RITM Laboratory Services by RITM

ROUTINE LABORATORY TESTS: CLINICAL HEMATOLOGY AVAILABLE LABORATORY PROCEDURE

SPECIMEN

VOLUME/ QUANTITY

TIME OF COLLECTION

COLLECTION/ STORAGE

HANDLING/ TRANSPORT

RUNNING DAY

CUT OFF DAY AND TIME

TAT

Complete Blood Count w/ Platelet Count

Blood

2 ml EDTA tube

anytime

Collect in EDTA tube. Mix by inversion 10x

Daily

2 hours

352.00

RBC / WBC

Blood

2 ml EDTA tube

anytime

Collect in EDTA tube. Mix by inversion 10x

Daily

1 hour

180.00

Hemoglobin/Hematocrit & Platelet

Blood

2 ml EDTA tube

anytime

Collect in EDTA tube. Mix by inversion 10x

Daily

2 hours

252.00

MCV / MCH / MCHC

Blood

2 ml EDTA tube

anytime

Collect in EDTA tube. Mix by inversion 10x

Daily

1 hour

180.00

Peripheral Blood Smear

Blood

2 slides smear

anytime

Collect in EDTA tube, & finger prick for direct smear

Daily

3 days

180.00

Reticulocyte Count

Blood

2 ml EDTA tube

anytime

Collect in EDTA tube. Mix by inversion 10x

Daily

2 hours

140.00

Erythrocyte Sedimentation Rate

Blood

2 ml EDTA tube

anytime

Collect in EDTA tube. Mix by inversion 10x

Daily

2 hours

200.00

Arterial Blood Gas

Heparinized blood

Transport immediately with ice

Daily

1 hour

1,500.00

1-2 cc blood

anytime

Collect in heparinized syringe for transport in ice Note: Avoid bubbles

FEE

Blood / RH Typing

Blood

2 ml EDTA tube

anytime

Collect in EDTA tube (violet top)

Daily

2 hours

380.00

Du Typing

Blood

2 ml EDTA tube

anytime

Collect in EDTA tube (violet top)

Daily

2 hours

280.00

Coombâ&#x20AC;&#x2122;s Test (Direct & Indirect)

Blood

3-5 ml plain tube

anytime

Collect in red plain tube. No inversion.

Daily

2 hours

660.00

Page 1 of 64

AVAILABLE LABORATORY PROCEDURE

SPECIMEN

VOLUME/ QUANTITY

TIME OF COLLECTION

COLLECTION/ STORAGE

HANDLING/ TRANSPORT

RUNNING DAY

CUT OFF DAY AND TIME

TAT

FEE

Coomb’s Test (Direct)

Blood

3-5 ml plain tube

anytime

Collect in red plain tube. No inversion.

Daily

2 hours

330.00

Coomb’s Test (Indirect)

Blood

3-5 ml plain tube

anytime

Collect in red plain tube. No inversion.

Daily

2 hours

330.00

Cross-Matching

Blood

3-5 ml plain tube

anytime

Collect in red plain tube. No inversion.

Daily

2 hours

1,100.00

Transport immediately

Daily

2 hours

550.00

Transport immediately

Daily

2 hours

550.00

Prothrombin

Blood

18 ml blue top

anytime

Collect in blue top (with 3.2% sodium citrate) plastic tube. Mix by inversion 3-4x only Centrifuge and separate plasma. Processed within 4 hours after collection. Collect in blue top (with 3.2% sodium citrate) plastic tube. Mix by inversion 3-4x only

Partial Thromboplastin Time

Blood

18 ml blue top

anytime

Bleeding Time

Blood

Drops of blood through finger prick

anytime

Collect in EDTA tube. Mix by inversion 10x

Daily

1 hour

140.00

Clotting Time

Blood

Drops of blood through finger prick

anytime

Collect in EDTA tube. Mix by inversion 10x

Daily

1 hour

170.00

Centrifuge and separate plasma. Processed within 4 hours after collection.

Page 2 of 64

ROUTINE LABORATORY TESTS: CLINICAL CHEMISTRY AVAILABLE LABORATORY PROCEDURE

Glucose (FBS)

SPECIMEN

Serum

VOLUME/ QUANTITY

TIME OF COLLECTION

2 cc blood

Monday to Friday (8am5pm); No OPD on Saturdays, Sundays and Holidays *For STAT patients anytime of the day

Glucose (OGTT)

Serum

2 cc blood

Monday to Friday (8am5pm); No OPD on Saturdays, Sundays and Holidays *For STAT patients anytime of the day

Glucose (1 hr. PPBS)

Serum

2 cc blood

Monday to Friday (8am5pm); No OPD on Saturdays, Sundays and Holidays *For STAT patients anytime of the day

Glucose (2 hrs. PPBS)

Serum

2 cc blood

Monday to Friday (8am5pm); No OPD on Saturdays, Sundays and Holidays *For STAT patients anytime of the day

Glucose (3 hrs. PPBS)

Serum

2 cc blood

Monday to Friday (8am5pm); No OPD on Saturdays, Sundays and Holidays

COLLECTION/ STORAGE

HANDLING/ TRANSPORT

RUNNING DAY

CUT OFF DAY AND TIME

TAT

Mon-Fri

No OPD on weekends and holidays

6 hours

126.00

Mon-Fri

No OPD on weekends and holidays

6 hours

504.00

Mon-Fri

No OPD on weekends and holidays

6 hours

252.00

Mon-Fri

No OPD on weekends and holidays

6 hours

252.00

Mon-Fri

No OPD on weekends and holidays

6 hours

252.00

FEE

*at least 8 hours Fasting Collect in red top (plain), or yellow top tube (with serum gel separator) Stand for 30 minutes Centrifuge and separate serum immediately into cryovial

Transport immediately with ice

*at least 8 hours Fasting Collect in red top (plain), or yellow top tube (with serum gel separator) Stand for 30 minutes Centrifuge and separate serum immediately into cryovial Collect in red top (plain), or yellow top tube (with serum gel separator) Stand for 30 minutes Centrifuge and separate serum immediately into cryovial Collect in red top (plain), or yellow top tube (with serum gel separator) Stand for 30 minutes Centrifuge and separate serum immediately into cryovial Collect in red top (plain), or yellow top tube (with serum gel separator) Stand for 30 minutes Centrifuge

Page 3 of 64

Transport immediately with ice

AVAILABLE LABORATORY PROCEDURE

Glucose (RBS)

SPECIMEN

Serum

VOLUME/ QUANTITY

2 cc blood

TIME OF COLLECTION

COLLECTION/ STORAGE

*For STAT patients anytime of the day

and separate serum immediately into cryovial

Monday to Friday (8am5pm); No OPD on Saturdays, Sundays and Holidays *For STAT patients anytime of the day

Glucose (1 hr. Challenge Test)

Serum

2 cc blood

Monday to Friday (8am5pm); No OPD on Saturdays, Sundays and Holidays *For STAT patients anytime of the day

Cholesterol

Serum

2 cc blood

Monday to Friday (8am5pm); No OPD on Saturdays, Sundays and Holidays *For STAT patients anytime of the day

HDL â&#x20AC;&#x201C; Cholesterol

Serum

2 cc blood

Monday to Friday (8am5pm); No OPD on Saturdays, Sundays and Holidays *For STAT patients anytime of the day

LDL â&#x20AC;&#x201C; Cholesterol

Serum

2 cc blood

Monday to Friday (8am5pm); No OPD on Saturdays, Sundays and Holidays

HANDLING/ TRANSPORT

RUNNING DAY

CUT OFF DAY AND TIME

TAT

Mon-Fri

No OPD on weekends and holidays

6 hours

126.00

Mon-Fri

No OPD on weekends and holidays

6 hours

126.00

Mon-Fri

No OPD on weekends and holidays

6 hours

210.00

Mon-Fri

No OPD on weekends and holidays

6 hours

420.00

Mon-Fri

No OPD on weekends and holidays

6 hours

511.00

FEE

10-12 hours Fasting Collect in red top (plain), or yellow top tube (with serum gel separator) Stand for 30 minutes Centrifuge and separate serum immediately into cryovial

Transport immediately with ice

10-12 hours Fasting Collect in red top (plain), or yellow top tube (with serum gel separator) Stand for 30 minutes Centrifuge and separate serum immediately into cryovial 10-12 hours Fasting Collect in red top (plain), or yellow top tube (with serum gel separator)

Page 4 of 64

Transport immediately with ice

AVAILABLE LABORATORY PROCEDURE

SPECIMEN

VOLUME/ QUANTITY

TIME OF COLLECTION

*For STAT patients anytime of the day

Triglycerides

Serum

2 cc blood

Monday to Friday (8am5pm); No OPD on Saturdays, Sundays and Holidays *For STAT patients anytime of the day

Albumin

Serum

2 cc blood

Monday to Friday (8am5pm); No OPD on Saturdays, Sundays and Holidays *For STAT patients anytime of the day

Alkaline Phosphate

Serum

2 cc blood

Monday to Friday (8am5pm); No OPD on Saturdays, Sundays and Holidays *For STAT patients anytime of the day

Bilirubin, Direct

Serum

2 cc blood

Monday to Friday (8am5pm); No OPD on Saturdays, Sundays and Holidays *For STAT patients anytime of the day

COLLECTION/ STORAGE

HANDLING/ TRANSPORT

RUNNING DAY

CUT OFF DAY AND TIME

TAT

Mon-Fri

No OPD on weekends and holidays

6 hours

252.00

Mon-Fri

No OPD on weekends and holidays

6 hours

196.00

Mon-Fri

No OPD on weekends and holidays

6 hours

196.00

Mon-Fri

No OPD on weekends and holidays

6 hours

196.00

FEE

Stand for 30 minutes Centrifuge and separate serum immediately into cryovial 10-12 hours Fasting Collect in red top (plain), or yellow top tube (with serum gel separator) Stand for 30 minutes Centrifuge and separate serum immediately into cryovial Collect in red top (plain), or yellow top tube (with serum gel separator) Stand for 30 minutes Centrifuge and separate serum immediately into cryovial Collect in red top (plain), or yellow top tube (with serum gel separator) Stand for 30 minutes Centrifuge and separate serum immediately into cryovial

Transport immediately with ice

Collect in red top (plain), or yellow top tube (with serum gel separator) Stand for 30 minutes Centrifuge and separate serum immediately into cryovial Note: Avoid direct sunlight; cover tube with carbon paper

Page 5 of 64

Transport immediately with ice

AVAILABLE LABORATORY PROCEDURE

Bilirubin, Total

SPECIMEN

Serum

VOLUME/ QUANTITY

TIME OF COLLECTION

2 cc blood

Monday to Friday (8am5pm); No OPD on Saturdays, Sundays and Holidays *For STAT patients anytime of the day

Bilirubin, (Direct, Indirect & Total)

Serum

2 cc blood

Monday to Friday (8am5pm); No OPD on Saturdays, Sundays and Holidays *For STAT patients anytime of the day

SGOT

Serum

2 cc blood

Monday to Friday (8am5pm); No OPD on Saturdays, Sundays and Holidays *For STAT patients anytime of the day

SGPT

Serum

2 cc blood

Monday to Friday (8am5pm); No OPD on Saturdays, Sundays and Holidays *For STAT patients anytime of the day

Total Protein

Serum

2 cc blood

Monday to Friday (8am5pm); No OPD on Saturdays, Sundays and Holidays

COLLECTION/ STORAGE

HANDLING/ TRANSPORT

RUNNING DAY

CUT OFF DAY AND TIME

TAT

Mon-Fri

No OPD on weekends and holidays

6 hours

392.00

Mon-Fri

No OPD on weekends and holidays

6 hours

588.00

Mon-Fri

No OPD on weekends and holidays

6 hours

168.00

Mon-Fri

No OPD on weekends and holidays

6 hours

168.00

Mon-Fri

No OPD on weekends and holidays

6 hours

196.00

FEE

Collect in red top (plain), or yellow top tube (with serum gel separator) Stand for 30 minutes Centrifuge and separate serum immediately into cryovial

Transport immediately with ice

Note: Avoid direct sunlight; cover tube with carbon paper Collect in red top (plain), or yellow top tube (with serum gel separator) Stand for 30 minutes Centrifuge and separate serum immediately into cryovial Collect in red top (plain), or yellow top tube (with serum gel separator) Stand for 30 minutes Centrifuge and separate serum immediately into cryovial Collect in red top (plain), or yellow top tube (with serum gel separator) Stand for 30 minutes Centrifuge and separate serum immediately into cryovial

Page 6 of 64

Transport immediately with ice

AVAILABLE LABORATORY PROCEDURE

SPECIMEN

VOLUME/ QUANTITY

TIME OF COLLECTION

COLLECTION/ STORAGE

HANDLING/ TRANSPORT

RUNNING DAY

CUT OFF DAY AND TIME

TAT

Mon-Fri

No OPD on weekends and holidays

6 hours

588.00

Mon-Fri

No OPD on weekends and holidays

6 hours

168.00

Mon-Fri

No OPD on weekends and holidays

6 hours

168.00

Daily

6 hours

350.00

Daily

6 hours

430.00

FEE

*For STAT patients anytime of the day

TPA/G (Total Protein A/G)

Serum

2 cc blood

Monday to Friday (8am5pm); No OPD on Saturdays, Sundays and Holidays *For STAT patients anytime of the day

BUN

Serum

2 cc blood

Monday to Friday (8am5pm); No OPD on Saturdays, Sundays and Holidays *For STAT patients anytime of the day

Creatinine

Serum

2 cc blood

Monday to Friday (8am5pm); No OPD on Saturdays, Sundays and Holidays *For STAT patients anytime of the day

Amylase

Serum

2 cc blood

Monday to Friday (8am5pm); No OPD on Saturdays, Sundays and Holidays *For STAT patients anytime of the day

CPK / CK

Serum

2 cc blood

Monday to Friday (8am5pm); No OPD on Saturdays, Sundays and Holidays

Collect in red top (plain), or yellow top tube (with serum gel separator) Stand for 30 minutes Centrifuge and separate serum immediately into cryovial Collect in red top (plain), or yellow top tube (with serum gel separator) Stand for 30 minutes Centrifuge and separate serum immediately into cryovial Collect in red top (plain), or yellow top tube (with serum gel separator) Stand for 30 minutes Centrifuge and separate serum immediately into cryovial Collect in red top (plain), or yellow top tube (with serum gel separator) Stand for 30 minutes Centrifuge and separate serum immediately into cryovial Collect in red top (plain), or yellow top tube (with serum gel separator) Stand for 30 minutes Centrifuge and separate serum immediately into cryovial

