Office: (608) 258-6914

A message from Adam Morgan, M.D. (Laboratory Medical Director | SSM Health St. Mary’s Hospital - Madison) ...

Urine Lab Critical Value Elimination Effective Date: 07/16/2024 SUBJECT: Eliminated urine critical value at St. Mary’s Hospital - Madison SITES: ST. MARY’S MADISON HOSPITAL Critical values are defined as values that are outside the normal range to a degree that may constitute an immediate health risk to the individual or require immediate action on the part of the ordering physician. Critical values in urine ketones/glucose serve as one parameter to identify patients in diabetic ketoacidosis, and a critical call value is currently called with urine ketones ≥ 80 mg/dL and glucose ≥ 50 mg/dL. The laboratory has received feedback from urgent care and the ED that the values do not rise to the level of critical requiring a direct notification from lab. In order to streamline lab processes, reduce the communication burden on hospital staff, and align with SSM system ministries, the urine critical value will be eliminated. This change has been reviewed and approved by the SMM Medical Executive Committee. Please communicate to colleagues and staff in your area accordingly. Thank you, Adam Morgan, M.D. Laboratory Medical Director Pathology, SSM Health St. Mary’s Hospital Madison 700 South Park Street Madison, WI 53715 Office: (608) 258-6914

A message from Adam Morgan, M.D. (Laboratory Medical Director | SSM Health St. Mary’s Hospital - Madison) ...

NOROVIRUS DETECTION BY PCR Notification Date: 7/1/2024 Effective Date: 7/9/2024 SUBJECT: NOROVIRUS DETECTION BY PCR available in-house 7/9/2024 The NOROVIRUS DETECTION BY PCR test will be performed in the Microbiology Laboratory at St. Mary’s Hospital in Madison (Test Code LAB02737) on 7/9/2024.  This will decrease the turnaround time for this test significantly.  Please review the specimen collection and specimen storage and transport conditions because some things have changed.  Test Performance: •           Daily 24/7, TAT ≤ 6 hours Please communicate to colleagues and staff in your area accordingly. Thank you, Adam Morgan, M.D. Laboratory Medical Director Pathology, SSM Health St. Mary’s Hospital Madison 700 South Park Street Madison, WI 53715 Office: (608) 258-6914

A message from Adam Morgan, M.D. (Laboratory Medical Director | SSM Health St. Mary’s Hospital - Madison) ...

Urinalysis testing Notification Date: 6/27/2024 Effective Date:  6/25/2024 SUBJECT: Urine specimen requirements have changed SITES: ST. MARY’S MADISON HOSPITAL Marble topped tubes are no longer acceptable containers for urine testing. Sterile urine cups are acceptable containers for these tests:   TEST NUMBER TEST NAME LAB07502 Urinalysis Reflex Microscopic Reflex culture LAB10361 Urinalysis with Microscopic NO culture LAB90205 Urinalysis with Microscopic Reflex to culture LAB07530 Urinalysis Reflex to Microscopic NO culture LAB07532 Urinalysis NO Microscopic NO culture LAB07500 Ketones Qual Urine Auto LAB07534 pH Urine Auto LAB07523 Protein Qualitative Urine Auto LAB07519 Specific Gravity Urine Please communicate to colleagues and staff in your area accordingly. Thank you, Adam Morgan, M.D. Laboratory Medical Director Pathology, SSM Health St. Mary’s Hospital Madison 700 South Park Street Madison, WI 53715 Office: (608) 258-6914

A message from Adam Morgan, M.D. (Laboratory Medical Director | SSM Health St. Mary’s Hospital - Madison) ...

Syphilis / RPR testing Notification Date: 5/15/2024 Effective Date: 5/16/2024 SUBJECT: RPR testing will be performed at St. Mary’s Hospital - Madison SITES: ST. MARY’S, ST CLARE, JANESVILLE, andMONROE HOSPITALS, and DEAN CLINICS Bringing RPR testing into St. Mary’s lab will further improve turnaround time for syphilis screening and provide more rapid turnaround time for assessment of congenital syphilis. To align with the system initiatives and reduce ordering confusion, we have streamlined the orderable syphilis tests as noted below: Syphilis Screening: SYPHILIS TOTAL AB SCREEN WITH REFLEX (LAB12272)   Congenital Syphilis/Syphilis Monitoring: RPR WITH REFLEX TO TITER (LAB12430) DISCONTINUED: RPR WITH REFLEX TITER AND TP-PA CONFIRMATION (LAB07050) – this traditional Syphilis screening method will be discontinued and no longer orderable. See below information for more detail on the reverse algorithm screen. Reverse syphilis testing algorithm starts with an assay to measure IgM and IgG antibodies specific to Treponema pallidum (TP) utilizing the Syphilis TP antibody CMIA assay which will be performed at St. Mary’s Madison.  Advantages of utilizing the Reverse Syphilis Screening Model: The TP antibody screening test is specific to syphilis (although false positives may occur). TP antibodies are more sensitive than RPR for detecting both primary and late syphilis. The TP antibody assay can be performed within the SSM Wisconsin region to improve turnaround time. Samples which are reactive for TP (syphilis) antibodies will be reflexed to rapid plasma reagin (RPR) confirmation testing to help distinguish between infection with T. pallidum (syphilis) versus a falsely reactive treponemal antibody result.  The TP antibody test and RPR test can identify persons previously treated for syphilis and those with untreated or incompletely treated syphilis. Discordant results between the syphilis TP antibody assay and RPR will be further reflexed to a second treponemal test, Treponema Pallidum Particle Agglutination (TP-PA) for further evaluation if necessary.  Please see the chart below for interpreting results utilizing the reverse screening model.            Table. Interpretation and follow-up of syphilis reverse screening results Patient History Syphilis (TP)  IgM/IgG antibody screen CMIA RPR TP-PA Interpretation Follow - up Unknown history of syphilis Nonreactive N/A N/A No serologic evidence of syphilis None, unless clinically indicated (e.g. early/acute/primary syphilis) Unknown history of syphilis Reactive Reactive N/A Untreated or recently treated syphilis See Centers for Disease Control and Prevention treatment guidelines Unknown history of syphilis Reactive Nonreactive Nonreactive Probable false-positive screening test No clinical follow-up testing, unless clinically indicated (e.g. acute/primary syphilis) Unknown history of syphilis Reactive Nonreactive Reactive Possible syphilis (e.g. early or latent) or previously treated syphilis Historical and clinical evaluation required Known history of syphilis Reactive Nonreactive Reactive or N/A Past, successfully treated syphilis None CMIA = Chemiluminescent microparticle immunoassay RPR = rapid plasma reagin TP-PA = Treponema pallidum particle agglutination Please communicate to colleagues and staff in your area accordingly. Please direct questions or comments to: Amy Little Soldier                         Molly Gurney, M.D. Laboratory Technical Specialist, Chemistry Assistant Laboratory Medical Director, Chemistry SSM Health St. Mary’s Hospital Madison SSM Health St. Mary’s Hospital Madison Office: (608) 258-6910 Office: (608) 258-6914 amy.littlesoldier@ssmhealth.com molly.gurney@ssmhealth.com Thank you, Adam Morgan, M.D. Laboratory Medical Director Pathology, SSM Health St. Mary’s Hospital Madison 700 South Park Street Madison, WI 53715 Office: (608) 258-6914