VIDRL Test Handbook

Victorian Infectious Diseases Reference Laboratory
Test Handbook
Third Edition 2004
Address for Specimens & Deliveries:
VIDRL
Jane Bell House
10 Wreckyn St
North Melbourne
Victoria, 3051 Australia.
Postal Address:
Victorian Infectious Diseases Reference Laboratory (VIDRL)
Private Bag 815
Carlton South
Victoria, 3053 Australia
A receptacle for specimen deliveries after hours is available at this address.
VIDRL Contact numbers:
Area Codes: within Australia (03) International (613)
General Enquiries (24 hours) Phone 9342 2600

Fax 9342 2660
9342 2666
Pathologist on call (Australia only) Phone 0438 599 437
Laboratories: Phone
Biochemistry 9342 2640
Electron Microscopy 9342 2678
Haematology 9342 2642
HIV Characterisation 9342 2623
Infectious Diseases Serology 9342 2647
Microbiology 9342 2668
Molecular Microbiology 9342 2615
Mycobacterium Reference 9342 2674
National Polio Reference 9342 2607
Specimen Reception 9342 2644
Virus Identification 9342 2628
Internet:
VIDRL Website http://www.vidrl.org.au
Page 1
VIDRL Hours of Operation:
0800 - 2000 Monday to Friday
1000 - 1200 Saturday (urgent specimens only)
An on-call service is provided at other times and a pathologist is available for

emergency after hours consultations (including information on the availability
of the National High Security Quarantine Laboratory).
For both these services call 0438 599 437 or 0438 599 439.
Page 2
1. Patient and Specimen Identification
The following information should be included with test requests:
Patient Information
Surname and given name(s) (or name code)
Gender
Date of birth
Address
Clinical Details
Presenting signs and symptoms
Date of onset of illness
Any recent travel history
Recent immunisation history
Specimen Information
Type of specimen
Date of specimen
Tests Requested
VIDRL requires that each specimen and its accompanying request card are labelled
with at least two identifiers which together are capable of distinguishing one
individual from another. Some requests may be coded to protect patient
confidentiality. A four-letter code consisting of the first two initials of the surname
and given name is the accepted convention. The full name (or name code) and date
of birth should be written on both the specimen and the request card. Failure to
comply with this procedure may delay specimen processing and reporting.
2. Specimens for Virus Detection
Some knowledge of the pathogenesis of the suspected viral infection is necessary for
optimal choice of specimens. For example: the duration and site of viral shedding, or
the presence and timing of viraemia. When possible, specimens for virus detection
should be obtained from the suspected site of infection (for example, CSF in
enteroviral meningitis, vesicular material in herpes simplex infection). Viruses are
often shed via the respiratory or gastrointestinal tracts, and occasionally in urine, all
of which are readily accessible. When specimens are difficult to obtain from the
affected organ system, these peripheral sites of viral shedding may provide the only
source of specimens for virus detection. For instance, enteroviruses potentially may
be detected in both faeces and respiratory secretions in a case of meningitis should
CSF not be available. Demonstration of peripheral shedding only provides indirect
evidence of end organ involvement however.
Polymerase Chain Reaction (PCR) is the method of choice at VIDRL for detection of
most viruses. PCR provides high levels of sensitivity, and the ability to detect viral
Page 3
nucleic acid irrespective of viral particle viability. However specimen quality still has
a profound effect on rates of detection.
Swabs should be rubbed firmly on the affected site, generally a lesion base or
mucosal surface, to dislodge infected cells and to soak them thoroughly in potentially
infected secretions. Vesicular lesions will require careful “de-roofing” with a small
gauge needle or scalpel blade to provide access to virus-rich vesicular fluid, and the
lesion base. By the time vesicular lesions crust quantities of virus are minimal and
sampling is not generally recommended. Sampling of several lesions and pooling
swabs or vesicle fluid may improve detection rates. Detection rates from the
respiratory tract can potentially be improved by pooling a throat swab and a swab
from one or both nostrils. Swabs should be broken off into viral transport medium
and transported to the laboratory as rapidly as possible.
For detection of viraemias anticoagulated blood is the preferred specimen. This

