Test DIRECTORY
Explore our comprehensive menu of laboratory tests designed to support accurate, reliable results across every specialty.
APG LAB's test directory provides a comprehensive list of specialty and general laboratory testing services.
There are currently 19 names in this directory beginning with the letter U.
UGT1A1 Irinotecan Toxicity
Synonyms
- Camptosar®
- Irinotecan
Expected Turnaround Time
5 - 7 days
Turnaround time is defined as the usual number of days from the date of pickup of a specimen for testing to when the result is released to the ordering provider. In some cases, additional time should be allowed for additional confirmatory or additional reflex tests. Testing schedules may vary.
Specimen Requirements
Specimen
Whole blood or LabCorp buccal swab kit (buccal swab collection kit contains instructions for use of a buccal swab)
Volume
7 mL whole blood or LabCorp buccal swab kit
Minimum Volume
3 mL whole blood or two buccal swabs
Container
Lavender-top (EDTA) tube, yellow-top (ACD) tube, or LabCorp buccal swab kit
Storage Instructions
Maintain specimen at room temperature or refrigerate at 4°C.
Causes for Rejection
Frozen specimen; hemolysis; quantity not sufficient for analysis; improper container; one buccal swab; wet buccal swab
Test Details
Use
Irinotecan (Camptosar®) is used, or under evaluation, in a broad spectrum of solid tumors, and is often prescribed for treating patients with metastatic cancer of the colon or rectum, especially when 5-fluorouracil treatment has not been entirely successful. Severe toxicity (eg, grade 4 neutropenia) is commonly observed in cancer patients receiving irinotecan who carry the UGT1A1*28 allele, also called TA. This test result will provide valuable information to physicians prior to initiating or modifying treatment or supplementing treatment with additional drugs.
UGT1A1 variants have also been reported in patients with disorders of bilirubin metabolism, such as Crigler-Najjar Types I and II, as well as Gilbert syndrome. Between 80% to 100% of Caucasian patients with Gilbert syndrome are reported to have either one or two copies of UGT1A1*28. G71R (*6), a UGT1A1 variant reported in Asian patients with Gilbert syndrome, is not detected by this assay.
Limitations
The current test will only test the TATA box polymorphism of the UGT1A1 gene. The other polymorphisms of this gene will not be detected.
This test was developed, and its performance characteristics determined, by LabCorp. It has not been cleared or approved by the US Food and Drug Administration (FDA).
Methodology
Polymerase chain reaction (PCR); capillary electrophoresis
Uniparental Disomy (UPD) Proband, DNA Analysis
Synonyms
- Angelman syndrome UPD analysis; Prader-Willi syndrome UPD analysis; Beckwith-Wiedemann syndrome UPD analysis; Russell-Silver syndrome UPD analysis; Chromosome 14 UPD analysis; Chromosome 15 UPD analysis; Chromosome 7 UPD analysis; Chromosome 11 UPD analysis
Special Instructions
This test code is reserved for proband testing. A separate test code is used for parental samples. A separate test request form must be completed for each family member for whom a specimen is submitted. Blood specimens from both parents should be submitted using the parental UPD test code [470115]. The patient's name, age, and relevant clinical and family history should be included on the corresponding test request form. Please include chromosome pair to be studied.
If cultured cells are needed, an additional 7-12 days may be required. Additional culture fee may be included.
Expected Turnaround Time
12 - 16 days
Turnaround time is defined as the usual number of days from the date of pickup of a specimen for testing to when the result is released to the ordering provider. In some cases, additional time should be allowed for additional confirmatory or additional reflex tests. Testing schedules may vary.
Specimen Requirements
Specimen
Whole blood, amniotic fluid, chorionic villus sample (CVS)
Volume
7 mL whole blood; 10 mL amniotic fluid; 2 flasks of amniocyte culture; or 20 mg of CVS tissue
Minimum Volume
3 mL whole blood; 5 mL amniotic fluid; 10 mg of CVS tissue
Container
Lavender-top (EDTA) tube; yellow-top (ACD) tube; sterile plastic conical tube or two confluent T-25 flasks for fetal testing
Storage Instructions
Maintain specimen at room temperature. Do not freeze.
Causes for Rejection
Frozen specimen; hemolysis; improper container; insufficient sample volume
Test Details
Use
Establish the parent of origin for syndromes that may result from single-parent inheritance of both homologues of a specific chromosome pair containing imprinted genetic loci. The best examples of this are Prader-Willi and Angelman syndromes in which maternal and paternal uniparental disomy (for chromosome 15), respectively, are reported. Other examples include Russell-Silver syndrome (chromosome 7) and Beckwith-Wiedemann syndrome (chromosome 11).
Limitations
False-positive or false-negative results may occur for reasons that include blood transfusions, bone marrow transplantation, erroneous representation of family relationships, or contamination of a fetal sample with maternal cells.
This test was developed, and its performance characteristics determined, by LabCorp. It has not been cleared or approved by the US Food and Drug Administration (FDA).
Methodology
Analysis of chromosomal Variable Number Tandem Repeats (VNTRs) and Amplified Fragment Length Polymorpisms (AMPFLPs) by polymerase chain reaction and DNA fragment sizing.
Unknown Substance Analysis
Expected Turnaround Time
10 - 14 days
Turnaround time is defined as the usual number of days from the date of pickup of a specimen for testing to when the result is released to the ordering provider. In some cases, additional time should be allowed for additional confirmatory or additional reflex tests. Testing schedules may vary.
Specimen Requirements
Specimen
Unknown substance or residue
Volume
2 mL or 50 mg
Minimum Volume
Trace or residue
Container
Screw-top container
Storage Instructions
Maintain specimen at room temperature.
Causes for Rejection
Urine from preservative tube
Test Details
Use
Identify drugs in powders, liquids, residues, etc
Methodology
Immunoassay (IA); gas chromatography/mass spectrometry (GC/MS); liquid chromatography with time-of-flight mass spectrometry (LC/TOF)
Upper Respiratory Culture, Routine
Synonyms
- Culture, Upper Respiratory, Routine
- Ear Culture
- Nasopharynx Culture
- Nose Culture
- Sinus Culture
- Throat Culture
Test Includes
Culture; isolation of potential aerobic pathogens, identification (additional charges/CPT code[s] may apply), and susceptibility testing if culture results warrant (additional charges/CPT code[s] may apply). CPT coding for microbiology and virology procedures often cannot be determined before the culture is performed. Requests with only a written order and no test number indicated will be processed according to Default Testing for Routine Microbiology.
