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Guide to Services 2020 CADHAM PROVINCIAL LABORATORY GUIDE TO SERVICES 2020 Serving Manitoba since 1897 Cadham Provincial Laboratory_V2.indd 1 2021-06-18 3:02 PM 2 I CADHAM PROVINCIAL LABORATORY Cadham Provincial Laboratory_V2.indd 2 2021-06-18 3:08 PM CADHAM PROVINCIAL LABORATORY MANITOBA HEALTH, SENIORS AND ACTIVE LIVING LOCATION: Cadham Provincial Laboratory 750 William Avenue Winnipeg, Manitoba Telephone: 204-945-6123 Fax: 204-786-4770 Email: [email protected] Website: www.manitoba.ca/health/publichealth/cpl MAILING ADDRESS: Cadham Provincial Laboratory P.O. Box 8450 Winnipeg, Manitoba R3C 3Y1 December 2011 Revised March 2013 (electronic version only) Revised November 2014 (electronic version only) Revised October 2015 (electronic version only) February 2018 September 2019 March 2020 GUIDE TO SERVICES 2020 I 3 Cadham Provincial Laboratory_V2.indd 3 2021-06-18 3:08 PM TABLE OF CONTENTS RESPONSIBILITIES ................................................................................................. 7 SENIOR STAFF ..........................................................................................................8 ABBREVIATIONS USED .........................................................................................9 GENERAL GUIDE TO LABORATORY USE .....................................................10 BIOHAZARD RESPONSE TEAM ........................................................................ 13 OUTBREAK RESPONSE SUPPORT .................................................................. 14 SEXUAL ASSAULT PROTOCOL .........................................................................17 NEEDLESTICK INJURY PROTOCOL ............................................................... 18 1.0 TECHNICAL SUPPORT SERVICES ................................................ 19 1.1 SPECIMEN SUBMISSION REQUIREMENTS ................................19 1.1.1 Requisition Requirements .......................................................19 1.1.2 Specimen Labeling Requirements (Specified on the Container) (Mandatory) ............................................................20 1.1.3 Newborn Screening and Maternal Serum Screening Requirements ....................................................................................21 1.1.4 Transport of Specimens .............................................................21 1.2 SPECIMEN REJECTION POLICY .......................................................22 1.3 PACKAGING AND TRANSPORT OF SPECIMENS ....................23 1.4 TRANSPORTING SPECIMENS TO CPL ..........................................25 1.5 TRANSPORT SUPPLIES ............................................................................29 1.6 TRANSPORT MEDIA (TM) ......................................................................30 1.7 TRANS-SHIPPING OF SPECIMENS BY CPL ................................31 2.0 CLINICAL MICROBIOLOGY .....................................................................32 2.1 SPECIMEN COLLECTION ......................................................................33 2.1.1 Abscesses ...........................................................................................34 2.1.2 Blood for Culture............................................................................34 2.1.3 Body Fluids (Except Urine and Cerebrospinal Fluid) .........................34 2.1.4 Bullae, Cellulitis, Petechiae, Vesicles ...............................35 4 I CADHAM PROVINCIAL LABORATORY Cadham Provincial Laboratory_V2.indd 4 2021-06-18 3:08 PM 2.1.5 Cerebrospinal Fluid ......................................................................35 2.1.6 Cervix and Endometrium ..........................................................36 2.1.7 Conjunctiva .......................................................................................36 2.1.8 Nasopharynx .....................................................................................37 2.1.9 Nose.......................................................................................................37 2.1.10 Pus..........................................................................................................37 2.1.11 SKIN .......................................................................................................37 2.1.12 Sputum ................................................................................................38 2.1.13 Stool, Feces, Rectal ....................................................................38 2.1.14 Throat ...................................................................................................39 2.1.15 Transtracheal Aspirate .............................................................39 2.1.16 Vagina ..................................................................................................39 