allows either plasma or the cellular fraction to be tested depending on which is the
most appropriate. Acid Citrate Dextrose (ACD) or EDTA are the preferred
anticoagulants. Heparin should never be used as it potentially inhibits PCR assays.
Body fluids such as CSF or urine are best transported undiluted in a sterile leak-
proof container. Tissue samples should be transported unfixed in a sterile leak-proof
container. A pea-sized sample of tissue is generally ample. Addition of a small
volume of sterile saline to very small specimens may alleviate the risk of drying in
transport.
In general, specimens should be kept cool (4°C - 8°C) when being transported. The
exception is blood for detection or quantitation of HIV nucleic acids, which should be
sent at room temperature.
3. Specimens for Infectious Diseases Serology.
Serum is the specimen of choice for serological testing. A minimum of 10 ml of

blood should be collected into a plain tube (no anti-coagulant) and transported to the
laboratory at 2-8°C as soon as possible. Unseparated blood may be stored at 2-8°C
for up to 24 hrs if immediate transport cannot be arranged. Lysed blood will produce
a less satisfactory serum for testing.
If longer delays in transporting are anticipated, the serum should be separated into a
suitable screw-cap vial and stored at 2-8°C. Plasma can also be used for serological
testing and should be transported to the laboratory at 2-8°C within 24 hrs of
collection. If long transport delays are anticipated, separate the plasma from the red
cells to avoid haemolysis.
The usefulness of serological results for diagnosis is highly dependent on the timing
of the specimens submitted. The appearance of measurable antibody responses may
vary between pathogens and between tests and some knowledge of those factors is
necessary to optimally time serum collection. For example specific IgM to hepatitis A
virus is usually present at symptom onset while measles IgM usually appears
Page 4
between 3-7 days after rash. When attempting to demonstrate a rising titre of total
or IgG antibody it is important to obtain an acute serum specimen early in the course
of an illness and an appropriately timed convalescent serum. Two weeks after
symptom onset is a general rule of thumb for timing of convalescent bleed collection,
but timing of IgG appearance varies. For example C. psittaci complement fixing
antibody may take over 3 weeks to appear, while measles IgG may generally be
detected by enzyme immunoassay from 1 week after rash.
4. Specimens for Haematology
All blood samples should be securely capped, then mixed by gentle inversion. Blood
tubes should be stored at 4oC. If no refrigerator is available, keep the samples in a
cool place. Please ensure that the samples are not exposed to direct sunlight.
5. Bacteriology
Parasitology
Specimen jars are now supplied in kit form (Para-Pak) for the transport of faecal
samples for both culture and parasite preservation. Directions to patients are
included with each kit.
For parasite studies, two specimens should be sent, each collected two days apart to
exploit the intermittent excretion of some parasites. Transport at room temperature
in SAF preservative supplied
Notes: Some substances may depress numbers of eggs or destroy protozoan

parasites - eg. urine, kaolin, magnesia, bismuth, barium, antibiotics, anti-protozoan
or anti-helminthic agents.
Faecal Specimens for Vibrio
If infection with Vibrio species is suspected (eg Cholera or enteric infections

following consumption of seafood), please send a fresh faecal specimen in a
preservative-free container, in addition to any samples submitted in preservative.
Legionella
Legionella from respiratory specimens. Suitable specimens include

expectorated sputum, induced sputum, nasopharyngeal aspirate, endobronchial
secretions, pleural fluid, lung biopsy or post-mortem tissue.
Legionella antigen detection. Legionella pneumophila serogroup 1 can be

diagnosed by detection of antigen in urine. Transport at room temperature.
Transport medium is not required.
6. Mycobacterium Reference Laboratory
Page 5
MRL Specimen Collection Data
It is essential that the following information be supplied for all Mycobacteriology

requests, as the MRL data provides part of Victoria’s TB and Mycobacteria
surveillance data. The standard MRL request form is preferred.
In addition to the usual information required (see section 1) the following