Page 7 of 64

Transport immediately with ice

AVAILABLE LABORATORY PROCEDURE

SPECIMEN

VOLUME/ QUANTITY

TIME OF COLLECTION

COLLECTION/ STORAGE

HANDLING/ TRANSPORT

RUNNING DAY

CUT OFF DAY AND TIME

TAT

Daily

6 hours

340.00

Daily

6 hours

210.00

Daily

6 hours

252.00

Daily

6 hours

252.00

FEE

*For STAT patients anytime of the day

LDH

Serum

2 cc blood

Monday to Friday (8am5pm); No OPD on Saturdays, Sundays and Holidays *For STAT patients anytime of the day

Uric Acid

Serum

2 cc blood

Monday to Friday (8am5pm); No OPD on Saturdays, Sundays and Holidays *For STAT patients anytime of the day

Collect in red top (plain), or yellow top tube (with serum gel separator) Stand for 30 minutes Centrifuge and separate serum immediately into cryovial

Transport immediately with ice

6-8 hours Fasting Collect in red top (plain), or yellow top tube (with serum gel separator) Stand for 30 minutes Centrifuge and separate serum immediately into cryovial

Transport immediately with ice

Collect in sterile bottle

CSF Glucose

CSF

1 cc

Monday to Friday (8am5pm); No OPD on Saturdays, Sundays and Holidays

Transport immediately with ice

*For STAT patients anytime of the day

CSF Protein

CSF

1 cc

Monday to Friday (8am5pm); No OPD on Saturdays, Sundays and Holidays

Collect in sterile bottle

*For STAT patients anytime of the day

Page 8 of 64

Transport immediately with ice

AVAILABLE LABORATORY PROCEDURE

Sodium (Na)

SPECIMEN

Serum

VOLUME/ QUANTITY

TIME OF COLLECTION

2 cc blood

Monday to Friday (8am5pm); No OPD on Saturdays, Sundays and Holidays *For STAT patients anytime of the day

Potassium (K)

Serum

2 cc blood

Monday to Friday (8am5pm); No OPD on Saturdays, Sundays and Holidays *For STAT patients anytime of the day

Chloride (Cl)

Serum

2 cc blood

Monday to Friday (8am5pm); No OPD on Saturdays, Sundays and Holidays *For STAT patients anytime of the day

Magnesium (Mg)

Serum

2 cc blood

Monday to Friday (8am5pm); No OPD on Saturdays, Sundays and Holidays *For STAT patients anytime of the day

Calcium (Ca)

Serum

2 cc blood

Monday to Friday (8am5pm); No OPD on Saturdays, Sundays and Holidays *For STAT patients anytime of the day

COLLECTION/ STORAGE

Page 9 of 64

HANDLING/ TRANSPORT

Transport immediately with ice

RUNNING DAY

CUT OFF DAY AND TIME

TAT

Daily

2 hours

322.00

Daily

2 hours

322.00

Daily

2 hours

218.00

Daily

2 hours

337.00

Daily

2 hours

300.00

FEE

AVAILABLE LABORATORY PROCEDURE

Inorganic Phosphorous

SPECIMEN

Serum

VOLUME/ QUANTITY

TIME OF COLLECTION

2 cc blood

Monday to Friday (8am5pm); No OPD on Saturdays, Sundays and Holidays *For STAT patients anytime of the day

COLLECTION/ STORAGE

Collect in red top (plain), or yellow top tube (with serum gel separator) Stand for 30 minutes Centrifuge and separate serum immediately into cryovial

Page 10 of 64

HANDLING/ TRANSPORT

Transport immediately with ice

RUNNING DAY

CUT OFF DAY AND TIME

TAT

Daily

2 hours

FEE

168.00

ROUTINE LABORATORY TESTS: CLINICAL MICROSCOPY AVAILABLE LABORATORY PROCEDURE Cell Count / Differential Count of Body Fluids

SPECIMEN

CSF

VOLUME/ QUANTITY

TIME OF COLLECTION

at least 8 ml

anytime

early morning/anytime of the day

COLLECTION/ STORAGE

Collect in sterile bottle

Urinalysis

Urine

15-30 ml

RBC Morphology

Urine

15-30 ml

early morning/anytime of the day

Collect in sterile bottle

Direct fecal Smear Microscopy

Stool

Approximately adult thumb size

anytime

Collect in a clean stool container

HANDLING/ TRANSPORT

Transport immediately with ice Transport immediately with ice Transport immediately with ice Room temperature 25 to 37 degree Celsius

RUNNING DAY

CUT OFF DAY AND TIME

TAT

FEE 300.00

Daily

2 hours

140.00 Daily

2 hours

Daily

2 hours

140.00

Mon-Fri

Monday-Friday (8AM-5PM) *After 5PM,

1 hour

210.00

Mon-Fri

Monday-Friday (8AM-5PM) *After 5PM,

30 minutes

140.00

Watery and soft specimen must reach the laboratory w/in 1hr from the time of passage Fecal Occult Blood Test

Stool

Approximately adult thumb size

anytime

Collect in a clean stool container

Page 11 of 64

Room temperature 25 to 37 degree Celsius

AVAILABLE LABORATORY PROCEDURE

SPECIMEN

VOLUME/ QUANTITY

TIME OF COLLECTION

COLLECTION/ STORAGE

HANDLING/ TRANSPORT

RUNNING DAY

CUT OFF DAY AND TIME

TAT

FEE

Microscopy for

Peri-anal swab

Duplicate (2)

Collection before taking a bath

Mon-Fri

Monday-Friday (8AM-5PM) *After 5PM, please submit specimen and request through Clinical Laboratory

1 hour

112.00

Malaria blood film microscopy (thick & thin film)

Blood

5-10 drops (duplicate)

anytime

Finger prick preferred Avoid exposure of smear to heat Protect smear from dust and insects

Room temperature 25 to 37 degree Celsius

Mon-Fri

Monday-Friday (8AM-5PM) *After 5PM, please submit specimen and request through Clinical Laboratory

1 hour

210.00

Enterobius vermicularis

Page 12 of 64

ROUTINE LABORATORY TESTS: CLINICAL MICROBIOLOGY (BACTERIOLOGIC TESTS) AVAILABLE LABORATORY PROCEDURE

Gram stain, Culture and Susceptibility Test

SPECIMEN

Blood

(Aerobic Culture)

Gram stain, Culture and Susceptibility Test

CSF

VOLUME/ QUANTITY

1-2 ml (If commercial bottle: follow manufacturer’s instructions.)

≥ 1 ml

TIME OF COLLECTION

COLLECTION/ STORAGE

HANDLING/ TRANSPORT

Aseptically collect blood and inoculate in Blood Culture Broth (BCB) and mix by swirling.

Transport as soon as possible at room temperature (RT); ≤ 2 hours RT; (BCB) < 24 hours, RT (If not transported after 2 hours, incubate 36 + 1oC prior to transport)

Acute stage of illness prior to antimicrobial therapy

Collect aseptically in a sterile screw-cap container.

Transport as soon as possible. ≤15 min., RT; < 24 hours, RT; (if BAP and CA are submitted, if possible, include the remaining CSF, RT) (If transport may be delayed, incubate the specimen at 36+ 1oC and/or may directly inoculate onto Blood Agar (BAP) and Chocolate Agar (CA) and incubate at 36+ 1oC prior to transport

Acute stage of illness prior to antimicrobial therapy

Collection is performed by a clinician. 1. Disinfect underlying skin with iodine. 2. Collect specimen via percutaneous needle aspiration or surgery. 3. Inoculate approx. 1-2 mL of specimen into the Blood Culture Broth and mix by swirling.

Acute stage of illness prior to antimicrobial therapy

(Aerobic Culture)

Gram stain, Culture and Susceptibility Test (Aerobic Culture)

Sterile body Fluids: pleural, synovial, peritoneal, pericardial, bile, joints, ascites, abdominal

minimum of 12 ml

Page 13 of 64

Transport as soon as possible. ≤15 min., RT; > 1 hour, on ice packs Storage: refrigerate prior to transport and include

RUNNING DAY

Daily

CUT OFF DAY AND TIME

TAT

Preliminary result: after 48 hours Final result : 8 days

1,320.00

Preliminary result after 24 hours. Final result after 3 days if no growth.

1,320.00

Preliminary result after 24 hours. Final result after 3 days if no growth.

1,320.00

FEE

Daily

AVAILABLE LABORATORY PROCEDURE

SPECIMEN

VOLUME/ QUANTITY

TIME OF COLLECTION

COLLECTION/ STORAGE **If further testing is anticipated, the rest of the sample may be saved

Gram stain, Culture and Susceptibility Test

Sputum (Expectorated or induced)

3-5 ml

(Aerobic Culture)

Culture and Susceptibility Test

Endotracheal/ Nasotracheal Aspirate; Bronchoalveolar lavage, brush or wash

Throat Swab (not diphtheria)

≥ 1 ml

Acute stage of illness prior to antimicrobial therapy

Rinse the mouth with water and bring up a deep cough. Collect in a sterile screw-cap container.

Acute stage of illness prior to antimicrobial therapy

Collect washing or aspirate in mucus trap; Place brush in 1 ml sterile NSS in a sterile container

Transport as soon as possible. ≤2 hours, RT; ≤ 24 hours, place on ice packs

2 swabs

(Aerobic Culture)

Acute stage of illness prior to antimicrobial therapy

Swab the posterior pharynx, tonsils and other inflamed areas. Unpreserved, place the swabs in sterile tube Preserved, place in Amies Transport Medium (TM)

Culture and Susceptibility Test (Aerobic Culture)

First morning voided urine is preferred. Urine a. fresh voided

2-5 ml

Acute stage of illness prior to antimicrobial therapy

-Cleanse the genital area with soap and water -then collect midstream portion in a sterile leak-proof container.

Page 14 of 64

RUNNING DAY

CUT OFF DAY AND TIME

TAT

FEE

the remaining specimen)

Transport as soon as possible. ≤2 hours, RT; ≤ 24 hours, place on ice pack

(Aerobic Culture) Gram stain, Culture and Susceptibility Test

HANDLING/ TRANSPORT

Unpreserved: Transport as soon as possible; ≤ 2 hours, RT;

Daily

1,320.00

Final result after 2-5 days

1,320.00

Final result after 2-5 days

1,320.00

Final result after 2-5 days

1,320.00

Daily

Preserved: ≤ 24 hours, Amies TM, RT Transport as soon as possible; < 2 hours, RT; ≤ 24 hours, on ice packs (Note: the container must be wrapped with a tape or sealing film when transported with ice packs)

Final result after 2-5 days

Daily

AVAILABLE LABORATORY PROCEDURE

SPECIMEN

VOLUME/ QUANTITY

TIME OF COLLECTION

COLLECTION/ STORAGE

HANDLING/ TRANSPORT

RUNNING DAY

1. Straight catheter:

CUT OFF DAY AND TIME

TAT

FEE

-Cleansing the urethral opening with soap and water. -Allow to pass ďż˝15 mL of urine. Collect in a sterile leak-proof container. Culture and Susceptibility Test (Aerobic Culture)

b. Urine catheterized: 1. Straight catheter 2. Indwelling catheter

2-5 ml (straight catheter) 5-10 ml (indwelling catheter)

Acute stage of illness prior to antimicrobial therapy

2. Indwelling catheter: Collect only from patient w/c are symptomatic. -Disinfect the catheter collection port with 70% alcohol. -Clamp catheter below port allow to collect in tubing for 2030 min.

Transport as soon as possible; Transport as soon as possible; < 2 hours, RT;

Daily

â&#x2030;Ľ 2 hours, on ice packs (see note above when transported with ice packs)

Final result after 2-5 days

1,320.00

Final result after 2-5 days

1,320.00

Final result after 2-5 days

1,320.00

-Use needle and syringe to aseptically collect 5-10 ml of urine aseptically and transfer in a sterile leak-proof container.

Culture and Susceptibility Test

Exudate

0.5-1 ml

(Aerobic Culture)

Acute stage of illness prior to antimicrobial therapy

Aspirate specimen with sterile needle into a sterile leak-proof container. s Unpreserved: place the swabs in sterile tube s Preserved: place in Amies Transport Medium (TM)

Culture and Susceptibility Test (Aerobic Culture)

Surface wound

2 swabs & smear

Preferably prior to antimicrobial therapy

Collect sufficient materials from affected area. Place swabs in sterile tubes. Collect another swab for smear on a clean glass slides. Label clearly Unpreserved: place the swabs in sterile tube

Page 15 of 64

Transport as soon as possible. > 2 hours, on ice packs (see note above when transported with ice packs)

Unpreserved: Transport as soon as possible; > 2 hours, place on ice packs. (see note above when transported with ice packs)

Daily

AVAILABLE LABORATORY PROCEDURE

Culture and Susceptibility Test

SPECIMEN

VOLUME/ QUANTITY

TIME OF COLLECTION

COLLECTION/ STORAGE

HANDLING/ TRANSPORT

Preserved: place in Amies Transport Medium ™

Preserved: ≤ 24 hours, Amies TM, RT

Open: remove the surface exudate by wiping with alcohol pad or with sterile saline. Aspirate if possible or pass the swab deep into the lesion to firmly sample the fresh border. Abscess

0.5-1 ml or 2 swabs

Preferably prior to antimicrobial therapy

(Aerobic Culture)

Closed: disinfect the site and aspirate with needle and syringe into a sterile container. Swabs: sterile container

RUNNING DAY

CUT OFF DAY AND TIME

TAT

FEE

Unpreserved: Transport as soon as possible; > 2 hours, place on ice packs. (see note above when transported with ice packs)

Daily

Final result after 2-5 days

1,320.00

Final result after 2-5 days

1,320.00

3-7 days

1,320.00

Preserved:≤ 24 hours, Amies TM, RT

Aspirates: transfer in a sterile container Unpreserved:Transport as soon as possible;

Culture and Susceptibility Test (Aerobic Culture)

Tissue/Biopsy material (see closed abscess)

Minimum diameter of 1 cm

Preferably prior to antimicrobial therapy

Collected during surgery or cutaneous biopsy procedure:place in sterile leak-proof container. Unpreserved: Dry sterile container Preserved:Immerse specimen in NSS

Culture and Susceptibility Test (Aerobic Culture)

Endocervical, vaginal /male urethral/penile discharge/anorectal swab

2 swabs and 12 smears

Acute stage of illness prior to antimicrobial therapy

Female: collect specimen from endocervical canal with 2 swabs. Male: collect discharge or insert the small swab into the urethra.