Special Instructions
Sterile specimens (eg, sinus aspirates or tympanocentesis fluid), collected by invasive procedures, should be submitted as sterile body fluid cultures. If the amount of material aspirated is small, it may be advisable to inject it into an anaerobic transport or absorb it onto the swab of the bacterial swab collection kit and use the bacterial transport. For throat specimens submitted for isolation of Neisseria gonorrhoeae, use GC (Neisseria gonorrhoeae) Culture Only [008128] and include inoculated Jembec® transport. Specimens from other sources, such as genital, stool, urine, upper and lower respiratory specimens, cannot be cultured under the aerobic bacterial culture test number. If specimens are incorrectly submitted with an order for aerobic bacterial culture, the laboratory will process the specimen for the test based on the source listed on the test request form. The client will not be telephoned to approve this change, but the change will be indicated on the report. Check expiration date of transport; do not use expired device.
Expected Turnaround Time
2 - 4 days
Turnaround time is defined as the usual number of days from the date of pickup of a specimen for testing to when the result is released to the ordering provider. In some cases, additional time should be allowed for additional confirmatory or additional reflex tests. Testing schedules may vary.
Related Information
Related Documents
Specimen Requirements
Specimen
Throat swab, nasopharynx swab, nares swab, ear swab
Volume
One swab or aspirated material
Container
Bacterial culture transport swab
Collection
Throat: Depress tongue and rub swab vigorously over each tonsillar area and posterior pharynx. Any exudate should be touched, and care should be taken to avoid the tongue and uvula. Place swab in transport.
Nasopharynx: With patient's head immobilized, insert flexible wire swab into nostril until it reaches posterior nares. Leave swab in place for 15 to 30 seconds. Rotate and remove. Place swab in transport.
Storage Instructions
Maintain specimen at room temperature.
Causes for Rejection
Unlabeled specimen or name discrepancy between specimen and request label; inappropriate specimen transport device; leaking specimen; specimen received after prolonged delay (usually more than 48 hours); expired transport
Test Details
Use
Isolate and identify potentially pathogenic organisms from throat, sinus etc; evaluate pharyngitis; evaluate nares for staph
Limitations
Interpretation requires a significant level of experience and technical proficiency in order to avoid false-positives and false-negatives.1 Many other etiologic agents can be responsible for pharyngitis.2 Note: This procedure does not include screening for Neisseria gonorrhoeae or Corynebacterium diphtheriae. Anaerobic organisms that are frequently implicated in chronic infection of the tonsils and adenoids are not recovered by aerobic culture methods.
Methodology
Culture
Reference Interval
Routine respiratory flora present or no growth
Additional Information
Thrush, oral candidiasis, and Candida esophagitis frequently complicate antineoplastic therapy, hyperalimentation, transplantation immunosuppression, pregnancy, and the acquired immunodeficiency syndrome (AIDS). In addition to a fungal culture, a saline wet preparation, Gram stain, or KOH preparation demonstrating yeast cells or pseudohyphae may also be useful in rapidly establishing the diagnosis of oral or mucocutaneous candidiasis.
Streptococcus pyogenes: (group A β-hemolytic strep) and other β-hemolytic streptococci in groups B, C, D, and G are generally susceptible to penicillin and its derivatives, therefore, susceptibility need not be routinely determined. The principal reason for considering an alternative drug for individual patients is allergy to penicillin. Erythromycin, a cephalosporin, or clindamycin might be substituted in these cases. Patients allergic to penicillins may also be allergic to cephalosporins.
In the late 1980s a resurgence of serious Streptococcus pyogenes infection was observed. Complications including rheumatic fever, sepsis, severe soft tissue invasion, and toxic shock-like syndrome (TSLS) are reported to be most common with the M1 serotype and a unique invasive clone has become the predominant cause of severe streptococcal infections.3
Ear: Normal flora of the skin of the healthy ear includes Staphylococcus epidermidis, Corynebacterium sp, and Staphylococcus aureus. Correlation of nasopharyngeal cultures with results of tympanocentesis culture is poor and lacks predictive value in identification of the causative agent of otitis media. In decreasing order of frequency, the following organisms have been recovered from tympanocentesis: S pneumoniae (50% to 75%), H influenzae (10% to 30%), Moraxella (Branhamella) catarrhalis (5% to 10%), Streptococcus pyogenes (5% to 10%), Staphylococcus aureus (1% to 5%), Pseudomonas aeruginosa (0.1% to 1%). E coli, Klebsiella pneumoniae, Pseudomonas aeruginosa may be isolated from neonates. In therapeutic failures, S aureus, and P aeruginosa are most frequently recovered. Tympanocentesis is not usually performed in primary infections. It is to be considered in treatment failures and neonates. Candida superinfection may complicate therapy for recurring ear infections and may be a cause of persistent otorrhea. Otitis externa is frequently caused by P aeruginosa and less frequently by Candida sp, Proteus sp, S aureus, and Trichophyton sp.
Uranium, Urine
Expected Turnaround Time
3 - 7 days
Turnaround time is defined as the usual number of days from the date of pickup of a specimen for testing to when the result is released to the ordering provider. In some cases, additional time should be allowed for additional confirmatory or additional reflex tests. Testing schedules may vary.
Specimen Requirements
Specimen
Urine (random)
Volume
10 mL
Minimum Volume
0.5 mL
Container
Metal-free plastic urine container or metal-free transfer tube
Storage Instructions
Submission/transport (<3 days): Room temperature. For storage beyond three days, specimen should be refrigerated or frozen.
Causes for Rejection
Use of non−metal-free collection containers or tubes
Test Details
Use
Evaluate exposure to uranium
Methodology
Inductively coupled plasma/mass spectrometry (ICP/MS); spectrophotometry (SPEC)D
Urea Nitrogen and Creatinine Profile, 24-Hour Urine
Synonyms
- Creatinine and Urea, 24-Hour Urine
- Urine Creatinine
- Urine Urea Nitrogen
Test Includes
Creatinine, 24-hour urine; creatinine, urine; eGFR calculation; urea nitrogen, 24-hour urine; urea nitrogen, urine
Special Instructions
State total 24-hour urine volume on the request form.