information is requested where possible:
• A succinct summary of the patient's history and findings. This may be important
for the assessment of significance of non-tuberculous mycobacterial isolates.
• Laboratories referring mycobacterial isolates should also note their smear result
(on ZN or AR staining) on the request slip.
• Further patient information on prior disease, contacts and treatment, country of
birth or extended residence, immunosuppression and other details will be sought
on new positive TB and Leprosy cases.
Blood Cultures for Mycobacteria
These specimens are especially useful for recovery of Mycobacterium avium complex.
Special mycobacteria blood culture bottles (Bactec Myco/F lytic) are available from
VIDRL.
Specimens for PCR and related tests to detect Mycobacteria
General Notes:
The cell wall of Mycobacteria is resistant to chemical attack, and current DNA and
RNA extraction methods for Mycobacteria are less efficient than for other organisms.
False-negative results occur in specimens with low numbers of Mycobacteria present.
Culture is still the most sensitive method for detection of viable MTB at the time of
writing. In addition culture provides an isolate for further study, namely
antimycobacterial drug susceptibility testing, or RFLP fingerprinting for
epidemiological purposes.
A number of biological substances, including blood and faecal material, may interfere
with the assays leading to false negative results.
PCR may detect DNA from non-viable organisms, and is not suitable for monitoring
of therapy at this stage.
For CSF examination by PCR for the presence of MTB, we recommend that at least 1
mL of un-centrifuged CSF be submitted to achieve adequate assay sensitivity.
Please note that PCR type assays for the diagnosis of tuberculosis are not yet
included on the Australian Medicare Benefits schedule, and a charge for the test will
be made in most cases.
Page 6
The Mycobacterium genus PCR, which can identify Mycobacteria to species complex
level is not intended as a routine diagnostic test, and will only be performed if
specifically requested and adequate clinical notes are provided. Requests for
“Mycobacterial PCR” that do not provide adequate information will initially be tested
using the TB PCR.
Requests for the Mycobacterium genus PCR on fixed tissues (unsuitable for culture)
will only be performed if AFB have been seen in the specimen, or there is other
clinical or pathological evidence supporting a mycobacterial infection. From paraffin
embedded fixed tissue specimens, we require at least 6 sections, each 10-20 µm
thick. We strongly recommend discussing the case with VIDRL before submitting
such specimens.
Specimen Types for Mycobacterial Culture
Gastric Lavage. This is appropriate when the patient cannot produce expectorated
sputum. These specimens must be neutralised to pH 7 within four hours of
collection to ensure the viability of any mycobacteria present.
Laryngeal Swab. These are taken as an alternative to the examination of gastric

juice from patients who cough but can produce no sputum.
Serous Fluids. These include inter-alia, cerebrospinal, pleural, pericardial, ascitic

and joint fluids. Note that tissues from these sites are often superior to fluids in
terms of recovery of mycobacteria.
Skin and Wound Swabs. Skin biopsies (obtained by excision or punch biopsies)
should be collected in sterile screw capped containers. In the case of wounds it is
advisable to send an aspirate of the exudate in preference to a swab.
Sputum. Three single, early morning samples of expectorated sputa collected on

different days are appropriate. A volume of 5-10 ml is adequate for each sample.
Once a diagnosis of tuberculosis has been established, specimens need to be sent
only every two to three months. (See section below on specimens for monitoring of
treatment).
Urine. Three single mid-stream specimens voided in the early morning should be
submitted. If delay is unavoidable, specimens should be refrigerated. Note that
microscopy is not routinely performed on urine specimens submitted for examination
for mycobacteria, due to the presence of commensal mycobacteria.
Tissue. Any tissue to be processed must be collected aseptically and transported to

the laboratory at once. If delay occurs, specimens should be transported to the
laboratory in a small volume of saline and kept at 4° C (not frozen). Specimens in
formal saline are not suitable for mycobacterial investigation by culture.
Page 7
MRL recommendations for specimen collection for the monitoring of anti-
tuberculous chemotherapy. For further information, please visit the VIDRL
website (http://www.vidrl.org.au) under the MRL section.
Examinations for Leprosy (Hansen's Disease)
For further information on specimen collection and result interpretation, please visit
the VIDRL website (http://www.vidrl.org.au).
QuantiFERON ® -TB Gold assay notes
The QuantiFERON ® -TB Gold assay detects CMI responses in-vitro to tuberculosis
infection by measuring interferon-gamma (IFN- γ) harvested in plasma from whole
blood incubated with the M. tuberculosis-specific antigens, ESAT-6 & CFP-10.
An IFN- γ response to either ESAT-6 or CFP-10 above the test cut-off is considered
indicative of M. tuberculosis infection
This test should be considered as an alternative to the Mantoux test, but has the
advantages that it can be used to detect latent TB infection in patients who have
been vaccinated with BCG and therefore have a positive Mantoux test. It can also be
used when a Mantoux test is contraindicated.
Please note this test is primarily intended to detect latent infection with M.
tuberculosis, and not for the diagnosis and management of active tuberculosis.
Should active TB be suspected, culture (and/or PCR testing) of appropriate clinical
specimens is still necessary for a definitive diagnosis.
This assay will not detect infection with M. bovis BCG strains used for vaccination or
immunotherapy.
For further information on this test and its interpretation, please visit the VIDRL
website (http://vidrl.org.au) under the MRL section.
7. Collection and Transport of Specimens from a Patient with