Page 16 of 64

Preserved: ≤ 24 hours., RT >24 hours, on ice packs (see note above)

Daily

Storage: ≤ 24 hours., RT; >24 hours, refrigerate (4-8oC) prior to transport suspend in 0.5-1 ml in sterile NSS Unpreserved: Swabs: Transport immediately Preserved: CA and MTM/BAP(optional):

Daily

AVAILABLE LABORATORY PROCEDURE

SPECIMEN

VOLUME/ QUANTITY

TIME OF COLLECTION

COLLECTION/ STORAGE

Anorectal swab-Insert a sterile swab approx. 2.5 cm into anal canal and allow swab to remain 10-30 sec for absorption.

HANDLING/ TRANSPORT

RUNNING DAY

CUT OFF DAY AND TIME

TAT

FEE

≤ 24 hours in candle jar, RT; Amies TM: < 4 hours, RT

Unpreserved: sterile container Preserved: Place one swab in Amies Transport Medium; and the other swab to make a smear for gram stain. (air dry the smear then cover with another clean slide and wrap with a clean paper)

Culture and Susceptibility Test

Stool

(Aerobic Culture)

Culture and Susceptibility Test (Aerobic Culture)

AFB Smear

Formed stool: Pea or Thumb size Liquid: 2-5 ml

Rectal swab (alternative to stool)

Pulmonary (Sputum, BAL, NPA)

Acute stage of illness prior to antimicrobial therapy

1-2 swabs Note: (commercial Transport Medium has only 1 swab)

Acute stage of illness prior to antimicrobial therapy

3-5 ml /container x 2 specimen

Spot or early morning specimen preferred

Unpreserved: Collect into a clean wide-mouth leak-proof container. Preserved: Swab the fresh stool and place in Cary Blair Transport Medium Moisten the swab with sterile NSS before collection and insert the swab into the rectum 1-1.5 inches and rotate the swab gently. Unpreserved: Sterile tube Preserved: Place in a Cary-Blair Transport Medium (TM) available at Clinical Laboratory Collect 2 specimens in a sterile transparent, 50 ml-capacity screw capped container. To

Page 17 of 64

Unpreserved: ≤ 2 hours, RT; < 6 hours, Transport on ice packs (must be processed within 6 hours after collection)

Daily

3-5 days

1,320.00

3-5 days

1,320.00

3 working days

420.00

Preserved: ≤ 7 days in Cary Blair TM, RT Unpreserved: Transport as soon as possible

Daily

Preserved:≤ 7 days in Cary Blair TM, RT

Refrigerate if cannot be transported immediately. Transport in ice

Mon-Fri

AVAILABLE LABORATORY PROCEDURE

AFB Smear

Rapid Plasma Reagin (RPR)

SPECIMEN

Extrapulmonary (CSF, tissue exudates, skin etc.)

(CSF, urine, serum)

VOLUME/ QUANTITY

3-5 ml /container x 2 specimen

1 – 2 ml

TIME OF COLLECTION

upon request

QUALITATIVE

Rapid Plasma Reagin (RPR)

(CSF, urine, serum)

1 – 2 ml

upon request

QUANTITATIVE

Treponema Pallidum Particle Agglutination (TPPA)

Serum

1 – 2 ml

upon request

COLLECTION/ STORAGE

HANDLING/ TRANSPORT

forward to the laboratory as FRESH as possible

following IATA procedure.

CSF keep at room temperature or in an incubator(37 degrees Celsius)until ready for transport to the laboratory; Gastric aspirate should be delivered promptly to the laboratory within 4 hours.

Refrigerate if cannot be transported immediately. Transport in ice following IATA procedure. CSF -to send the specimen IMMEDIATELY in transport box WITHOUT ICE.

Transfer separated serum into sterile 2 ml screw-capped vial or properly sealed red top tube.

QUALITATIVE

Transport immediately, RT; ≤ 1 hour, RT; > 1 hour, transport on ice packs

CUT OFF DAY AND TIME

TAT

FEE Two (2) specimens per test

210.00

3 working days

Mon-Fri

One (1) specimen per test No charge for DOTS and PMDT patients

Mon-Wed-Fri

3 working day

500.00

3 working day

2,500.00

3 working day

1,155.00

Storage: ≥ 1 hour, freeze prior to transport Transport immediately, RT; ≤ 1 hour, RT; > 1 hour, transport on ice packs

Mon-Wed-Fri

Storage: ≥ 1 hour, freeze prior to transport Transport immediately, RT; ≤ 1 hour, RT; > 1 hour, transport on ice packs Storage:

Page 18 of 64

RUNNING DAY

Mon-Wed-Fri

AVAILABLE LABORATORY PROCEDURE

SPECIMEN

VOLUME/ QUANTITY

TIME OF COLLECTION

COLLECTION/ STORAGE

HANDLING/ TRANSPORT

RUNNING DAY

CUT OFF DAY AND TIME

TAT

FEE

≥ 1 hour, freeze prior to transport

Treponema Pallidum Particle Agglutination (TPPA)

Serum

1 – 2 ml

upon request

QUANTITATIVE

Transfer separated serum into sterile 2 ml screw-capped vial or properly sealed red top tube.

Transport immediately, RT; ≤ 1 hour, RT; > 1 hour, transport on ice packs

3 working day

Mon-Wed-Fri

2,500.00

Storage: ≥ 1 hour, freeze prior to transport

ROUTINE LABORATORY TESTS: CLINICAL MICROBIOLOGY (VIROLOGIC TESTS) AVAILABLE LABORATORY PROCEDURE

SPECIMEN

VOLUME/ QUANTITY

TIME OF COLLECTION

COLLECTION/ STORAGE

HANDLING/ TRANSPORT

RUNNING DAY

CUT OFF DAY AND TIME

TAT

(see collection / storage procedures)

Tuesday

Monday (4:00 PM)

6 working days

500.00

FEE

Hepatitis A Virus Serology (AntiHAV IgM)

Serum

1 ml

anytime

Collect in red /yellow top tube and aliquot sample into cryotube. Transport at cold chain / in ice within 72 hours.

Hepatitis B Virus Serology (HBsAg)

Serum

1 ml

anytime

Collect in red /yellow top tube and aliquot sample into cryotube. Transport at cold chain / in ice within 72 hours.

(see collection / storage procedures)

Thursday

Wednesday (4:00PM)

6 working days

252.00

anytime

Collect in red /yellow top tube and aliquot sample into cryotube. Transport at cold chain / in ice within 72 hours.

(see collection / storage procedures)

Thursday

Wednesday (4:00 PM)

6 working days

420.00

Hepatitis B Virus Serology (AntiHBsAg)

Serum

1 ml

Page 19 of 64

AVAILABLE LABORATORY PROCEDURE Hepatitis B Virus Serology (HBeAg)

Hepatitis B Virus Serology (AntiHBeAg) Hepatitis B Virus Serology (AntiHBc)

SPECIMEN

Serum

VOLUME/ QUANTITY

1 ml

TIME OF COLLECTION

COLLECTION/ STORAGE

HANDLING/ TRANSPORT

RUNNING DAY

CUT OFF DAY AND TIME

TAT

anytime

Collect in red /yellow top tube and aliquot sample into cryotube. Transport at cold chain / in ice within 72 hours.

(see collection / storage procedures)

Wednesday

Tuesday (4:00 PM)

6 working days

300.00

anytime

Collect in red /yellow top tube and aliquot sample into cryotube. Transport at cold chain / in ice within 72 hours.

(see collection / storage procedures)

Wednesday

Tuesday (4:00 PM)

6 working days

300.00

anytime

Collect in red /yellow top tube and aliquot sample into cryotube. Transport at cold chain / in ice within 72 hours.

(see collection / storage procedures)

Monday

Friday (4:00 PM)

6 working days

300.00

(see collection / storage procedures)

Tuesday

Monday (4:00 PM)

6 working days

600.00

FEE

Hepatitis C Virus Serology (AntiHCV)

Serum

1 ml

anytime

Collect in red /yellow top tube and aliquot sample into cryotube. Transport at cold chain / in ice within 72 hours.

Dengue Virus NS1-Ag (Rapid Test)

Serum

2 cc blood

Mon-Fri

Collect in red plain tube. No inversion.

Daily

2 hours

700.00

Dengue Virus IgM & IgG (Rapid Test)

Serum

2 cc blood

Mon-Fri

Collect in red plain tube. No inversion.

Daily

2 hours

700.00

5 cc x 2 yellow top SST tube

Mon-Fri (8-3 PM)

To be collected by RITM Clinical Laboratory Staff, after undergoing pre-counseling from RITM Counsellor.

Mon-Fri

3PM

3 hours

HIV 1 & 3 HAT Screening

Page 20 of 64

No Charge for OHAT Patients

ROUTINE LABORATORY TESTS: ANATOMIC PATHOLOGY AVAILABLE LABORATORY PROCEDURE

SPECIMEN

VOLUME/ QUANTITY

TIME OF COLLECTION

COLLECTION/ STORAGE

HANDLING/ TRANSPORT

RUNNING DAY

CUT OFF DAY AND TIME

TAT

FEE 210.00 (small) 360.00 (medium) 560.00 (large)

HematoxylinEosin Stain

Tissue

Small, less than 3 cm Medium 3-5 cm Large 5-7 cm Radical, more than 7 cm

Upon biopsy or autopsy soak sample in Buffered Neutral Formalin (BNF) at least 1:15 ratio

Tissue specimen could be left in BNF indefinitely at room temperature

Tue-Thu (STAT: a day after specimen receipt)

4PM

7 -10 working days STAT: 3-5 working days

640.00 (radical) STAT 350.00 (small) 510.00 (medium) 780.00 (large)

Modified Acid Fast (MAF)/ Modified Gram's Stain (MGS)

Periodic Acid Schiff (PAS)

Tissue

n/a

Upon biopsy or autopsy soak sample in Buffered Neutral Formalin (BNF) at least 1:15 ratio

Tissue specimen could be left in BNF indefinitely at room temperature

Upon biopsy or autopsy soak sample in Buffered Neutral Formalin (BNF) at least 1:15 ratio

Tissue specimen could be left in BNF indefinitely at room temperature

Page 21 of 64

1,190.00 (radical)

2-3 days after receipt (STAT: a day after specimen receipt) 2-3 days after receipt (STAT: a day after specimen receipt)

350.00

4PM

3-7 working days

350.00

4PM

3-7 working days

STAT 530.00

AVAILABLE LABORATORY PROCEDURE

SPECIMEN

VOLUME/ QUANTITY

TIME OF COLLECTION

COLLECTION/ STORAGE

HANDLING/ TRANSPORT

RUNNING DAY

CUT OFF DAY AND TIME

TAT

Recut of Tissue for H & E

Tissue sections

Next day after receipt of request

7-10 working days

100.00

Recut for Unstained slide for send out

Tissue sections

Next day after receipt of request

7-10 working days

100.00

Pull-out of Tissue Block

Tissue Block

Requires approved letter of request after validation

280.00

Same day processing

7-10 working days

600.0

Same day processing

12NN

7-10 working days

600.00

Upon collection, send immediately to the laboratory or store in the ref. if not processed immediately Upon collection, send immediately to the laboratory or store in the ref. if not processed immediately

FEE

Cell block with Cytology

Body fluids

3 - 5 ml

Cell block with Cytology

Pleural fluids

100 - 300 ml

Final Autopsy report

Full/partial tissue organs

1 month

5,000.00

Referrals from RITM Pathologists: H & E

Tissue biopsy

3-5 working days

42.00 One (1) tissue cassette

Referrals from RITM Pathologists: PAPs /Tzank smear/ Cytology

Body fluids/ vaginal smear

3-5 working days

16.00 One (1) Slide

Page 22 of 64

AVAILABLE LABORATORY PROCEDURE Mucicarmine Stain

SPECIMEN

Tissue

Gomorri's Ammoniacal Silver Stain (GAS)

Tissue

Tzanck Smear

Smears on glass slide in 95% ethanol for at least 15 minutes

VOLUME/ QUANTITY

n/a

TIME OF COLLECTION

COLLECTION/ STORAGE

HANDLING/ TRANSPORT

Upon biopsy or autopsy soak sample in Buffered Neutral Formalin (BNF) at least 1:15 ratio

Tissue specimen could be left in BNF indefinitely at room temperature

Upon biopsy or autopsy soak sample in Buffered Neutral Formalin (BNF) at least 1:15 ratio

Tissue specimen could be left in BNF indefinitely at room temperature

Fresh smears are made on prelabeled glass slides in a circular motion, allow to dry at the edges and immerse immediately in 95% ethanol

Soak the smear for at least 15 minutes and then air dry and send to the lab. In slide mailers with proper label

Page 23 of 64

RUNNING DAY

CUT OFF DAY AND TIME

2-3 days after receipt (STAT: a day after specimen receipt)

4PM

Mon-Fri

3-7 working days STAT: ??