Expected Turnaround Time
Within 1 day
Turnaround time is defined as the usual number of days from the date of pickup of a specimen for testing to when the result is released to the ordering provider. In some cases, additional time should be allowed for additional confirmatory or additional reflex tests. Testing schedules may vary.
Related Information
Related Documents
Specimen Requirements
Specimen
Urine (24-hour)
Volume
10 mL aliquot of entire collection
Minimum Volume
1 mL aliquot
Container
Plastic urine container, no preservative
Collection
Instruct the patient to void at 8 AM and discard the specimen. Then collect all urine, including the final specimen voided at the end of the 24-hour collection period (ie, 8 AM the following morning). Fasten the lid securely. The container must be labeled with the patient's full name, the date and time the collection began, and the date and time collection ended.
Storage Instructions
Room temperature
Stability Requirements
| Temperature | Period |
|---|---|
| Room temperature | 7 days |
| Refrigerated | 14 days |
| Frozen | 14 days |
| Freeze/thaw cycles | Stable x3 |
Urea Nitrogen Clearance
Synonyms
- Urea Clearance
- UUN Clearance
Test Includes
Blood urea nitrogen; urine clearance; urine urea nitrogen
Special Instructions
Must be a timed collection.
Expected Turnaround Time
Within 1 day
Turnaround time is defined as the usual number of days from the date of pickup of a specimen for testing to when the result is released to the ordering provider. In some cases, additional time should be allowed for additional confirmatory or additional reflex tests. Testing schedules may vary.
Related Information
Related Documents
Specimen Requirements
Specimen
Serum and urine (24-hour)
Volume
1 mL serum and 10 mL urine aliquot
Minimum Volume
0.5 mL serum and 1 mL urine aliquot
Container
Gel-barrier tube or transport tube and plastic urine container
Collection
Serum must be drawn during urine collection. Separate serum from cells within 45 minutes of collection.
Storage Instructions
Maintain specimen at room temperature.
Stability Requirements
| Temperature | Period |
|---|---|
| Room temperature | 14 days |
| Refrigerated | 14 days |
| Frozen | 14 days |
| Freeze/thaw cycles | Stable x3 |
Test Details
Use
Renal function test
Methodology
Enzymatic (urease)
Urea Nitrogen, 24-Hour Urine
Synonyms
- BUN
- Nitrogen Balance Study
- Urine Urea Nitrogen
Special Instructions
Record total 24-hour urine volume on the request form.
Expected Turnaround Time
Within 1 day
Turnaround time is defined as the usual number of days from the date of pickup of a specimen for testing to when the result is released to the ordering provider. In some cases, additional time should be allowed for additional confirmatory or additional reflex tests. Testing schedules may vary.
Related Information
Related Documents
Specimen Requirements
Specimen
Urine (24-hour)
Volume
10 mL aliquot of entire collection
Minimum Volume
1 mL aliquot
Container
Plastic urine container, no preservative
Collection
Refrigerate the specimen as it is collected. Instruct the patient to void at 8 AM and discard the specimen. Then collect all urine including the final specimen voided at the end of the 24-hour collection period (ie, 8 AM the next morning). Screw the lid on securely. Container must be labeled with patient's full name, date and time collection started, and date and time collection finished.
Storage Instructions
Room temperature
Stability Requirements
| Temperature | Period |
|---|---|
| Room temperature | 14 days |
| Refrigerated | 14 days |
| Frozen | 14 days |
| Freeze/thaw cycles | Stable x3 |
Causes for Rejection
Improper labeling
Test Details
Use
Renal function test; coarse nitrogen-wasting test on patients on hyperalimentation; indicate nitrogen balance in hyperalimentation; rule out tap of urinary bladder in amniocentesis, paracentesis
Methodology
Urease
Reference Interval
12−20 g/24 hours
Uric Acid
Synonyms
- UA
- Urate
Expected Turnaround Time
Within 1 day
Turnaround time is defined as the usual number of days from the date of pickup of a specimen for testing to when the result is released to the ordering provider. In some cases, additional time should be allowed for additional confirmatory or additional reflex tests. Testing schedules may vary.
Related Documents
Specimen Requirements
Specimen
Serum (preferred) or plasma
Volume
1 mL
Minimum Volume
0.5 mL
Container
Red-top tube, gel-barrier tube, green-top (heparin) tube, or lavender-top (EDTA) tube
Collection
Separate serum or plasma from cells within 45 minutes of collection.
Storage Instructions
Maintain specimen at room temperature.1
Stability Requirements
| Temperature | Period |
|---|---|
| Room temperature | 14 days |
| Refrigerated | 14 days |
| Frozen | 14 days |
| Freeze/thaw cycles | Stable x3 |
Patient Preparation
At least four-hour fast preferred
Causes for Rejection
Improper labeling
Test Details
Use
Uric acid measurements are useful in the diagnosis and treatment of gout, renal failure, and a variety of other disorders including leukemia, psoriasis, starvation, and other wasting conditions. Patients receiving cytotoxic drugs may be monitored with uric acid measurements. Only a minority of individuals with hyperuricemia develop gout. An increased uric acid level does not necessarily translate to a diagnosis of gout.3 The therapeutic goal for uric acid-lowering therapy is to promote crystal dissolution and prevent crystal formation. This is achieved by maintaining a uric acid level <6 mg/dL.2
Elevated uric acid: Elevations of uric acid occur with increased purine synthesis, inherited metabolic disorders, excess dietary purine intake, increased nucleic acid turnover, malignancy, cytotoxic drugs, decreased excretion due to chronic renal failure, and increased renal reabsorption.