2.1.17 Urethra ................................................................................................39 2.1.18 Urinary Specimens .....................................................................40 2.1.19 Wounds ..............................................................................................40 2.2 STI BACTERIOLOGY ..................................................................................40 2.2.1 Gonorrhea Culture .....................................................................40 2.2.2 Chlamydia and Gonorrhea Detection by NAAT .......41 2.3 REFERENCE MICROBIOLOGY ............................................................43 2.4 ANTIBIOTIC SUSCEPTIBILITY TESTING .......................................44 2.5 REPORTING .....................................................................................................44 2.6 CLINICAL MICROBIOLOGY TURNAROUND TIMES ..............44 3.0 SEROLOGY - PARASITOLOGY ................................................................47 3.1 SEROLOGY TESTS ........................................................................................48 3.1.1 Hepatitis B Testing Guidelines ...........................................48 3.1.2 Galactomannan (GM) Antigen Test .................................49 3.1.3 Interferon Gamma Release Assay (IGRA) for Latent Tuberculosis Infection .............................................................50 3.1.4 Viral Load (NAAT) Testing and Genotyping .................51 3.1.4.1 HBV, HCV and HIV Viral Loads ..........................52 3.1.4.2 HIV1/2 and HTLV-I/II Provirus Testing .........52 3.1.5 Syphilis PCR .....................................................................................53 3.1.6 HIV Point-Of-Care Testing (HIV POCT) .........................53 3.1.7 Haemophilus Influenzae Type b Antibody (IgG) for Immune Status Assessment ..................................................54 3.1.8 COVID-19 Serology (Antibody Testing) .........................54 3.2 SEROLOGY TEST SCHEDULE ............................................................. 55 GUIDE TO SERVICES 2020 I 5 Cadham Provincial Laboratory_V2.indd 5 2021-06-18 3:08 PM 3.3 SAMPLE REQUIREMENTS.................................................................... 56 3.4 REQUISITIONS ............................................................................................. 56 3.5 TRANSPORT .................................................................................................. 56 3.6 REFERRED OUT SEROLOGY TESTS ...............................................57 3.7 PARASITOLOGY TESTING .....................................................................58 4.0 VIRUS DETECTION .................................................................................... 63 4.1 SPECIMEN REQUIREMENTS ................................................................64 4.2 SPECIMEN COLLECTION ...................................................................... 65 5.0 PERINATAL CHEMISTRY ...........................................................................72 5.1 NEWBORN SCREENING PROGRAM ...............................................73 5.2 MATERNAL SERUM SCREENING (QUAD TESTING) PROGRAM .........................................................................................................82 5.2.1 Adding Nuchal Translucency (NT) to the Risk Calculation ........................................................................................83 5.2.2 Non-Invasive Prenatal Screening (NIPS) .....................83 6.0 INFORMATION MANAGEMENT ............................................................ 85 7.0 ALPHABETICAL INDEX OF TESTING................................................... 89 8.0 FORMS AND REQUISITIONS....................................................................122 INFECTIOUS SPECIMEN TRANSPORT GUIDELINES .....................123 BLUE TRANSPORT BOX OR COOLER PACKAGING DIRECTIONS ...............................................................................124 6 I CADHAM PROVINCIAL LABORATORY Cadham Provincial Laboratory_V2.indd 6 2021-06-18 3:08 PM RESPONSIBILITIES Cadham Provincial Laboratory (CPL) is responsible for several province-wide public health, reference and diagnostic services. It is the central public health microbiology reference laboratory for Manitoba and supports Manitoba Health disease control programs. CPL is directly linked to Manitoba Health, Seniors and Active Living in surveillance of communicable diseases and is the principal laboratory participant in outbreak investigations. CPL is also the sole centre for laboratory services in virology, chlamydiology and infectious diseases serology and serves patients, practitioners and public health units in Manitoba, and parts of Nunavut, Northwest Ontario and
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