2-3 days after receipt (STAT: a day after specimen receipt)

TAT

4PM

12NN

3-7 working days STAT: 3 working days

7 working days

FEE

350.00 STAT 490.00

420.00 STAT 600.00

200.00 STAT 300.00

SPECIAL LABORATORY TESTS: ELECTRON MICROSCOPY AVAILABLE LABORATORY PROCEDURE

SPECIMEN

Package A/TEM Complete tissue processing with micrograph

Tissue

VOLUME/ QUANTITY

3mm x 3mm in 1-2 ml 2.5% glutaraldehyde solution

TIME OF COLLECTION

Package A/TEM Complete tissue processing with micrograph

Body fluids

Package B/TEM Specimen processing with viewing only

Tissue

Fixative of 1:10 ratio

3mm x 3mm in 1-2 ml 2.5% glutaraldehyde solution

Package B/TEM Specimen processing with viewing only

Body fluids

Fixative of 1:10 ratio

COLLECTION/ STORAGE

HANDLING/ TRANSPORT

Upon biopsy or autopsy soak sample in cold (4oC) 2.5% glutaraldehyde at 1:10 ratio for 2.5 hours

Transport in ice ASAP. If not possible wash tissue with 2 changes of phosphate buffer & store in refrigerator in phosphate buffer at 1:10 ratio

Upon biopsy or autopsy soak sample in cold (4oC) 2.5% glutaraldehyde at 1:10 ratio for 2.5 hours

Transport in ice ASAP. If not possible wash tissue with 2 changes of phosphate buffer & store in refrigerator in phosphate buffer at 1:10 ratio

Upon biopsy or autopsy soak sample in cold (4oC) 2.5% glutaraldehyde at 1:10 ratio for 2.5 hours

Transport in ice ASAP. If not possible wash tissue with 2 changes of phosphate buffer & store in refrigerator in phosphate buffer at 1:10 ratio

Upon biopsy or autopsy soak sample in cold (4oC) 2.5% glutaraldehyde at 1:10 ratio for 2.5 hours

Transport in ice ASAP. If not possible wash tissue with 2 changes of phosphate buffer & store in refrigerator in phosphate buffer at 1:10 ratio

Page 24 of 64

RUNNING DAY

Monday

CUT OFF DAY AND TIME

TAT

2 weeks

FEE

5,000.00 (Nonclinical sample) 10,000.00 (Clinical sample)

Monday

2 weeks

5,000.00 (Nonclinical sample) 10,000.00 (Clinical sample) 4,200.00

Monday

1 week

Nonclinical sample

4,200.00

Monday

1 week

Nonclinical sample

AVAILABLE LABORATORY PROCEDURE Package C/TEM Viewing only

Package C/TEM Viewing only

SPECIMEN

VOLUME/ QUANTITY

Tissue

sample on the grid ready for viewing

Body fluids; Biological samples

sample on the grid ready for viewing

Tissue

sample already blocked (polymerized resin)

Body fluids; Biological samples

sample already blocked (polymerized resin)

Package D/TEM Viewing with Micrograph Package D/TEM Viewing with Micrograph

Negative staining with photomicrograph

Body fluids; Biological samples

No fixative

TIME OF COLLECTION

COLLECTION/ STORAGE

HANDLING/ TRANSPORT

RUNNING DAY

CUT OFF DAY AND TIME

TAT

FEE 700.00

Transport in Proper container

Monday

1 day

Nonclinical sample 700.00

Transport in Proper container

Monday

1 day

Nonclinical sample 1,820.00

Transport in Proper container

Monday

1 week

Nonclinical sample 1,820.00

Upon biopsy or autopsy transport immediately to the lab in ice pack

Page 25 of 64

Monday

1 week

Nonclinical sample 3,500.00 (Nonclinical sample) 8,500.00 (Clinical sample)

SPECIAL LABORATORY TESTS: BACTERIOLOGIC TESTS AVAILABLE LABORATORY PROCEDURE Confirmation/ Re-identification of the isolate (Aerobic organisms) Confirmation/Reidentification of the isolate and Susceptibility Test (Aerobic organisms)

SPECIMEN

Pure fresh Isolate (plated or tubed medium)

VOLUME/ QUANTITY

TIME OF COLLECTION

COLLECTION/ STORAGE

HANDLING/ TRANSPORT

RUNNING DAY

Transport as soon as possible < 24 hours, RT; > 24 hours, on ice packs

Daily

Transport as soon as possible < 24 hours, RT; > 24 hours, on ice packs

Daily

Pseudomembrane: can be removed or swab beneath the membrane or the inner portion. Place in sterile tube or any sterile container or inoculate/rub the inner portion of the membrane onto Blood Agar plate Culture and Susceptibility Test for

Corynebacterium diphtheriae

Pseudomembrane/ Throat swab/ Nasopharyngeal swab (NPS)

piece/s of or swabs from pseudomembrane or 2 Throat swabs

As soon As the suspicion arises, preferably prior to antimicrobial therapy

Throat swab (TS): swab the tonsils, posterior pharynx and other inflamed area. Place swabs in sterile test tube or Amies TM. NPS: insert small swab (dacron/rayon) into the posterior nasopharynx via the nose. Rotate the swab for 5 sec. to absorb secretions. Place swabs in sterile test tube or Amies TM.

Page 26 of 64

CUT OFF DAY AND TIME

Not Applicable

TAT

FEE

5-7 days

1,200.00

5-7 days

1,320.00

5-7 days

1,680.00

Unpreserved : Transport as soon as possible; ≤ 2 hours, RT Preserved: Amies Transport Medium / Blood Agar Plate: ≤ 24 hours, RT (if BAP only is submitted, include the remaining pseudomembrane) Note: plate or tube must be wrapped with sealing film or any adhesive tape.

Daily

Not Applicable

AVAILABLE LABORATORY PROCEDURE

Culture for B. pertussis/ B. parapertussis

SPECIMEN

Nasopharyngeal Swab (NPS)

VOLUME/ QUANTITY

1-2 swabs

TIME OF COLLECTION

COLLECTION/ STORAGE

As soon as the suspicion arises, preferably prior to antimicrobial therapy

A dacron or rayon swab is inserted into the nostrils w/ gently downward pressure in the lower nasal floor to the posterior wall of the nasopharynx. The swab is allowed to stay for a few seconds to saturate then remove gently; Swab (2) the collected sample; Place the 2 swabs (NPS/NPA) in Regan Lowe Transport Medium

HANDLING/ TRANSPORT

RUNNING DAY

CUT OFF DAY AND TIME

TAT

FEE

Unpreserved: Transport as soon as possible, RT Preserved: Regan Lowe < 24 hours, RT; > 24 hours, on ice packs

Mon-Wed-Fri

Not Applicable

7-10 days

2,500.00

7-10 days

2,500.00

3-5 working days

4,000.00

3-5 working days

4,000.00

Storage: Refrigerate (2-8째C) prior to transport Unpreserved: Transport as soon as possible, RT

Culture for B. pertussis/ B. parapertussis

Nasopharyngeal Aspirate (NPA)

1 ml

As soon as the suspicion arises, preferably prior to antimicrobial therapy

Swab (2) the collected sample; Place the 2 swabs (NPS/NPA) in Regan Lowe Transport Medium

Preserved: Regan Lowe < 24 hours, RT; > 24 hours, on ice packs

Mon-Wed-Fri

Not Applicable

Storage: Refrigerate (2-8째C) prior to transport

Molecular test for B. pertussis/ B. parapertussis

Nasopharyngeal Swab (NPS)

Molecular test for B. pertussis/ B. parapertussis

Nasopharyngeal Aspirate (NPA)

1-2 swabs

As soon as the suspicion arises, preferably prior to antimicrobial therapy

1 ml

As soon as the suspicion arises, preferably prior to antimicrobial therapy

Collection: see collection of NPS above TRANSPORT Medium: Place the 2 swabs in Regan Lowe Transport Medium,if unavailable, use Universal Transport Medium (UTM) or Atypical Pneumonia Transport Medium (APTM)

Transport on ice packs Storage: Freeze (20째C) prior to transport

Mon-Wed-Fri

Not Applicable

Transport on ice packs Collect in a sterile screw-capped tube.

Page 27 of 64

Storage: Freeze (20째C) prior to transport

Mon-Wed-Fri

Not Applicable

AVAILABLE LABORATORY PROCEDURE

Culture for Pathogenic Leptospira spp.

SPECIMEN

Whole blood

CSF

Urine

VOLUME/ QUANTITY

3 - 5 ml

0.5 - 1 ml

10 - 20 ml

TIME OF COLLECTION

COLLECTION/ STORAGE

within 10 days after onset of symptoms

Bedside collection only. 1. Acquire 4 tubes of EMJH or Korthof’s medium (to be requested from referral laboratory) 2. Label tubes 1, 2, 3 and 4. 3. Aseptically inoculate one (1) drop of blood into tube 1, two (2) drops into tube 2, three (3) drops into tubes 3 and 4. 4. Wrap with opaque material (preferably an aluminum foil).

5-10 days after onset of symptoms

Bedside collection only. 1. Acquire 2 tubes of EMJH or Korthof’s medium (to be requested from referral laboratory). 2. Aseptically inoculate 0.5 ml of sample inti each tube. If quantity is not sufficient, inoculate into one tube only. 3. Wrap with opaque material (preferably an aluminum foil).

2nd week up to 30 days after onset of symptoms

1. Collect 10-20 ml of midstream urine into sterile leak-proof container. 2. Follow the inoculation procedure of whole blood stated above for urine.

Page 28 of 64

HANDLING/ TRANSPORT

RUNNING DAY

CUT OFF DAY AND TIME

TAT

FEE

Transport tubes at an upright and steady position, Room Temperature (RT) Storage: Store at RT, in closed compartment (e.g. cabinet) until ready for transport. (for specimen with Philippine Integrated Disease Survey (PIDSR) or RITM Outbreak referral Form: no longer than 2 weeks) Transport tubes at an upright and steady position, Room Temperature (RT) Storage: Store at RT, in closed compartment (e.g. cabinet) until ready for transport. (for specimen with Philippine Integrated Disease Survey (PIDSR) or RITM Outbreak referral Form: no longer than 2 weeks) Transport tubes at an upright and steady position, Room Temperature (RT) Storage: Store at RT, in closed compartment (e.g. cabinet) until ready for transport. (for specimen with

Mon to Fri

Not Applicable

12 weeks

2,900.00

12 weeks

2,900.00

12 weeks

2,900.00

AVAILABLE LABORATORY PROCEDURE

SPECIMEN

VOLUME/ QUANTITY

TIME OF COLLECTION

COLLECTION/ STORAGE

HANDLING/ TRANSPORT

RUNNING DAY

CUT OFF DAY AND TIME

TAT

FEE

Philippine Integrated Disease Survey (PIDSR) or RITM Outbreak referral Form: no longer than 2 weeks) Serologic test for Pathogenic Leptospira spp.

Serum (Acute Phase)

> 0.5 ml

(MAT).

Serologic test for Pathogenic Leptospira spp. (MAT)

Molecular test for Pathogenic Leptospira spp.

5-10 days after onset of symptoms

Transfer separated serum into sterile 2 ml screw-capped tube or properly sealed red top tube

Serum (Convalescent Phase)

> 0.5 ml

5-20 days after onset of symptoms

Transfer separated serum into sterile 2 ml screw-capped tube or properly sealed red top tube

Whole blood

3 - 5 ml

within 10 days after onset of symptoms

Aseptically collect blood into EDTA Tube (purple top)

>0.5 ml

within 10 days after onset of symptoms

Transfer separated serum into sterile 2 ml screw-capped tube or properly sealed red top tube

0.5 ml - 2 ml

within 10 days after onset of symptoms

Serum

CSF

Store into sterile 2 mL screwcapped tube

Page 29 of 64

Transport on cold pack as soon as possible Storage: Freezer temperature (-20째C) prior to transport Transport on cold pack as soon as possible Storage: Freezer temperature (-20째C) prior to transport Transport at Room Temperature as soon as possible

Mon to Fri

Transport on ice pack as soon as possible Storage: Freezer temperature (-20째C) prior to transport

Mon to Fri

Not Applicable

7 working days

2,900.00

Not Applicable

7 working days

2,900.00

3-5 working days

3,500.00

3-5 working days

3,500.00

3-5 working days

3,500.00

Not Applicable

Transport on ice pack as soon as possible Storage: Freezer temperature (-20째C) prior to transport

Mon to Fri

Not Applicable

AVAILABLE LABORATORY PROCEDURE

Molecular test for Pathogenic Leptospira spp.

Solid TB Culture/DST for Mycobacterium Tuberculosis

SPECIMEN

Urine

Pulmonary (Sputum, BAL, NPA)

Extrapulmonary (CSF, tissue exudates, skin etc.)

VOLUME/ QUANTITY

>10 - 20 ml

3-5 ml /container x 2 specimen

TIME OF COLLECTION

2nd week up to 30 days after onset of symptoms

Spot or early morning specimen preferred

COLLECTION/ STORAGE

Collect in sterile screw capped tubes

HANDLING/ TRANSPORT

CUT OFF DAY AND TIME

TAT

Mon to Fri

Not Applicable

3-5 working days

Monday to Friday (2:00:00 PM)

Culture: 63 calendar days; DST: 49 calendar days (7 weeks after release of positive culture)

Monday to Friday (2:00:00 PM)

Culture: 63 calendar days; DST: 49 calendar days (7 weeks after release of positive culture)

Transport on ice pack as soon as possible Storage: Freezer temperature (-20Â°C) prior to transport

Collect 2 specimens in a sterile transparent, 50 ml-capacity screw capped container. To forward to the laboratory as FRESH as possible

Refrigerate if cannot be transported immediately. Transport in ice following IATA procedure.

CSF keep at room temperature or in an incubator(37 degrees Celsius)until ready for transport to the laboratory; Gastric aspirate should be delivered promptly to the laboratory within 4 hours.

Refrigerate if cannot be transported immediately. Transport in ice following IATA procedure. CSF -to send the specimen IMMEDIATELY in transport box WITHOUT ICE.