Drugs: Drugs causing increased uric acid concentration include diuretics, pyrazinamide, ethambutol, and nicotinic acid.3
Endocrine: Hypothyroidism, hypoparathyroidism, hyperparathyroidism, pseudohypoparathyroidism, diabetes insipidus of nephrogenic type, and Addison disease can cause uric acid elevation. Lead poisoning from paint, batteries, and moonshine can cause elevated uric acid.4 Toxemia of pregnancy, diet, weight loss, fasting, or starvation can elevate uric acid levels.5
Decreased uric acid: Drugs bearing a relationship to low serum uric acid levels include aspirin (high doses), x-ray contrast agents, glyceryl guaiacolate, allopurinol corticosteroids, and probenecid.6 Massive doses of vitamin C increase urine uric acid secretion, lowering serum uric acid.4 Poor dietary intake of purines and protein can decrease serum uric acid. Diabetes, Fanconi syndrome, Wilson's disease, cystinosis, galactosemia, hypophosphatemia, heavy metal poisoning, malignant neoplasms, hypereosinophilic syndrome, and Xanthinuria (deficiency of xanthine oxidase) can lower serum uric acid.4,6,7 Hypouricemia is reported with acute intermittent porphyria and severe liver disease (especially obstructive biliary disease).8 Isolated defects in the tubular transport of uric acid have been associated with increased renal clearance of urate, hypouricemia, hypercalciuria, and decreased bone density.9
Methodology
Uricase
Reference Interval
• Male:1
− 0 to 1 month: 3.3−8.4 mg/dL
− 1 to 12 months: 1.9−8.1 mg/dL
− 1 to 12 years: 1.9−5.8 mg/dL
− 12 to 18 years: 3.4−7.8 mg/dL
− 18 years and older: 3.7−8.6 mg/dL
• Female:
− 0 to 1 month: 2.4−6.5 mg/dL
− 1 to 12 months: 2.1−6.5 mg/dL
− 1 to 12 years: 2.0−5.8 mg/dL
− 12 to 18 years: 2.4−6.3 mg/dL
− 18 years and older: 2.5−7.1 mg/dL
Therapeutic target for gout patients: <6.02
Additional Information
Drug effects have been summarized.10
Urinalysis, Complete With Microscopic Examination With Reflex to Urine Culture, Routine
Test Includes
Reflex to routine urine culture (equivalent to test 008847). Specimen will reflex to a routine urine culture if any one of the following criteria is present:
1. Positive nitrite on reagent strip
2. Positive leukocyte esterase on reagent strip
3. >5 WBC/hpf on urinalysis microscopic examination
4. ≥Moderate bacteria on urinalysis microscopic examination
Expected Turnaround Time
1 - 3 days
Turnaround time is defined as the usual number of days from the date of pickup of a specimen for testing to when the result is released to the ordering provider. In some cases, additional time should be allowed for additional confirmatory or additional reflex tests. Testing schedules may vary.
Related Documents
Specimen Requirements
Specimen
Urine (random)
Volume
Urinalysis: 10 mL; Culture: To fill line on Vacutainer® gray-top culture transport tube
Container
BD urine transport tube (preferred) and Vacutainer® gray-top urine culture transport tube with preservative or sterile cup for both assays
Collection
A voided specimen is usually suitable. If the specimen is likely to be contaminated, a clean-catch midstream specimen is desirable.
Storage Instructions
BD urine transport tube: Refrigerated or room temperature for up to 72 hours.
Urine cup: Room temperature up to 2 hours and refrigerated up to 48 hours.
Vacutainer® gray-top urine culture transport tube: Maintain at room temperature.
Causes for Rejection
Urinalysis ONLY: Quantity not sufficient for analysis; improper labeling; tubes with boric acid or tartaric acid (eg, BD gray-top C&S tube); LabCorp red-top C&S tube; Boricon, Bortiex, or Boricult yellow-top C&S tubes, specimen received in BD urine transport tube more than 72 hours old; specimen received in urine cup stored at room temperature greater than 2 hours old; specimen received in urine cup refrigerated more than 48 hours old; frozen specimens
Culture ONLY: Quantity not sufficient for analysis; improper labeling; specimen received in urine cup stored at room temperature greater than 2 hours old; specimen received in urine cup refrigerated more than 48 hours old, frozen specimens
Test Details
Use
Detect abnormalities of urine; diagnose and manage renal diseases, urinary tract infection, urinary tract neoplasms, systemic diseases, and inflammatory or neoplastic diseases adjacent to the urinary tract.
Limitations
Insufficient volume may limit the extent of procedures performed. Metabolites of Pyridium® may interfere with the dipstick reactions by producing color interference. High vitamin C intake may cause an underestimate of glucosuria, or a false-negative nitrite test. Survival of WBCs is decreased by low osmolality, alkalinity, and lack of refrigeration.
Methodology
Reagent strip with light microscopy
Urinalysis, Routine With Microscopic Examination on Positives
Test Includes
Color, appearance, specific gravity, pH, protein, glucose, ketones, occult blood, leukocyte esterase, nitrite, bilirubin, and urobilinogen. These tests are done on all routine urinalysis ordered and if protein, leukocyte, occult blood, and nitrites are all negative, microscopic examination is not performed; just the above parameters are reported.
Expected Turnaround Time
Within 1 day
Turnaround time is defined as the usual number of days from the date of pickup of a specimen for testing to when the result is released to the ordering provider. In some cases, additional time should be allowed for additional confirmatory or additional reflex tests. Testing schedules may vary.
Related Documents
Specimen Requirements
Specimen
Urine (random)
Volume
10 mL
Minimum Volume
2 mL
Container
BD urine transport tube (preferred) or urine cup (STAT/DAY lab setting)
Collection
A voided specimen is usually suitable. If the specimen is likely to be contaminated, a clean-catch, midstream specimen is desirable.
Storage Instructions
BD urine transport tube: Refrigerated or room temperature for up to 72 hours.
Urine cup: Room temperature up to 2 hours and refrigerated up to 48 hours.
Causes for Rejection
Quantity not sufficient for analysis; improper labeling; tubes with boric acid or tartaric acid (eg, BD gray-top C&S tube); LabCorp red-top C&S tube; Boricon, Bortiex, or Boricult yellow-top C&S tubes; specimen received in BD urine transport tube more than 72 hours old; specimen received in urine cup stored at room temperature greater than 2 hours old; specimen received in urine cup refrigerated more than 48 hours old; frozen specimens
Test Details
Use
Detect abnormalities of urine; diagnose and manage renal diseases, urinary tract infection, urinary tract neoplasms, systemic diseases, and inflammatory or neoplastic diseases adjacent to the urinary tract
Limitations
Insufficient volume may limit the extent of procedures performed. Metabolites of Pyridium® may interfere with the dipstick reactions by producing color interference. High vitamin C intake may cause an underestimate of glucosuria, or a false-negative nitrite test. Survival of WBCs is decreased by low osmolality, alkalinity, and lack of refrigeration. Sperm is not reported in routine urinalysis exams. Spermatozoa may be seen in male urine related to recent or retrograde ejaculation. For sperm reporting in males only, order Postejaculatory Urine Microscopic Examination for Sperm [133116].
Methodology
Reagent strip
Urine Culture, Prenatal, With Group B Streptococcus Susceptibility Reflex
Special Instructions
Specimens from other sources, such as genital, stool, urine, upper and lower respiratory specimens, cannot be cultured under the aerobic bacterial culture test number. If specimens are incorrectly submitted with an order for aerobic bacterial culture, the laboratory will process the specimen for the test based on the source listed on the test request form. The client will not be telephoned to approve this change, but the change will be indicated on the report.
Expected Turnaround Time
2 - 4 days
Turnaround time is defined as the usual number of days from the date of pickup of a specimen for testing to when the result is released to the ordering provider. In some cases, additional time should be allowed for additional confirmatory or additional reflex tests. Testing schedules may vary.
Related Information
Related Documents
Specimen Requirements
Specimen
Urine
Volume
To fill line on Vacutainer® gray-top urine culture transport tube
Collection
Storage Instructions
Maintain specimen at room temperature.
Patient Preparation
Causes for Rejection
Unrefrigerated specimen older than two hours may be subject to overgrowth and may not yield valid results; unlabeled specimen or name discrepancy between specimen and request label; specimen in expired transport container; specimen received after prolonged delay (usually >36 hours for urine); specimen collected via Foley catheter; unpreserved specimen
Test Details
Use
Evaluation of pregnant women for asymptomatic bacteriuria has been recommended.1
Methodology
Culture
Additional Information
A single culture is about 80% accurate in the female; two containing the same organism with count of 105 or more represents 95% chance of true bacteriuria; three such specimens mean virtual certainty of true bacteriuria.2 If the patient is receiving antimicrobial therapy at the time the specimen is collected, any level of bacteriuria may be significant. When more than two organisms are recovered, the likelihood of contamination is high; thus, the significance of definitive identification of the organisms and susceptibility testing in this situation is severely limited. A repeat culture with proper specimen collection, including patient preparation, is often indicated. Cultures of specimens from Foley catheters yielding multiple organisms with high colony counts usually represents colonization of the catheter and not true significant bacteriuria. Most laboratories limit to two the number of organisms that will be identified when recovered from urine. Similarly, most do not routinely perform susceptibility tests on isolates from presumably contaminated specimens. Failure to recover aerobic organisms from patients with pyuria or positive Gram stains of urinary sediment may indicate the presence of mycobacteria or anaerobes.
Urine Culture, Routine
Synonyms
- Culture, Urine, Routine
- Midstream Urine Culture, Routine
- Routine Culture, Urine, Clean Catch
- Urine Culture, Catheter
- Urine Culture, Routine, Midvoid Specimen
Test Includes
Culture; quantitation, isolation, identification (additional charges/CPT code[s] may apply), and susceptibility testing of up to two organisms at >10,000 colonies/mL if culture results warrant (additional charges/CPT code[s] may apply). CPT coding for microbiology and virology procedures often cannot be determined before the culture is performed. Requests with only a written order and no test number indicated will be processed according to Default Testing for Routine Microbiology.
Special Instructions
Unrefrigerated, unpreserved urine specimens greater than two hours old may be subject to overgrowth with organisms normally present in the urethra and periurethral areas, and may yield inaccurate or misleading results. If specimens are incorrectly submitted with an order for aerobic bacterial culture, the laboratory will process the specimen for the test based on the source listed on the request form. The client will not be contacted to approve this change, but the change will be indicated on the report.
Expected Turnaround Time
2 - 4 days
Turnaround time is defined as the usual number of days from the date of pickup of a specimen for testing to when the result is released to the ordering provider. In some cases, additional time should be allowed for additional confirmatory or additional reflex tests. Testing schedules may vary.
Related Information
Related Documents
For more information, please view the literature below.
Microbiology Specimen Collection and Transport Guide
Specimen Requirements
Specimen
Urine
Volume
To minimum fill line (4 mL) on Vacutainer® gray-top urine culture transport tube with preservative (preferred)
Container
Vacutainer® gray-top urine culture transport tube with preservative (preferred). If less than 4 mL of urine is collected, usually from pediatric and geriatric patients or from a catheter, submit refrigerated in a sterile, screw cap container or tube. Do not submit low volume urine specimens in underfilled gray top tubes.
Collection
Clean catch mid-stream collection. First morning specimens yield highest bacterial counts from overnight incubation in the bladder, and are the best specimens. Read Patient Preparation.
Storage Instructions
Preserved: Room temperature for 48 hours
Unpreserved: Refrigerated for 24 hours
Patient Preparation
Patient should be instructed on the proper collection of a clean catch midstream urine specimen. Avoid contamination with normal flora from skin, rectum or vagina. If a clean catch urine cannot be obtained from an infant, obtain a bagged specimen: clean area as for a clean catch, attach U-bag, and put collected urine into a sterile container.
Clean catch specimen: Have patient urinate into a small clean disposable cup (styrofoam or “Dixie”). Afterward, collection site staff can transfer the urine to the urine culture transport tube using the special collection straw-puncture device designed for use with the Vacutainer® tubes. The numbers of bacteria in a clean unused cup are so few as to be inconsequential when the urine transport stabilizer is added. Thoroughly instruct patient for proper collection of a “clean catch” specimen. Patient must be instructed to thoroughly cleanse skin and collect a midstream specimen. The patient should be instructed to follow the directions provided with the urine collection kit as follows.
Catheterized specimen: Refers to an “in and out” catheter that is placed into the bladder solely for collection of the specimen and then withdrawn. Do not collect urine from the drainage bag when an indwelling catheter is in place because growth of bacteria can occur in the bag itself. Rather, clean catheter with an alcohol sponge, puncture with a sterile needle, and collect in sterile syringe. Catheter tips are contaminated by the urethra as they are withdrawn; do not culture them.
Male: Wash hands thoroughly with soap and water. Rinse them well and dry with a paper towel.
• Tear open the towelette packages so that the towels can be easily removed with one hand as they are needed. Do not touch any of the inside surfaces of the collection cup.