Page 30 of 64

RUNNING DAY

Mon-Fri

FEE

3,500.00

4,600.00 per case inclusive of AFB smear; No Charge for DOTS and PMDT Program

4,600.00 per case inclusive of AFB smear No Charge for DOTS and PMDT Program

AVAILABLE LABORATORY PROCEDURE Molecular test for NDM1 Molecular test for ESBL (E. coli / K. pneumoniae)

Molecular test for mecA (Staphylococcus aureus)

Molecular test for Atypical Pneumonia:

Legionella pneumophila, Mycoplasma pneumoniae and Chlamydophila pneumoniae

Molecular test for Atypical Pneumonia:

Legionella pneumophila, Mycoplasma pneumoniae and Chlamydophila pneumoniae

SPECIMEN

VOLUME/ QUANTITY

TIME OF COLLECTION

COLLECTION/ STORAGE

HANDLING/ TRANSPORT

RUNNING DAY

CUT OFF DAY AND TIME

TAT

Pure isolate of E.coli/K. pneumoniae

n/a

Monday to Thursday

Nutrient Agar slant/butt

Mon-Thu

3 working days

4,000.00

Pure isolate of E.coli/K. pneumoniae

n/a

Monday to Thursday

Nutrient Agar slant/butt

Mon-Thu

3 working days

4,000.00

3-5 working days

4,000.00

3-5 working days

4,000.00

Nasopharyngeal Swab (NPS)

1 swab

As soon as the suspicion arises, preferably prior to antimicrobial therapy

Collection: see collection of NPS above TRANSPORT Medium: Regan Lowe Transport Medium, if unavailable, use Universal Transport Medium (UTM) or Atypical Pneumonia Transport Medium (APTM)

FEE

Not Applicable Transport in cold chain, on ice packs within 72 hours Storage: Freeze (20°C) prior to transport

Mon-Wed-Fri

Not Applicable

Nasopharyngeal Aspirate (NPA)

1 ml

As soon as the suspicion arises, preferably prior to antimicrobial therapy

Collect in a sterile screw-capped tube.

Page 31 of 64

Transport in cold chain, on ice packs within 72 hours Storage: Freeze (20°C) prior to transport

Mon-Wed-Fri

AVAILABLE LABORATORY PROCEDURE

Molecular test for Haemophillus influenzae, Neisseria meningitidis, Streptococcus pneumoniae

SPECIMEN

VOLUME/ QUANTITY

TIME OF COLLECTION

COLLECTION/ STORAGE

HANDLING/ TRANSPORT

RUNNING DAY

Transport in cold chain,< 72 hours, on ice packs

CSF

0.5 ml - 2 ml

As soon as the suspicion arises, preferably prior to antimicrobial therapy

Collect in a sterile screw-capped tube/vial

Storage: Freeze (20°C) prior to transport (If culture is requested, take a separate sterile container that will be transported at room temperature)

CUT OFF DAY AND TIME

TAT

FEE

Not Applicable

Mon to Fri

Note: during weekends, holidays and after office hours specimens are received in the clinical laboratory

3-5 working days

5,000.00

3-5 working days

5,000.00

3-5 working days

5,000.00

Not Applicable Molecular test for Haemophillus influenzae, Neisseria meningitidis, Streptococcus pneumoniae

Serum

0.5 ml - 2 ml

As soon as the suspicion arises, preferably prior to antimicrobial therapy

Collect in red top tube only; place serum in a sterile vial/tube.

Transport in cold chain,< 72 hours, on ice packs Storage: Freeze (20°C) prior to transport

Mon to Fri

Transport in cold chain,<72 hours, on ice pack Molecular test for Neisseria meningitidis

CSF

0.5 ml - 2 ml

As soon as the suspicion arises, preferably prior to antimicrobial therapy

Collect in a sterile screw-capped tube/vial

Page 32 of 64

Storage: Refrigerate (2-8°C) prior to transport (If culture is requested, take a separate sterile container that will be transported at room temperature)

Note: during weekends, holidays and after office hours specimens are received in the clinical laboratory

Not Applicable

Mon to Fri

Note: during weekends, holidays and after office hours specimens are received in the clinical laboratory

AVAILABLE LABORATORY PROCEDURE

SPECIMEN

VOLUME/ QUANTITY

TIME OF COLLECTION

COLLECTION/ STORAGE

HANDLING/ TRANSPORT

RUNNING DAY

CUT OFF DAY AND TIME

TAT

FEE

Not Applicable

Molecular test for Neisseria meningitidis

Serum

0.5 ml - 2 ml

As soon as the suspicion arises, preferably prior to antimicrobial therapy

Pulsed Field Gel Electrophoresis (PFGE) Salmonellae/Shige llae/Methicillin resistant S. aureus/V. cholera 01

Pure isolate of Salmonellae/Shige llae/Methicillin resistant S. aureus& V. cholera 01

n/a

Monday to Thursday

Cryptococcal Antigen detection test (Qualitative)

CSF

1 ml

Upon request, preferably prior to antifungal treatment

Collect in red top tube only; place serum in a sterile vial/tube.

Nutrient Agar slant/butt

Collect aseptically into a sterile vial

Transport in cold chain,< 72 hours, on ice packs Storage: Freeze (20°C) prior to transport

Transport immediately, RT; ≤ 1 hour, RT; > 1 hour, transport on ice packs Storage: ≥ 1 hour, freeze prior to transport

Page 33 of 64

Mon to Fri

Mon-Thu

Note: during weekends, holidays and after office hours specimens are received in the clinical laboratory

3-5 working days

5,000.00

3 working days

4,500.00

Not Applicable

Mon-Thu

Note: during weekends, holidays and after office hours specimens are received in the clinical laboratory

1,200.00 3 days

STAT 1,700.00

AVAILABLE LABORATORY PROCEDURE

Cryptococcal Antigen detection test (Qualitative)

Cryptococcal Antigen detection test (Quantitative)

SPECIMEN

serum

CSF

serum

VOLUME/ QUANTITY

0.5 ml

1 ml

0.5 ml

TIME OF COLLECTION

Upon request, preferably prior to antifungal treatment

COLLECTION/ STORAGE

Collect aseptically into a sterile vial

HANDLING/ TRANSPORT

Transport immediately, RT; ≤ 1 hour, RT; > 1 hour, transport on ice packs

RUNNING DAY

Collect aseptically into a sterile vial

Mon-Thu

Collect aseptically into a sterile vial

Storage: ≥ 1 hour, freeze prior to transport

Page 34 of 64

Note: during weekends, holidays and after office hours specimens are received in the clinical laboratory

FEE

1,200.00 3 days

Mon-Thu

Note: during weekends, holidays and after office hours specimens are received in the clinical laboratory

STAT 4,500.00 3 days

Mon-Thu

10 dilutions 6,000.00 STAT 6,500.00 5 dilutions 4,000.00

Not Applicable Note: during weekends, holidays and after office hours specimens are received in the clinical laboratory

STAT 1,700.00

5 dilutions 4,000.00

Not Applicable

Storage: ≥ 1 hour, freeze prior to transport

Transport immediately, RT; ≤ 1 hour, RT; > 1 hour, transport on ice packs

TAT

Not Applicable

Storage: ≥ 1 hour, freeze prior to transport

Transport immediately, RT; ≤ 1 hour, RT; > 1 hour, transport on ice packs

CUT OFF DAY AND TIME

STAT 4,500.00 3 days

10 dilutions 6,000.00 STAT 6,500.00

AVAILABLE LABORATORY PROCEDURE

Serotyping Other Diarrheagenic E. coli: (ETEC/EPEC/EHEC /EIEC)

Serotyping Salmonella spp.

Serotyping Shigella spp.

SPECIMEN

Isolate of Diarrheagenic E. coli: (ETEC/EPEC/EHEC /EIEC)

Isolate of Salmonella spp.

Isolate of Shigella spp.

VOLUME/ QUANTITY

TIME OF COLLECTION

n/a

COLLECTION/ STORAGE

Pure, fresh subculture on Nutrient agar

Page 35 of 64

HANDLING/ TRANSPORT

Transport as soon as possible < 24 hours, RT; > 24 hours, on ice packs

RUNNING DAY

Mon-Fri

Storage: >24 hours, refrigerate (4-8oC) prior to transport

FEE

Note: during weekends, holidays and after office hours specimens are received in the clinical laboratory

3-5 days

3,000.00

2-5 days

3,500.00

2-3 days

1,500.00

Not Applicable

Mon-Fri

Storage: >24 hours, refrigerate (4-8oC) prior to transport

Transport as soon as possible < 24 hours, RT; > 24 hours, on ice packs

TAT

Not Applicable

Storage: >24 hours, refrigerate (4-8oC) prior to transport

Transport as soon as possible < 24 hours, RT; > 24 hours, on ice packs

CUT OFF DAY AND TIME

Note: during weekends, holidays and after office hours specimens are received in the clinical laboratory

Not Applicable

Mon-Fri

Note: during weekends, holidays and after office hours specimens are received in the clinical laboratory

AVAILABLE LABORATORY PROCEDURE

SPECIMEN

VOLUME/ QUANTITY

TIME OF COLLECTION

COLLECTION/ STORAGE

HANDLING/ TRANSPORT

RUNNING DAY

CUT OFF DAY AND TIME

TAT

1-3 ml

As soon as the suspicion arises, preferably prior to antimicrobial therapy

Collect aseptically into a sterile vial.

Transport immediately, RT;

Mon-Wed-Fri

Not Applicable

1 day

4,500.00

2-3 days

1,320.00

FEE

Bacterial Antigen Detection (BAD)

Streptococcus B; Haemophilus influenzae b; Streptococcus pneumoniae; Neisseria meningitidis; Escherichia coli K1

Serotyping Vibrio cholerae 1

Body fluids

Isolate of Vibrio spp.

n/a

Pure, fresh subculture on Nutrient agar

Page 36 of 64

Transport as soon as possible < 24 hours, RT; > 24 hours, on ice packs Storage: >24 hours, refrigerate (4-8oC) prior to transport

Not Applicable

Mon-Fri

Note: during weekends, holidays and after office hours specimens are received in the clinical laboratory

SPECIAL LABORATORY TESTS: MYCOLOGY TESTS AVAILABLE LABORATORY PROCEDURE

SPECIMEN

VOLUME/ QUANTITY

TIME OF COLLECTION

COLLECTION/ STORAGE

HANDLING/ TRANSPORT

RUNNING DAY

CUT OFF DAY AND TIME

TAT

FEE

Preliminar y report: after 1 week

Fungal Culture (request must be accompanied by clinical abstract)

Blood

Bone Marrow Aspirate

1-2 ml (If commercial bottle: follow manufacturer’s instructions.)

as much as possible or as in Blood specimen

If the suspected causative agent comes from the active infective site prior to antifungal therapy

Collection: Cleanse the skin with alcohol then disinfect with iodine or chlorhexidine prior to collecting blood sample. BHI broth or Blood Culture Broth (BCB) is available at the Micro lab / Clinical lab.)

Collect aseptically in heparinized tube or heparinize syringe and place in a sterile container; or in BHI broth or Blood Culture Broth (BCB) and a smear for gram stain

Page 37 of 64

≤ 2 hours, Room Temperature (RT);

Daily

Not Applicable

(BCB) ≤ 24 hours, RT

≤ 2 hours, Room Temperature (RT); (BCB) ≤ 24 hours, RT

Final report:Aft er 4 weeks if there is no fungus isolated (some may require up to six (6) weeks of incubatio n depending on the clinical impressio n)

2,500.00

Preliminar y report: after 1 week Daily

Not Applicable

Final report:Aft er 4 weeks if there is no fungus isolated

2,500.00

AVAILABLE LABORATORY PROCEDURE

SPECIMEN

VOLUME/ QUANTITY

TIME OF COLLECTION

COLLECTION/ STORAGE

HANDLING/ TRANSPORT

RUNNING DAY

CUT OFF DAY AND TIME

TAT

FEE

(some may require up to six (6) weeks of incubatio n depending on the clinical impressio n) Preliminar y report: after 1 week

Fungal Culture (request must be accompanied by clinical abstract)

Abscess drainage, exudates, wound discharge or pus, drainage (note: aspirate is preferable)

Aspirates: 0.5-1 mL; or 2 swabs

If the suspected causative agent comes from the active infective site prior to antifungal therapy

Fungal Culture (request must be accompanied by clinical abstract)

Eye (note: aspirate is preferable)

as much as possible

If the suspected causative agent comes from the active infective

Collection: Clean the surface or top of the infected area by blotting with alcohol pad or with NSS prior to collection and place in a sterile container; if the specimen is scanty, moisten the swab with sterile NSS before collection.

Collection is done by physicians. Corneal scrapings: Specimen should be inoculated directly to the culture media.

Page 38 of 64

≤ 2 hours, Room Temperature (RT);

Daily

Not Applicable

≤ 24 hours, RT

≤ 15 min, Room Temperature (RT); ≤ 24 hours, RT

Daily

Not Applicable

Final report:Aft er 4 weeks if there is no fungus isolated (some may require up to six (6) weeks of incubatio n depending on the clinical impressio n) Preliminar y report: after 1 week

2,500.00

AVAILABLE LABORATORY PROCEDURE

SPECIMEN

VOLUME/ QUANTITY

TIME OF COLLECTION

COLLECTION/ STORAGE

site prior to antifungal therapy

Vitreous humor: place in a sterile container

HANDLING/ TRANSPORT

RUNNING DAY

CUT OFF DAY AND TIME

TAT

FEE

Final report:Aft er 4 weeks if there is no fungus isolated (some may require up to six (6) weeks of incubatio n depending on the clinical impressio n) Preliminar y report: after 1 week

See collection of specimen for aerobic culture Fungal Culture (request must be accompanied by clinical abstract)

Endocervical, vaginal /male urethral/penile discharge/anorect al swab

2 swabs and 1-2 smears

If the suspected causative agent comes from the active infective site prior to antifungal therapy

Unpreserved: sterile container; Preserved: Place one swab in Amies Transport Medium; and the other swab to make a smear (air dry the smear then cover with another clean slide and wrap with a clean paper)

Page 39 of 64

Transport as soon as possible; (Unpreserved) ≤ 2 hours, RT; (Preserved) ≤ 24 hours, RT

Daily

Not Applicable

Final report:Aft er 4 weeks if there is no fungus isolated (some may require up to six (6) weeks of incubatio n depending on the clinical

2,500.00

AVAILABLE LABORATORY PROCEDURE

SPECIMEN

VOLUME/ QUANTITY

TIME OF COLLECTION

COLLECTION/ STORAGE

HANDLING/ TRANSPORT

RUNNING DAY

CUT OFF DAY AND TIME

TAT

FEE

impressio n)

Preliminar y report: after 1 week

Fungal Culture (request must be accompanied by clinical abstract)

Catheter tip (intravascular)

Sterile body fluids:CSF, pericardial, synovial or peritoneal fluids

1-3 mL

If the suspected causative agent comes from the active infective site prior to antifungal therapy

Remove distal 3 to5 cm. of line tip and place in a sterile container

Collect into a sterile container or CSF in plain BHI broth; other body fluids in heparinized tubes. Specify fungal species suspected

Page 40 of 64

≤ 15 min., RT < 24 hours, RT, refrigerate (4-8oC) prior to transport

Daily

Not Applicable

Heparinized specimen: ≤ 24 hours, RT

2,500.00

Preliminar y report: after 1 week

Transport immediately; Unpreserved CSF: ≤ 15 min., RT;

Final report:Aft er 4 weeks if there is no fungus isolated (some may require up to six (6) weeks of incubatio n depending on the clinical impressio n)

Daily

Not Applicable

Final report: After 4 weeks if there is no fungus isolated

2,500.00

AVAILABLE LABORATORY PROCEDURE

SPECIMEN

VOLUME/ QUANTITY

TIME OF COLLECTION

COLLECTION/ STORAGE

HANDLING/ TRANSPORT

RUNNING DAY

CUT OFF DAY AND TIME

TAT

FEE

(some may require up to six (6) weeks of incubatio n depending on the clinical impressio n) Preliminar y report: after 1 week

Cleanse the affected area with 70% alcohol and allow to dry prior to collection.

Fungal Culture (request must be accompanied by clinical abstract)

Skin scrapings; Nail, or shavings or debris under nail; Hair

as much as possible

If the suspected causative agent comes from the active infective site prior to antifungal therapy

Skin: Scrape the edge of the skin lesion with a dull edge of the scalpel or alcohol sterilized glass slide and place in a sterile container. Nail: small clippings or scrape the top or under the nail with a scalpel. Hair: pluck 10-12 infected hairs. Note: All specimens must be placed in a dry, sterile container or in a clean dry paper envelope or place between 2 glass slides wrapped with clean paper.

Page 41 of 64

Transport as soon as possible; â&#x2030;¤ 3 days, RT (Note: Never refrigerate)

Daily

Not Applicable

Final report: After 4 weeks if there is no fungus isolated (some may require up to six (6) weeks of incubatio n depending on the clinical impressio n)

2,500.00

AVAILABLE LABORATORY PROCEDURE

SPECIMEN

VOLUME/ QUANTITY

TIME OF COLLECTION

COLLECTION/ STORAGE

HANDLING/ TRANSPORT

RUNNING DAY

CUT OFF DAY AND TIME

TAT

FEE

Preliminar y report: after 1 week

Fungal Culture (request must be accompanied by clinical abstract)

Respiratory tract, lower: Sputum, bronchial aspirates and BAL fluid

1-5 mL

If the suspected causative agent comes from the active infective site prior to antifungal therapy

Sputum: Collect first morning specimen after brushing of teeth Bronchial aspirates: surgically collect brushings. BAL fluid: surgically collected Note: place all samples in sterile leak-proof container

(Sputum) < 2 hours, RT; (BAL fluid) < 24 hours, RT If longer, wrapped the specimen container in plastic /cellophane and place on cold pack or if not transported on same day.

Daily

Not Applicable

Respiratory, upper: Oral swab, oropharyngeal swab, and sinus samples

Swabs: 2 Sinus content: 1-5 mL

If the suspected causative agent comes from the active infective site prior to antifungal therapy

Swab oral lesions; Use flexible swab for oropharynx; sinus content is surgically collected and place in a sterile container or in Amies TM. Specify suspected fungal species

Page 42 of 64

If longer: Oral/oropharyngeal: ≤ 2 hours, RT; ≤ 24 hours, RT Sinus sample: ≤ 15 min., RT; < 24 hours, RT

(some may require up to six (6) weeks of incubatio n depending on the clinical impressio n)

2,500.00

Preliminar y report: after 1 week

Transport immediately;

Fungal Culture (request must be accompanied by clinical abstract)

Final report: After 4 weeks if there is no fungus isolated

Daily

Not Applicable

Final report: After 4 weeks if there is no fungus isolated (some may require up

2,500.00

AVAILABLE LABORATORY PROCEDURE

SPECIMEN

VOLUME/ QUANTITY

TIME OF COLLECTION

COLLECTION/ STORAGE

HANDLING/ TRANSPORT

RUNNING DAY

CUT OFF DAY AND TIME

TAT

FEE

to six (6) weeks of incubatio n depending on the clinical impressio n) Final report: After 4 weeks if there is no fungus isolated Fungal Culture (request must be accompanied by clinical abstract)

Fungal Culture (request must be accompanied by clinical abstract)

Throat/Mouth scrapings

Stool (stool sample should be discouraged, tissue biopsy of GI tract is the preferred specimen if available, see tissue)

as much as possible

Thumb size

preferably prior to antifungal therapy

Scrape throat/mouth with a sterile tongue depressor and place in a sterile container

Collect into a sterile container. Specify fungal species suspected

≤ 2 hours, RT; ≤ 24 hours, RT

Transport as soon as possible; ≤ 2 hours, RT

Daily

Not Applicable

Some may require up to six (6) weeks of incubatio n depending on the clinical impressio n Final report: After 4 weeks if there is no fungus isolated Some may require up to six (6) weeks of incubatio

Page 43 of 64

2,500.00

AVAILABLE LABORATORY PROCEDURE

SPECIMEN

VOLUME/ QUANTITY

TIME OF COLLECTION

COLLECTION/ STORAGE

HANDLING/ TRANSPORT

RUNNING DAY

CUT OFF DAY AND TIME

TAT

FEE

n depending on the clinical impressio n

Fungal Culture (request must be accompanied by clinical abstract)

Urine (24-hour specimens are unacceptable)

5-10 ml

preferably prior to antifungal therapy

First morning clean catch or subrapubic or catheterized (see collection of urine for aerobic culture) urine in a sterile leakproof container. Specify suspected fungal species

Collected during surgery or cutaneous biopsy procedure: Fungal Culture (request must be accompanied by clinical abstract)

Tissue

as much as possible

preferably prior to antifungal therapy

-place in sterile leak-proof container. Unpreserved: Dry sterile container Preserved: If small specimen add few drops of sterile NSS; If bigger, 0.5-1 ml in sterile NSS

Page 44 of 64

Final report: After 4 weeks if there is no fungus isolated

≤ 2 hours, RT; ≤ 24 hours, on ice packs (wrap the container in a plastic wrapper/cellophane and place with ice packs)

Daily

Not Applicable

Storage: ≤ 24 hours., RT; >24 hours, refrigerate (48oC) prior to transport

2,500.00

Final report: After 4 weeks if there is no fungus isolated

Unpreserved: Transport as soon as possible; Preserved: ≤ 24 hours., RT >24 hours, on ice packs (see note above)

Some may require up to six (6) weeks of incubatio n depending on the clinical impressio n

Daily

Not Applicable

Some may require up to six (6) weeks of incubatio n depending on the

2,500.00

AVAILABLE LABORATORY PROCEDURE

SPECIMEN

VOLUME/ QUANTITY

TIME OF COLLECTION

COLLECTION/ STORAGE

HANDLING/ TRANSPORT

RUNNING DAY

CUT OFF DAY AND TIME

suspend in 0.5-1 ml in sterile NSS

Antifungal Susceptibility Test (including reidentification of isolates)

India ink (Microscopy)

Potassium Hydroxide (Microscopy)

TAT

FEE

clinical impressio n

Isolates of Candida spp., Cryptococcus spp., Aspergillus spp. and other miscellaneous rapid growing yeast spp.

See all specimen for fungal culture

Tue-Thu

Not Applicable

1 week

CSF and all possible specimens for the detection of Cryptocccus sp.

Fluids, Exudates: 0.5-3 ml Tissue: as much as possible Sputum: 1-5 ml

Prior to antifungal therapy

See all specimen for fungal culture

Daily

Not Applicable

1 day

170.00

All clinical specimens

Fluids, Exudates: 0.5-3 ml; Tissue: as much as possible; Sputum: 1-5 ml; Skin: as much as possible

Daily

Not Applicable

1 day

170.00

1,950.00

See all specimen for fungal culture Prior to antifungal therapy

See all specimen for fungal culture

Page 45 of 64

(If the specimen was already placed on a slide, cover with another clean slide and wrap in a clean paper)

SPECIAL LABORATORY TESTS: VIROLOGIC TESTS AVAILABLE LABORATORY PROCEDURE

SPECIMEN

VOLUME/ QUANTITY

TIME OF COLLECTION

COLLECTION/ STORAGE

HANDLING/ TRANSPORT

RUNNING DAY

CUT OFF DAY AND TIME

TAT

Tue/Thu

Mon/Wed

7 days

4,000.00

Tue/Thu

Mon/Wed

7 days

4,000.00

Tue/Thu

Mon/Wed

7 days

5,000.00

FEE

VIRUS PANEL TESTING Molecular test for Panel 1 (CNS): Japanese Encephalitis + West Nile Virus

Serum

1 ml

Upon first contact with the patient

路 Collect in plain or red top tube 路 Allow to clot 路 Centrifuge 路 Separate serum from blood

Upon first contact with the patient

Collect aseptically in a sterile glass/plastic container

Molecular test for Panel 1 (CNS): Japanese Encephalitis + West Nile Virus

CSF

1 ml

Transport in ice to be received at RITM within 72 hours Immediately refrigerate at 2-8 degree Celsius while awaiting transport Transport in ice to be received at RITM within 72 hours Place container in a ziplock/leakproof plastic bags Immediately refrigerate at 2-8 degree Celsius while awaiting transport

Molecular test for Panel 2 (CNS): Japanese Encephalitis + West Nile Virus + Enterovirus

Immediately refrigerate at 2-8 degree Celsius while awaiting transport

CSF

1 ml

Upon first contact with the patient

Collect aseptically in a sterile glass/plastic container

Transport in ice to be received at RITM within 72 hours Place container in a ziplock/leakproof plastic bags

Page 46 of 64

AVAILABLE LABORATORY PROCEDURE

SPECIMEN

VOLUME/ QUANTITY

TIME OF COLLECTION

COLLECTION/ STORAGE

Molecular test for Panel 2 (CNS): Japanese Encephalitis + West Nile Virus + Enterovirus

Serum

1 ml

Molecular test for Panel 3 (CNS): HSV-1 & 2, CMV

CSF

1 ml

Upon first contact with the patient

· Collect in plain or red top tube · Allow to clot · Centrifuge · Separate serum from blood

Upon first contact with the patient

Collect aseptically in a sterile glass/plastic container

Immediately refrigerate at 2-8 degree Celsius while awaiting transport

RUNNING DAY

CUT OFF DAY AND TIME

TAT

Tue/Thu

Mon/Wed

7 days

5,000.00

Tue/Thu

Mon/Wed

7 days

5,000.00

Tue/Thu

Mon/Wed

7 days

8,000.00

FEE

Transport in ice to be received at RITM within 72 hours Immediately refrigerate at 2-8 degree Celsius while awaiting transport Transport in ice to be received at RITM within 72 hours Place container in a ziplock/leak-proof plastic bags Immediately refrigerate at 2-8 degree Celsius while awaiting transport

Molecular test for Panel 4 (CNS): West Nile Virus, Japanese Encephalitis, Enteroviruse, HSV 1&2, CMV

HANDLING/ TRANSPORT

CSF

1 ml

Upon first contact with the patient

Collect aseptically in a sterile glass/plastic container

Transport in ice to be received at RITM within 72 hours Place container in a ziplock/leak-proof plastic bags

Rapid Test: IF Panel 5 (RESPI): Flu/Respiratory viruses panel: Influenza A&B RSV Parainfluenza 1,2,3 Adenovirus HSV 1 & 2

NPA

1 ml

Within 5 days from onset of symptoms

· Collect in a mucus trap/extractor · Suspend in VTM/UTM

Page 47 of 64

Immediately refrigerate at 2-8 degree Celsius while awaiting transport Transport in ice to be received at RITM within 72 hours

Mon-Fri

Tue-Thu

7 days

1,500.00 per target 5,000.00 Al targets

AVAILABLE LABORATORY PROCEDURE

SPECIMEN

VOLUME/ QUANTITY

TIME OF COLLECTION

COLLECTION/ STORAGE

HANDLING/ TRANSPORT

RUNNING DAY

CUT OFF DAY AND TIME

TAT

MWF

TTh

3 weeks

5,000.00

MWF

TTh

3 weeks

5,000.00

MWF

TTh

3 weeks

5,000.00

FEE

Virus isolation Panel 5 (RESPI): Flu/Respiratory viruses panel: Influenza A&B RSV Parainfluenza 1,2,3 Rhinovirus Adenovirus Enterovirus HSV 1 & 2

NPS/OPS

2 swabs

Within 5 days from onset of symptoms

· Use Dacron or rayon swabs with plastic shafts · Suspend in VTM/UTM

Immediately refrigerate at 2-8 degree Celsius while awaiting transport Transport in ice to be received at RITM within 72 hours

Virus isolation Panel 5 (RESPI): Flu/Respiratory viruses panel: Influenza A&B RSV Parainfluenza 1,2,3 Rhinovirus Adenovirus Enterovirus HSV 1 & 2

NPA

2 ml

Within 5 days from onset of symptoms

· Collect in a mucus trap/extractor · Suspend in VTM/UTM

Immediately refrigerate at 2-8 degree Celsius while awaiting transport Transport in ice to be received at RITM within 72 hours

Virus isolation Panel 5 (RESPI): Flu/Respiratory viruses panel: Influenza A&B RSV Parainfluenza 1,2,3 Rhinovirus Adenovirus Enterovirus HSV 1 & 2

Lung aspirate

1 ml

Within 5 days from onset of symptoms

· Collect in a mucus trap/extractor · Suspend in VTM/UTM

Page 48 of 64

Immediately refrigerate at 2-8 degree Celsius while awaiting transport Transport in ice to be received at RITM within 72 hours

AVAILABLE LABORATORY PROCEDURE

SPECIMEN

VOLUME/ QUANTITY

TIME OF COLLECTION

COLLECTION/ STORAGE

Molecular test for Panel 6 (RESPI): Metapneumovirus + Respiratory syncytial virus (RSV)