• Pull back the foreskin to expose the head of the penis completely.
• Wash the head of the penis thoroughly using first one towelette then the other. Discard the used towelettes into the toilet bowl.
• Pass a small amount of urine into the toilet bowl, then pass a sample into the container. Do not allow the container to touch the legs or penis. Keep fingers away from the rim and inner surface of the container. Fill the container half full.
• The urine specimen should be transferred to the Vacutainer® tube within 10 minutes of collection.
Female: Wash hands thoroughly with soap and water. Rinse them well and dry with a paper towel.
• Tear open the towelette packages so that the towels can be easily removed with one hand as they are needed. Do not touch any of the inside surfaces of the collection cup.
• Remove undergarments and sit on the toilet seat with legs spread widely apart.
• With one hand, spread labia apart to expose the vulva. Keep this hand in place during the washing and urinating procedure.
• Use one towelette to wash the vulva well passing the towelette only from front to back, not back and forth. Repeat this procedure using the second towelette. Discard the used towelettes into the toilet bowl.
• Begin urinating into the toilet bowl then, without stopping the stream, insert the collection cup to collect the specimen. Do not allow the container to touch the legs, vulva, or clothing. Keep fingers away from the rim and inner surface of the container. Fill the container about half full.
• The urine specimen should be transferred to the Vacutainer® tube within 10 minutes of collection.
Causes for Rejection
Unrefrigerated, unpreserved specimen greater than two hours old; unlabeled specimen or name discrepancy between specimen and request label; specimen in expired transport container; specimen received after prolonged delay (usually more than 48 hours for urine); specimen collected from a Foley catheter bag; specimen in nonsterile or leaking container
Test Details
Use
Semiquantitative culture to isolate and identify bacterial causes of urinary tract infection. Detect up to two pathogenic bacterial organisms at levels above 10,000 cfu/mL.
Methodology
Culture
Additional Information
A single culture is about 80% accurate in the female; two containing the same organism with a count of 100,000 cfu/mL or more represent a 95% chance of true bacteriuria; three such specimens mean virtual certainty of true bacteriuria. A single clean voided specimen from an adult male may be considered diagnostic with proper preparation and care in specimen collection. If the patient is receiving antimicrobial therapy at the time the specimen is collected, any level of bacteriuria may be significant. When more than two organisms are recovered, the likelihood of contamination is high; thus, the significance of definitive identification of the organisms and susceptibility testing in this situation is severely limited. A repeat culture with proper specimen collection including patient preparation is often indicated. Cultures of specimens from Foley catheters yielding multiple organisms with high colony counts usually represents colonization of the catheter and not true significant bacteriuria. Failure to recover aerobic organisms from patients with pyuria or positive Gram stains of urinary sediment may indicate the presence of mycobacteria or anaerobes.
Urine Cytology
Synonyms
- Urine, Bladder Washings/Lavage
Special Instructions
Include patient's name, date of birth, sex, Social Security number, previous malignancy, drug therapy, radiation therapy, and all other pertinent clinical information, including history of alcohol abuse, on the request form. A first morning voided specimen is not suitable. Collection method must be identified. For CMV Study, indicate chemotherapy or immunosuppression.
Expected Turnaround Time
Within 1 day
Turnaround time is defined as the usual number of days from the date of pickup of a specimen for testing to when the result is released to the ordering provider. In some cases, additional time should be allowed for additional confirmatory or additional reflex tests. Testing schedules may vary.
Specimen Requirements
Specimen
Second morning specimen; voided or catheterized urine; intraoperative washings of urinary bladder, urethra, ureters, or renal pelvis
Volume
Not less than 20 mL
Container
Sterile plastic urine container
Collection
Have patient drink one glass (6 oz) every 15 minutes for two to three hours. At the end of two hours, have the patient void or catheterize. Discard specimen.
Technique I (routine): One hour after collection of discarded specimen, have patient void and save the specimen. Send labeled specimen to the laboratory immediately.
Technique II (when residual bladder urine is present): Thirty minutes to one hour after collection of discarded specimen, catheterize bladder. Send labeled specimen to the laboratory immediately.
Technique III (for detection of upper urinary tract lesions): Catheterize ureters to pelvis for suspected renal or pelvic lesions. Repeat procedure using either ureter for control. For ureteral lesion, catheterize ureter to a point just below the level of the suspected lesion. Catheterize other ureter for control. Collect urine for 30 minutes. Label appropriately, right and left ureteral or pelvic specimen. Ship specimen immediately to the laboratory.
Storage Instructions
If collected after hours, add equal amount of 50% ethyl alcohol or Saccomanno fixative and place in the laboratory refrigerator. (Note: Specimens prepared with fixatives that contain 50% ethyl alcohol, eg, Saccomanno fixative, are not acceptable for microbiology testing.) Specify source of specimen.
Patient Preparation
Hydrate patient (give several glasses of water 30 minutes to one hour prior to collection).
Causes for Rejection
Improper labeling; improper fixation; 24-hour collection; undue delay in transport; specimen submitted in vial that expired according to manufacturer's label; frozen specimen
Test Details
Use
Establish the presence of primary or metastatic neoplasms; aid in the diagnosis of infections with herpesvirus, cytomegalovirus, Blastomyces, and Schistosoma; evaluate malacoplakia; establish the presence of cytomegalic inclusion disease
Limitations
Low-grade papillary transitional cell or urothelial carcinomas may not be diagnosed by cytologic examination. Calculi or recent instrumentation may produce atypical changes in urothelial cells simulating malignancy. Chemotherapy and radiation may also produce changes stimulating neoplasia. Viral culture is the method of choice for the diagnosis of CMV but cytology can provide faster results.
Methodology
The fluid will be centrifuged, supernatant poured off, and diagnostic cells aspirated from the remaining material. Filters, monolayers, and/or cytospins will be made along with a cell block, if applicable. Microscopic examination is performed.
Usher Syndrome Type IF
Special Instructions
If cultured cells are needed, an additional 7-12 days may be required. Additional culture fee may be included.
Expected Turnaround Time
7 - 14 days
Turnaround time is defined as the usual number of days from the date of pickup of a specimen for testing to when the result is released to the ordering provider. In some cases, additional time should be allowed for additional confirmatory or additional reflex tests. Testing schedules may vary.