NPS/OPS

2 swabs

Within 5 days from onset of symptoms

· Use Dacron or rayon swabs with plastic shafts · Suspend in VTM/UTM

Within 5 days from onset of symptoms

· Collect in a mucus trap/extractor · Suspend in VTM/UTM

Within 5 days from onset of symptoms

· Collect in a mucus trap/extractor · Suspend in VTM/UTM

Within 5 days from onset of symptoms

· Use Dacron or rayon swabs with plastic shafts · Suspend in VTM/UTM

Within 5 days from onset of symptoms

· Use Dacron or rayon swabs with plastic shafts · Suspend in VTM/UTM

Molecular test for Panel 6 (RESPI): Metapneumovirus + Respiratory syncytial virus (RSV)

NPA

2 ml

Molecular test for Panel 6 (RESPI): Metapneumovirus + Respiratory syncytial virus (RSV)

Lung aspirate

1 ml

Molecular test for Panel 7 (RESPI): RSV, MPV, ADV

NPS/OPS

2 swabs

Molecular test for Panel 8 (RESPI): Parainfluenza 1-3, EV

NPS/OPS

2 swabs

Page 49 of 64

HANDLING/ TRANSPORT Immediately refrigerate at 2-8 degree Celsius while awaiting transport Transport in ice to be received at RITM within 72 hours Immediately refrigerate at 2-8 degree Celsius while awaiting transport Transport in ice to be received at RITM within 72 hours Immediately refrigerate at 2-8 degree Celsius while awaiting transport Transport in ice to be received at RITM within 72 hours Immediately refrigerate at 2-8 degree Celsius while awaiting transport Transport in ice to be received at RITM within 72 hours Immediately refrigerate at 2-8 degree Celsius while awaiting transport Transport in ice to be received at RITM within 72 hours

RUNNING DAY

CUT OFF DAY AND TIME

TAT

Tue/Thu

Mon/Wed

7 days

4,000.00

Tue/Thu

Mon/Wed

7 days

4,000.00

Tue/Thu

Mon/Wed

7 days

4,000.00

Tue/Thu

Mon/Wed

7 days

5,000.00

Tue/Thu

Mon/Wed

7 days

5,000.00

FEE

AVAILABLE LABORATORY PROCEDURE Molecular test for Panel 9 (RESPI): RSV, MPV, ADV, Parainfluenza 1-3, EV

SPECIMEN

NPS/OPS

VOLUME/ QUANTITY

2 swabs

TIME OF COLLECTION

COLLECTION/ STORAGE

Within 5 days from onset of symptoms

· Use Dacron or rayon swabs with plastic shafts · Suspend in VTM/UTM

Within 14 days from onset of diarrhea

Collect in sterile / clean screwcapped container

Molecular test for Panel 10 (GI): Rotavirus, Norovirus Genogroup 1 & 2

Stool

Adult thumb size/5-10 ml liquid stool

Within 14 days from onset of diarrhea

Collect in sterile / clean screwcapped container

CUT OFF DAY AND TIME

TAT

Tue/Thu

Mon/Wed

7 days

8,500.00

Tuesday

Monday

10 days

5,500.00

Tue/Thu

Mon/Wed

10 days

5,000.00

Tue/Thu

Mon/Wed

10 days

8,500.00

FEE

Transport in ice to be received at RITM within 72 hours Immediately refrigerate at 2-8 degree Celsius while awaiting transport Transport in ice to be received at RITM within 72 hours

Transport in ice to be received at RITM within 72 hours Place container in a ziplock/leakproof plastic bags Immediately refrigerate at 2-8 degree Celsius while awaiting transport

Molecular test for Panel 12 (GI): Rotavirus, Norovirus, Adenovirus, Enterovirus

Immediately refrigerate at 2-8 degree Celsius while awaiting transport

RUNNING DAY

Place container in a ziplock/leakproof plastic bags Immediately refrigerate at 2-8 degree Celsius while awaiting transport

Molecular test for Panel 11 (GI): Adeno virus, Enterovirus

Adult thumb size/5-10 ml liquid stool

HANDLING/ TRANSPORT

Stool

Adult thumb size/5-10 ml liquid stool

Within 14 days from onset of diarrhea

Collect in sterile / clean screwcapped container

Transport in ice to be received at RITM within 72 hours Place container in a ziplock/leakproof plastic bags

Page 50 of 64

AVAILABLE LABORATORY PROCEDURE

SPECIMEN

VOLUME/ QUANTITY

TIME OF COLLECTION

RUNNING DAY

CUT OFF DAY AND TIME

COLLECTION/ STORAGE

HANDLING/ TRANSPORT

Tissue samples must be fresh or frozen and should not be chemically preserved. Cooked, burned and autolyzed samples will be rejected.

Use protective clothing (gloves, gown, apron, face mask and or face shield) -20°C if testing is delayed. 2°C - 8°C if to be tested immediately. Transport in ice.

Mon-Thu (except holidays)

0.5 ml saliva collected serially by aspiration, every 4-6 hours. 3-5 sample collections pooled & aliquoted for antemortem/tests & specimen banking.

Use protective clothing (gloves, gown, apron, face mask and or face shield) -20°C if testing is delayed. 2°C - 8°C if to be tested immediately. Transport in ice.

Mon-Thu (except holidays)

Wear proper personal protective clothing (gown, double gloves, mask, face shield or eye protection). Can be collected without opening the skull, via the atlanto-occipital joint. Must be stored frozen or buffered glycerol (1:1 glycerol and normal saline).

Put tissue in a tube or specimen vial then place the vial into a leak-proof secondary container, then again in a tertiary leak-proof packaging (e.g. Ziploc). Lastly, place in a sturdy outer packaging (e.g. cooler) for transport. Frozen brain tissue must be transported to the laboratory immediately. Dry ice may be used for longer transport. Tissue stored in buffered

TAT

FEE

RABIES VIRUS Serologic

Molecular test for Rabies virus

Rabies Antigen Detection by direct FLUORESCENT ANTIBODY TEST (dFAT)

Brain Tissue

Saliva

Brain Tissue

Approximately 30 mm x 3 mm

5 ml per collection

1 cm x 1 cm

Post mortem

Upon appearance of rabies specific signs and symptoms

As soon as the patient died, with consent from the relative

Page 51 of 64

Mon-Fri (except holidays), acceptance of specimen is 24 hours

5 days after a batch test (Batch testing done every 10th and 25th day of the month) 5 days after a batch test (Batch testing done every 10th and 25th day of the month)

72 working hours upon receipt by the Special Pathogens Laborator y (VRDSPL)

5,000.00

No charge until further notice

AVAILABLE LABORATORY PROCEDURE

SPECIMEN

VOLUME/ QUANTITY

TIME OF COLLECTION

COLLECTION/ STORAGE

HANDLING/ TRANSPORT

RUNNING DAY

CUT OFF DAY AND TIME

TAT

Mon-Fri

7 days

1,500.00

Tuesday

Monday

10 days

4,000.00

Wednesday

Tuesday

3 weeks

3,000.00

Thursday

Wednesday

10 days

1,500.00

Tuesday

Monday

10 days

4,000.00

FEE

glycerol must also be transported with ice.

MEASLES and other EXANTHEMS Serology: IgM Measles Virus

Molecular test for Measles Virus

Virus isolation (Measles Virus)

Serology: IgM/IgG Mumps

Molecular test for Mumps

Serum

NPS/OPS

Serum

Buccal swab

2 ml

2 swabs

1 ml

2 swabs

Within 4-28 days from onset of rash

· Collect in plain or red top tube or yellow SST · Allow to clot · Centrifuge · Separate serum from blood

Within 7 days from onset of rash

· Use Dacron or rayon swabs with plastic shafts · Suspend in VTM/UTM

Within 7 days from onset of rash

· Use Dacron or rayon swabs with plastic shafts · Suspend in VTM/UTM

5 days after onset of fever

· Collect in plain or red top tube · Allow to clot · Centrifuge · Separate serum from blood

Upon first contact w/ the patient

· Use Dacron or rayon swabs with plastic shafts · Suspend in VTM/UTM

Page 52 of 64

Immediately refrigerate at 2-8 degree Celsius while awaiting transport Transport in ice to be received at RITM within 72 hours Immediately refrigerate at 2-8 degree Celsius while awaiting transport Transport in ice to be received at RITM within 72 hours Immediately refrigerate at 2-8 degree Celsius while awaiting transport Transport in ice to be received at RITM within 72 hours Immediately refrigerate at 2-8 degree Celsius while awaiting transport Transport in ice to be received at RITM within 72 hours Immediately refrigerate at 2-8 degree Celsius while awaiting transport

AVAILABLE LABORATORY PROCEDURE

SPECIMEN

VOLUME/ QUANTITY

TIME OF COLLECTION

COLLECTION/ STORAGE

HANDLING/ TRANSPORT

RUNNING DAY

CUT OFF DAY AND TIME

TAT

Tuesday

Monday

10 days

4,000.00

Mon-Fri

7 days

1,500.00

Tuesday

Monday

10 days

4,000.00

Wednesday

Tuesday

3 weeks

3,000.00

FEE

Serology: IgM Rubella Virus

Molecular test for Rubella Virus

Virus isolation (Rubella Virus)

Urine

Serum

NPS/OPS

10 ml

1-2 ml

2 swabs

>4 days onset of fever

Collect first morning midstream in a sterile wide-mouth container

Within 4-28 days from onset of rash

· Collect in plain or red top tube or yellow SST · Allow to clot · Centrifuge · Separate serum from blood

Within 7 days from onset of rash

· Use Dacron or rayon swabs with plastic shafts · Suspend in VTM/UTM

Within 7 days from onset of rash

· Use Dacron or rayon swabs with plastic shafts · Suspend in VTM/UTM

Page 53 of 64

Transport in ice to be received at RITM within 72 hours Place container in a ziplock/leakproof plastic bags Immediately refrigerate at 2-8 degree Celsius while awaiting transport Transport in ice to be received at RITM within 72 hours Immediately refrigerate at 2-8 degree Celsius while awaiting transport Transport in ice to be received at RITM within 72 hours Immediately refrigerate at 2-8 degree Celsius while awaiting transport Transport in ice to be received at RITM within 72 hours

AVAILABLE LABORATORY PROCEDURE

SPECIMEN

VOLUME/ QUANTITY

TIME OF COLLECTION

COLLECTION/ STORAGE

HANDLING/ TRANSPORT

RUNNING DAY

CUT OFF DAY AND TIME

TAT

Wednesday

Monday AM

7 days

4,000.00

Tuesday

Monday

10 days

1,500.00

Thursday

Wednesday

10 days

1,500.00

Tue/Thu

Mon/Wed

7 days

4,000.00

FEE

DENGUE and other ARBOVIRUSES

Molecular test for Dengue Virus

Serology: IgM Japanese Encephalitis

Serology: ELISA IgM Chikungunya (CHIKV)

Molecular test for Chikungunya (CHIKV)

Serum

CSF and Serum (paired)

Serum

1 ml

Within 5 days from onset of fever

· Collect in plain or red top tube. · Allow to clot · Centrifuge · Separate serum from blood

Upon first contact w/ the patient

Collect aseptically in a sterile glass/plastic container

7 days after onset of fever

· Collect in plain or red top tube. · Allow to clot · Centrifuge · Separate serum from blood

7 days after onset of fever

· Collect in plain or red top tube. · Allow to clot · Centrifuge · Separate serum from blood

ROTAVIRUS and other ENTERIC VIRUSES

Page 54 of 64

Immediately refrigerate at 2-8 degree Celsius while awaiting transport Transport in ice to be received at RITM within 72 hours Immediately refrigerate at 2-8 degree Celsius while awaiting transport Transport in ice to be received at RITM within 72 hours Place container in a ziplock/leak-proof plastic bags Immediately refrigerate at 2-8 degree Celsius while awaiting transport Transport in ice to be received at RITM within 72 hours Immediately refrigerate at 2-8 degree Celsius while awaiting transport Transport in ice to be received at RITM within 72 hours

AVAILABLE LABORATORY PROCEDURE

Serology: Antigen Detection

SPECIMEN

Stool

Rotavirus

Molecular test for Rotavirus

Molecular test for Norovirus Group 1 &2

Stool

VOLUME/ QUANTITY

Adult thumb size/5-10 ml liquid stool

TIME OF COLLECTION

Within 14 days from onset of diarrhea

COLLECTION/ STORAGE

Collect in sterile / clean screwcapped container

HANDLING/ TRANSPORT Immediately refrigerate at 2-8 degree Celsius while awaiting transport

RUNNING DAY

CUT OFF DAY AND TIME

TAT

10 days

1,500.00

10 days

4,000.00

Tuesday

Monday

10 days

4,000.00

Tuesday

Monday

10 days

4,000.00

Tuesday

Monday

10 days

4,000.00

FEE

Transport in ice to be received at RITM within 72 hours Immediately refrigerate at 2-8 degree Celsius while awaiting transport Transport in ice to be received at RITM within 72 hours Immediately refrigerate at 2-8 degree Celsius while awaiting transport Transport in ice to be received at RITM within 72 hours

POLIOVIRUS and other ENTEROVIRUSES Immediately refrigerate at 2-8 degree Celsius while awaiting transport Molecular test for Enterovirus (EV)

Molecular test for Enterovirus (EV)

Stool/Rectal swab

CSF

1 thumb sized or 5 to 10 ml if diarrheic

1 ml

Within 14 days from onset of symptoms

Within 7 to 10 days after from onset of symptoms

Place in a clean screw- capped container

Collect aseptically in a sterile glass/plastic container

Page 55 of 64

Transport in ice to be received at RITM within 72 hours Place container in a ziplock/leakproof plastic bags Immediately refrigerate at 2-8 degree Celsius while awaiting transport

AVAILABLE LABORATORY PROCEDURE

SPECIMEN

VOLUME/ QUANTITY

TIME OF COLLECTION

COLLECTION/ STORAGE

HANDLING/ TRANSPORT

RUNNING DAY

CUT OFF DAY AND TIME

TAT

Tuesday

Monday

10 days

4,000.00

Tuesday

Monday

10 days

4,000.00

MWF

Tue/Thu

2 weeks

3,000.00

FEE

Transport in ice to be received at RITM within 72 hours Place container in a ziplock/leak-proof plastic bags Immediately refrigerate at 2-8 degree Celsius while awaiting transport Molecular test for Enterovirus (EV)

NPS/OPS

2 swabs

Within 5 days from onset of fever

路 Use Dacron or rayon swabs with plastic shafts 路 Suspend in VTM/UTM

Transport in ice to be received at RITM within 72 hours Place container in a ziplock/leak-proof plastic bags Immediately refrigerate at 2-8 degree Celsius while awaiting transport

Molecular test for Enterovirus (EV)

Vesicular swab

2 swabs

With presence of unraptured vesicle

路 Use Dacron or rayon swabs with plastic shafts 路 Suspend in VTM/UTM

Place container in a ziplock/leak-proof plastic bags Immediately refrigerate at 2-8 degree Celsius while awaiting transport

Virus isolation Enterovirus (EV) 1. Polioviruses 2. NPEV (Nonpolio enteroviruses)

Transport in ice to be received at RITM within 72 hours

Stool

1 thumb sized or 5 to 10 ml if diarrheic

Within 14 days from onset of paralysis

Place in a clean screw- capped container

Transport in ice to be received at RITM within 72 hours Place container in a ziplock/leak-proof plastic bags

Page 56 of 64

AVAILABLE LABORATORY PROCEDURE

SPECIMEN

VOLUME/ QUANTITY

TIME OF COLLECTION

COLLECTION/ STORAGE

HANDLING/ TRANSPORT

RUNNING DAY

CUT OFF DAY AND TIME

TAT

Thursday

Wednesday

10 days

4,000.00

Thursday

Wednesday

10 days

4,000.00

Tue/Thu

Mon/Wed

7 days

3,000.00

Tue/Thu

Mon/Wed

7 days

3,000.00

Mon-Fri (batch testing)

None

8 weeks

6,000.00

FEE

INFLUENZA and other RESPIRATORY VIRUSES Molecular test for Influenza A&B with subtyping (H1, H3)

NPS/OPS

Molecular test for Influenza A&B with subtyping (H1, H3)

Endotracheal Aspirate; Bronchoalveolar lavage

2 ml

Molecular test for Adenovirus (AdV)

Stool

Molecular test for Adenovirus (AdV)

NPS/OPS

Within 5 days from onset of symptoms

路 Use Dacron or rayon swabs with plastic shafts 路 Suspend in VTM/UTM

Within 7 days from onset of symptoms

Collect aseptically in a sterile glass/plastic container

Adult thumb size/5-10 ml liquid stool

Within 14 days from onset of diarrhea

Collect in sterile / clean screwcapped container

2 swabs

Within 5 days from onset of fever

路 Use Dacron or rayon swabs with plastic shafts 路 Suspend in VTM/UTM

2 swabs

HUMAN IMMUNODEFICIENCY VIRUS (HIV) HIV-1 Drug resistance genotyping by sequencing

Plasma

> 2ml

Anytime

Collect in 4-ml EDTA (purpletop) tube. Freeze prior to transport

Page 57 of 64

Transport in ice within 24 hours after collection. Pack and transport as

AVAILABLE LABORATORY PROCEDURE

SPECIMEN

VOLUME/ QUANTITY

TIME OF COLLECTION

COLLECTION/ STORAGE

HANDLING/ TRANSPORT

RUNNING DAY

CUT OFF DAY AND TIME

TAT

5 working days

3,000.00

FEE

Category B infectious substances (UN 3373)

HIV-1 & HIV-3 CD4 Molecular test

HIV-1 & HIV-4 Viral Load testing Molecular test

Whole blood

Plasma

2 EDTA tube x 4 ml

Mon-Fri (except Wed)

Collect in 2 plastic tubes of 4ml EDTA, freshly collected specimen is needed

Transport immediately at room temperature

Mon-Fri except Wednesday

Mon-Fri

Collect in 2 plastic tubes of 4ml EDTA and separate plasma into 2 cryotubes (1.5-2.5 mL) within 4 hours. Store at -20⁰C or below if not transported immediately.

*10AM for scheduled clients *2PM for referral and inpatient

Freeze, transport with ice

Mon-Fri

1 month

3,000.00

Tue/Thu

Mon/Wed

7 days

4,000.00

Tue/Thu

Mon/Wed

7 days

4,000.00

OTHER VIRUSES Immediately refrigerate at 2-8 degree Celsius while awaiting transport Molecular test for Cytomegalovirus (CMV)

Molecular test for Cytomegalovirus (CMV)

Urine (Ideal sample)

Whole blood

5-10 ml

10 ml

Within 5 days from onset of fever

Collect first morning midstream in a sterile wide-mouth container

· Collect in purple/violet top (EDTA) tube · Invert gently to mix anticoagulant

Page 58 of 64

AVAILABLE LABORATORY PROCEDURE

SPECIMEN

VOLUME/ QUANTITY

TIME OF COLLECTION

COLLECTION/ STORAGE

HANDLING/ TRANSPORT

RUNNING DAY

CUT OFF DAY AND TIME

TAT

Tue/Thu

Mon/Wed

7 days

4,000.00

Tuesday

Monday

10 days

4,000.00

Tuesday

Monday

10 days

4,000.00

Tuesday

Monday

10 days

4,000.00

FEE

Immediately refrigerate at 2-8 degree Celsius while awaiting transport Molecular test for Cytomegalovirus (CMV)

Molecular test for HFMD (Handfoot-mouth disease)

CSF

1 ml

Within 5 days from onset of fever

Collect aseptically in a sterile glass/plastic container

Transport in ice to be received at RITM within 72 hours Place container in a ziplock/leak-proof plastic bags Immediately refrigerate at 2-8 degree Celsius while awaiting transport

Stool/Rectal swab

CSF

NPS/OPS

1 thumb sized or 5 to 10 ml if diarrheic

1 ml

2 swabs

Within 14 days from onset of symptoms

Within 7 to 10 days after from onset of symptoms

Within 5 days from onset of fever

Place in a clean screw- capped container

Transport in ice to be received at RITM within 72 hours Place container in a ziplock/leak-proof plastic bags Immediately refrigerate at 2-8 degree Celsius while awaiting transport

Collect aseptically in a sterile glass/plastic container

· Use Dacron or rayon swabs with plastic shafts · Suspend in VTM/UTM

Page 59 of 64

AVAILABLE LABORATORY PROCEDURE

SPECIMEN

VOLUME/ QUANTITY

TIME OF COLLECTION

COLLECTION/ STORAGE

HANDLING/ TRANSPORT

RUNNING DAY

CUT OFF DAY AND TIME

TAT

Tuesday

Monday

10 days

4,000.00

Tue/Thu

Mon/Wed

7 days

4,000.00

Thursday

Wednesday

10 days

4,000.00

FEE

Place container in a ziplock/leak-proof plastic bags

Molecular test for HFMD (Handfoot-mouth disease)

Molecular test for HSV 1 & 2

Immediately refrigerate at 2-8 degree Celsius while awaiting transport Vesicular swab

Genital swab Endocervical swab Urethral swab Vesicular swab

2 swabs

With presence of unraptured vesicle

路 Use Dacron or rayon swabs with plastic shafts 路 Suspend in VTM/UTM

Transport in ice to be received at RITM within 72 hours Place container in a ziplock/leak-proof plastic bags Immediately refrigerate at 2-8 degree Celsius while awaiting transport

2 swabs

Within 3 days from onset of vesicles

路 Use Dacron or rayon swabs with plastic shafts 路 Suspend in VTM/UTM

Transport in ice to be received at RITM within 72 hours Place container in a ziplock/leak-proof plastic bags Immediately refrigerate at 2-8 degree Celsius while awaiting transport

Molecular test for HSV 1 & 2

CSF

1 ml

Within 7 to 10 days from onset of encephalitis

Collect aseptically in a sterile glass/plastic container

Transport in ice to be received at RITM within 72 hours Place container in a ziplock/leak-proof plastic bags

Page 60 of 64

SPECIAL LABORATORY TESTS: NON-HUMAN SAMPLE TESTING AVAILABLE LABORATORY PROCEDURE

Anti-Rabies Antibody Detection

SPECIMEN

Animal Serum

VOLUME/ QUANTITY

At least 0.5 ml

ELISA

TIME OF COLLECTION

Animal Head

n/a

Ebola Virus IgG ELISA

Animal Serum

0.5 ml

Taxonomic identification of medicallyimportant insects & other arthropods

Insect and other medicallyimportant arthropods; can either be live or

a single specimen may be accepted on condition that most anatomical

HANDLING/ TRANSPORT

RUNNING DAY

CUT OFF DAY AND TIME

TAT

A day after a batch test (Batch testing done every 10th and 25th day of the month)

5,000.00

No charge until further notice

700.00

Mon-Fri (except holidays)

Use serum separator gel/red top blood collection tube. Use gloves

-20°C if testing is delayed. 2°C - 8°C if to be tested immediately. Transport in ice.

As soon as the animal died

Wear personal protective equipment (gown, eye protection, double gloves, mask). Cut the head using a sharp knife. Place in cold chain with ice.

Place the head inside a leak proof plastic bag, then place the sealed plastic bag into a secondary container. To be transported to laboratory within 6-8 hours after death with ice. If cannot be immediately brought to the laboratory, place the specimen in a freezer or ice chest with frequent addition of ice. Always transport with ice.

Mon-Fri (except holidays), acceptance of specimen is 24 hours

72 working hours upon receipt by the Special Pathogen s Laborator y (VRDSPL)

As required

Use serum separator gel/ red top blood collection tube. Use gloves.

Mon-Thu (except holidays)

3 working days

* Collection – clients will collect the specimen submitted to the department. Entomology staff shall prepare the specimen as appropriate to identification and

1-5 working days for specimen that does

At least 2 weeks after vaccination

Rabies Virus Antigen Detection direct FLUORESCENT ANTIBODY TEST (dFAT)

COLLECTION/ STORAGE

Page 61 of 64

see collection / storage procedures

Batch Testing: 10th and 25th of the month. Release of results on the next day.

Mon-Fri

FEE

210.00 Per species

causing diseases, allergy, and others

preserved specimen

parts are present. However submission of 3 or more individuals of the same species may be more appropriate

following requirements of additional tests subsequent to identification. * Storage – submitted samples may be stored in small rigid containers that protect from physical damage. They may either be in 70% alcohol, dried or frozen depending on requirements of additional tests subsequent to identification. * Handling – unless samples will be subjected to further analysis with specific requirements, no special handling is required. * Transport – for preserved or dried specimens, samples should be brought in the lab in proper container as cited above. However, refer to transport requirements of “dangerous goods” when alcohol or dry ice are included

Page 62 of 64

not need special preparatio n prior to identificat ion 5-10 working days for specimen to be slidemounted prior to identificat ion

SPECIAL LABORATORY TESTS: PUBLIC HEALTH CONCERN To be coordinated with the Surveillance and Response Unit of RITM AVAILABLE LABORATORY PROCEDURE

SPECIMEN

VOLUME/ QUANTITY

TIME OF COLLECTION

COLLECTION/ STORAGE

HANDLING/ TRANSPORT

RUNNING DAY

CUT OFF DAY AND TIME

TAT

As required

Use serum separator gel/ red top blood collection tube. Use gloves.

Mon-Thu (except holidays)

3 working days

3-10 days after onset of symptoms

Collect in 1 plastic EDTA (purpletop) tube. In addition, also collect either in 1 plastic red tube or in one plastic yellow (serum separator) tube. If centrifugation is required, use a dedicated centrifuge with leak-proof rotor lid, preferably use within biosafety cabinet, secure tube cover with sealing film, and do not uncover tube once collection is completed.

Decontaminate tube exterior with 0.5 % (v/v) sodium hypochlorite. Pack and transport as Category A infectious substances (UN 2814) and at -20 °C

Mon-Fri (regular testing schedule); Saturday and Sunday (for samples classified as urgent)

10:00 AM

48 hours

Mon-Fri (regular testing schedule); Saturday and Sunday (for samples classified as urgent)

10:00 AM

48 hours

EBOLA VIRUS Ebola Virus IgG ELISA

Molecular test for Ebolavirus Zaire strain

Serum

Whole blood

0.5 ml

> 4 ml per tube

CORONAVIRUSES (MERS-CoV, SARS-CoV)

Molecular test for Middle East Respiratory Syndrome Coronavirus (MERSCoV)

For symptomatics, collect both: Lower respiratory tract: sputum in sterile container, endotracheal aspirate in sterile container, or bronchoalveolar lavage in sterile container, lung tissue without fixative (post-mortem) in VTM or sterile saline; Upper respiratory tract: NPS and/or

≥500µl for NPS and/or OPS, nasopharyngeal wash, nasopharyngeal aspirate, sputum, endotracheal aspirate, bronchoalveolar lavage 1-2g for unfixed lung tissue

For symptomatic: collect on presentation of symptoms; For asymptomatic contacts: within 14 days of last documented contact; to confirm clearance of the virus, sample collection to be repeated until the results are negative on 2

Collect using Dacron/Rayon-tip swabs with plastic shaft and place immediately in VTM. Wrap specimen tubes in absorbent material. Place in 50 ml conical tube, then inside ziplock bag. Consult Specimen Collection Guidelines at RITM website

Refrigerate prior to transport; Transport in ice within 48 hours after collection; If the specimen is expected to reach lab beyond 72 hrs, store at 20C to -80C and ship on dry ice; Transport as Category B infectious substances (UN 3373)

Page 63 of 64

AVAILABLE LABORATORY PROCEDURE

SPECIMEN

VOLUME/ QUANTITY

OPS in VTM, nasopharyngeal aspirate in sterile container

TIME OF COLLECTION

COLLECTION/ STORAGE

HANDLING/ TRANSPORT

RUNNING DAY

CUT OFF DAY AND TIME

TAT

sequential samples.

For asymptomatic contact: NPS and OPS in VTM Lower respiratory tract specimen (as identified above), if possible

INFLUENZA VIRUSES Molecular test for Avian Influenza (H5, H7)

NPS/OPS

Molecular test for Avian Influenza (H5, H7)

Endotracheal Aspirate; Bronchoalveolar lavage

2 swabs

2 ml

Within 5 days from onset of symptoms

· Use Dacron or rayon swabs with plastic shafts · Suspend in VTM/UTM

Within 7 days from onset of symptoms

Collect aseptically in a sterile glass/plastic container

Page 64 of 64

Thursday

Wednesday

10 days

5,000.00

Thursday

Wednesday

10 days

5,000.00