Specimen Requirements
Specimen
Whole blood, amniotic fluid, chorionic villus sample (CVS) (Submission of maternal blood is required for fetal testing.), or LabCorp buccal swab kit (Buccal swab collection kit contains instructions for use of a buccal swab.)
Volume
7 mL whole blood, 10 mL amniotic fluid, 20 mg CVS, or LabCorp buccal swab kit
Minimum Volume
3 mL whole blood, 5 mL amniotic fluid, 10 mg CVS, or two buccal swabs
Container
Lavender-top (EDTA) tube, yellow-top (ACD) tube, sterile plastic conical tube or two confluent T-25 flasks for fetal testing, or LabCorp buccal swab kit
Storage Instructions
Maintain specimen at room temperature.
Test Details
Use
Detect Usher syndrome type IF
Methodology
DNA analysis
Additional Information
Usher syndrome type IF occurs at increased frequency in individuals of Ashkenazi Jewish descent, with a carrier frequency of 1 in 141. This type of Usher syndrome causes profound deafness at birth, severe balance problems, as well as vision impairment. Blindness progresses over time. Children with this disorder are slow to sit without support and typically don't walk independently before 18 months. Decline in visual acuity typically begins by age 10. Currently, there is no treatment. Couples who are planning a pregnancy or who are already pregnant may decide to have testing to find out whether they are carriers and at risk of having a baby with Usher syndrome type IF. Usher syndrome type IF mutation analysis tests for one mutation for a 75% carrier detection rate in the Ashkenazi Jewish population.
Usher Syndrome Type III
Special Instructions
If cultured cells are needed, an additional 7-12 days may be required. Additional culture fee may be included.
Expected Turnaround Time
8 - 14 days
Turnaround time is defined as the usual number of days from the date of pickup of a specimen for testing to when the result is released to the ordering provider. In some cases, additional time should be allowed for additional confirmatory or additional reflex tests. Testing schedules may vary.
Specimen Requirements
Specimen
Whole blood, amniotic fluid, chorionic villus sample (CVS) (Submission of maternal blood is required for fetal testing.), or LabCorp buccal swab kit (Buccal swab collection kit contains instructions for use of a buccal swab.)
Volume
7 mL whole blood, 10 mL amniotic fluid, 20 mg CVS, or LabCorp buccal swab kit
Minimum Volume
3 mL whole blood, 5 mL amniotic fluid, 10 mg CVS, or two buccal swabs
Container
Lavender-top (EDTA) tube, yellow-top (ACD) tube, sterile plastic conical tube or two confluent T-25 flasks for fetal testing, or LabCorp buccal swab kit
Storage Instructions
Maintain specimen at room temperature.
Test Details
Use
Detect Usher syndrome type III
Methodology
DNA analysis
Additional Information
Usher syndrome type III occurs at increased frequency in individuals of Ashkenazi Jewish descent, with a carrier frequency of 1 in 107. This type of Usher syndrome causes hearing problems that progressively worsen, although the rate of detection varies. Individuals are usually completely blind by adulthood, and hearing loss is moderate to severe. Balance is not usually affected. Currently, there is no treatment. Couples who are planning a pregnancy or who are already pregnant may decide to have testing to find out whether they are carriers and at risk of having a baby with Usher syndrome type III. Usher syndrome type III mutation analysis tests for one mutation for a 98% carrier detection rate in the Ashkenazi Jewish population.
Ustekinumab and Anti-Ustekinumab Antibody, DoseASSURE™ UST
Synonyms
- Anti-interleukin antibody drug, Anti-IL12, IL23 inhibitor
- Biologic monitoring, therapeutic drug monitoring (TDM)
- DoseASSURE
- Immunogenicity testing, anti-drug antibody
- Stelara
Expected Turnaround Time
11 - 25 days
Turnaround time is defined as the usual number of days from the date of pickup of a specimen for testing to when the result is released to the ordering provider. In some cases, additional time should be allowed for additional confirmatory or additional reflex tests. Testing schedules may vary.
Related Documents
For more information, please view the literature below.
Inflammatory Bowel Disease Biologics Flyer
Rheumatic Biologics Flyer
Therapeutic Drug Monitoring Options for Rheumatoid Arthritis Brochure
Rheumatoid Arthritis Brochure
Rheumatologist Services Brochure
Inflammatory Bowel Disease Brochure
Specimen Requirements
Specimen
Serum (preferred) or plasma
Volume
3 mL
Minimum Volume
1 mL (Note: This volume does not allow for repeat testing.)
Container
Red-top tube, gel-barrier tube, plasma EDTA tube, or plasma heparin tube
Collection
Allow a minimum clotting time of 30 to 60 minutes with serum separation within 2 hours of collection. Send serum in a plastic transport tube. To avoid delays in turnaround time when requesting multiple tests on frozen samples, please submit separate frozen specimens for each test requested.
Storage Instructions
Frozen (preferred) or refrigerated
Stability Requirements
| Temperature | Period |
|---|---|
| Room temperature | 14 days |
| Refrigerated | 14 days |
| Frozen | 14 days |
| Freeze/thaw cycles | Stable x6 |
Test Details
Use
Provides ustekinumab drug concentration and anti‐ustekinumab antibodies in order to optimize treatment and facilitate clinical decision‐making.
This assay may be helpful in any patients on ustekinumab therapy for Crohn's disease, psoriasis, or other autoimmune conditions.
Limitations
Drug concentration should be interpreted with confirmation of specimen collection timing.
Non‐trough concentrations may be misleading.
Trough blood collection (just before or within 24 hrs. of next dose) is suitable because target ranges and therapeutic cut‐offs have been established in clinical studies using trough concentration.
The drug half‐life should be taken into consideration when interpreting results from non‐perfect trough collections.
Some primary non‐responders have inadequate clinical response despite adequate trough levels.
As with other biologics, the optimal ustekinumab concentration depends upon patient‐specific factors including co‐morbidities, disease and desired therapeutic endpoint.
Positive anti‐ustekinumab antibodies should be interpreted in the context of the concomitant free ustekinumab drug level.
Methodology
Electrochemiluminescence immunoassay (ECLIA)
Reference Interval
Ustekinumab drug level: <0.1 μg/mL
• Result ≥0.1 μg/mL indicates detection of ustekinumab
• In the presence of anti-ustekinumab antibodies, the ustekinumab drug level reflects the free, antibody-unbound fraction of ustekinumab in serum.
Anti-ustekinumab antibody: <40 ng/mL
• Result ≥40ng/mL indicates detection of anti-ustekinumab antibodies.
Additional Information
Drug Assay: The ustekinumab drug level typically reflects the antibody-unbound (the free fraction) of ustekinumab when serum anti-ustekinumab antibodies are present. In the absence of anti-ustekinumab antibodies, the ustekinumab drug level typically reflects the total ustekinumab concentration in serum.
Anti-drug Antibody Assay: This anti-ustekinumab antibody assay is “drug-tolerant”, that is, the presence of serum ustekinumab does not impede the detection and quantitation of anti-ustekinumab antibodies. This anti-ustekinumab antibody assay is specific; antibodies against other biologic drugs do not cross-react with this assay. All positive anti-ustekinumab antibody results are verified by a confirmatory test.
Both drug and anti-drug antibody assays have been developed and validated in accordance with FDA Guidance for Industry documents: Bioanalytical Method Validation (2013) and Assay Development and Validation for Immunogenicity Testing of Therapeutic Protein Products (2016).
Uterine Cancer Monitor Profile
Test Includes
Cancer antigen 125-II (CA 125), serial monitor report; lipid-associated sialic acid (LASA), serial monitor report
Special Instructions
The account must submit the patient's Social Security number to monitor. Values obtained with different assay methods should not be used interchangeably in serial testing. It is recommended that only one assay method be used consistently to monitor each patient's course of therapy.
This test may exhibit interference when sample is collected from a person who is consuming a supplement with a high dose of biotin (also termed as vitamin B7 or B8, vitamin H, or coenzyme R). It is recommended to ask all patients who may be indicated for this test about biotin supplementation. Patients should be cautioned to stop biotin consumption at least 72 hours prior to the collection of a sample.
Expected Turnaround Time
2 - 3 days
Turnaround time is defined as the usual number of days from the date of pickup of a specimen for testing to when the result is released to the ordering provider. In some cases, additional time should be allowed for additional confirmatory or additional reflex tests. Testing schedules may vary.
Related Documents
Specimen Requirements
Specimen
Serum
Volume
4 mL
Minimum Volume
2 mL
Container
Red-top tube or gel-barrier tube
Collection
If a red-top tube is used, transfer separated serum to a plastic transport tube.
Storage Instructions
Refrigerate
Stability Requirements
| Temperature | Period |
|---|---|
| Room temperature | 14 days |
| Refrigerated | 14 days |
| Frozen | 14 days |
| Freeze/thaw cycles | Stable x3 |
Causes for Rejection
Hemolysis; whole blood specimen
Test Details
Use
Monitor the course of uterine cancer, patient response to treatment, and disease recurrence
Limitations
This profile should not be used as a diagnostic or screening test for cancer.
The LASA test was developed and its performance characteristics determined by LabCorp. It has not been cleared or approved by the Food and Drug Administration.
Methodology
See individual tests.
Uveal Melanoma Prognostic Test
Test Includes
Copy number testing (using MLPA) on chromosomes 1p, 3, 6, and 8 to detect monosomy, disomy, and trisomy; microsatellite analysis (MSA) on chromosome 3 to detect loss of a chromosome copy and isodisomy; sequencing GNAQ and GNA11 to detect frequently occurring mutations in UM tumor for confirmation of tumor sampling.
Special Instructions
This test is performed at Impact Genetics, Bowmanville, Ontario, Canada. Please direct any questions regarding this test to Impact Genetics at 877-624-9769.
Specimen Requirements
Specimen
Whole blood or buccal swab and tumor biopsy (FNAB or other)
Volume
8.5 mL whole blood
Minimum Volume
4 mL whole blood
Container
Yellow-top (ACD) tube or lavender-top (EDTA) tube. Collection kits for buccal swabs and tumors should be ordered directly from Impact Genetics.
Collection
Whole blood samples must be received at Impact Genetics within five days of collection. Do not freeze.
Storage Instructions
Room temperature. Whole blood is stable at room temperature for five days. Buccal swab and tumor in Impact Genetics collection kit is stable for 21 days.
Test Details
Use
Genetic testing of eye tumor tissue to determine whether the original eye tumor has a high risk of metastasis
Limitations
This test was developed, and its performance characteristics determined, by LabCorp. It has not been cleared or approved by the US Food and Drug Administration (FDA).
Methodology
Multiplex ligation-dependent probe amplification (MLPA); microsatellite analysis; sequencing
Common Lab Tests
LEARN MORE
This test, also known as a CBC, is the most common blood test performed. It measures the types and numbers of cells in the blood, including red and white blood cells and platelets. This test is used to determine general health status, screen for disorders and evaluate nutritional status. It can help evaluate symptoms such as weakness, fatigue and bruising, and can help diagnose conditions such as anemia, leukemia, malaria and infection.
LEARN MORE
Also known as PT and Pro Time, this test measures how long it takes blood to clot. This coagulation test measures the presence and activity of five different blood clotting factors. This test can screen for bleeding abnormalities, and may also be used to monitor medication treatments that prevent the formation of blood clots.
LEARN MORE
This test measures glucose, sodium, potassium, calcium, chloride, carbon dioxide, blood urea nitrogen and creatinine which can help determine blood sugar level, electrolyte and fluid balance as well as kidney function. The Basic Metabolic Panel can help your doctor monitor the effects of medications you are taking, such as high blood pressure medicines, can help diagnose certain conditions, or can be part of a routine health screening. You may need to fast for up to 12 hours before this test.
LEARN MORE
The lipid panel is a group of tests used to evaluate cardiac risk. It includes cholesterol and triglyceride levels.
LEARN MORE
The liver panel is a combination of tests used to assess liver function and establish the possible presence of liver tumors.
LEARN MORE
This test is used to diagnose and monitor diabetes.
LEARN MORE
Often the first lab test performed, this is a general screening test used to check for early signs of disease. It may also be used to monitor diabetes or kidney disease.
LEARN MORE
Cultures are used to test for diagnosis and treatment of infections. Illnesses such as urinary tract infections, pneumonia, strep throat, MRSA and meningitis can be detected and tested for appropriate antibiotic treatment.
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