Suspected Risk Group 4 Virus Infection.
When a patient with suspected quarantinable viral haemorrhagic fever (VHF)

(associated with Ebola, Marburg, Lassa, Rift Valley Fever or Crimean Congo virus
infection) is suspected, direct contact with the pathologist on-call at VIDRL is
essential to arrange receipt of specimens and for advice regarding specimen
collection, packaging and transport to the laboratory.
Specimens most useful for detection of the above viruses include venous blood
(clotted and unclotted (EDTA), urine and a combined nose/throat swab.
Collection of specimens should be undertaken with extreme care and using personal
protective equipment including gloves, gown, mask and eye protection. Glass
Page 8
containers should not be used. Disposable sharp objects such as scalpel blades
should not be handled unnecessarily after use and should be autoclaved or
incinerated.
Needles used to collect blood should not be recapped, bent, broken, removed from
disposable syringes or otherwise handled. Blood-taking equipment should be placed
in a rigid plastic container filled with disinfectant solution and autoclaved or
incinerated.
Prior to transport, the outside of each specimen container should be swabbed with
disinfectant (sodium hypochlorite, 5000 ppm available chlorine is recommended) and
a label should be attached bearing the patient's name, hospital identification, the
date of collection and the nature of the suspected infection. Specimens should be
double-bagged in secure, airtight and watertight bags which have been similarly
labelled. Bags containing specimens should be swabbed with disinfectant before
they are removed from the patient's room.
Specimens thought to contain Risk Group 4 viruses, or isolates of these viruses, must
be transported under highly regulated conditions, irrespective of whether the
shipment is by air, road, rail or sea. In general, the International Air Transportation
Association (IATA) Dangerous Goods Regulations are the most comprehensive and
cover the requirements of other non-airline organizations. Senders should be aware
of their obligation to satisfy current shipping requirements when they first make
contact with the Pathologist on-call or other senior staff regarding the transport of
possible Risk Group 4 viruses to VIDRL.
Senders should notify VIDRL of shipping details when they become available. These
include the airline, flight departure and arrival times, air waybill number and contact
details of the courier assigned the job of transporting the package between airports.
The packaging required for transport to and from VIDRL of Risk Group 4 viruses is
stringent, and must comply with NZ/CAA 38281-1. Such packaging is available
commercially (eg. LabPak-1, LabServ). A diagnostic specimen or virus isolate
reasonably expected to fall within the category of a Risk Group 4 pathogen must be
identified as UN No. 2814 (infectious substance affecting humans) and should
comply with Packaging Instruction No. 602. The maximum allowable shipment
quantity under these regulations is 50 ml (passenger aircraft) or 4 litres (cargo
plane).
A completed Shipper’s Declaration for Dangerous Goods form should be attached to

the outside of all packages shipped to VIDRL.
In most instances, biological material contained in packages shipped to VIDRL will be

transported cold or in the frozen state. This requires the use of freezer bricks or dry
ice, respectively, held within an outer polystyrene container. Regulations applying to
the use of these substances should be followed and couriers should be made aware
of their presence and of the need to keep the package cool during transport.
Page 9
Test List
Test Activated Partial Thromboplastin Time

(APTT)
Specimen Required Blood (sodium citrate 3.8%)
When Tested Daily
Normal Ranges Manual: 30-45 sec
Automated: 20-35 sec
Therapeutic Range: Manual 50-100 sec
Automated: 40-75 sec
Contact 9342 2644
Test Adenovirus PCR

Specimen Required Eye swab, respiratory specimens, faeces,
urine, biopsy
When Tested M,W,F
See also: Respiratory Virus PCR
Notes Eye swabs are best tested in this PCR.
Respiratory specimens are tested in the
Respiratory virus PCR.
Contact 9342 2628
Test Adenovirus Serology

Assay IgG
Specimen Required: Serum (clotted blood)
When Tested Weekly
Contact 9342 2649/9342 2650
Test Alanine aminotransferase (ALT)

Specimen Required Serum (clotted blood)
When Tested Daily
See also: Liver Function Tests
Reference Ranges <50
Units U/L
Contact 9342 2640
Test Albumin
When Tested Daily
References Ranges 35-52
Units gm/L
Contact 9342 2640
Page 10
Test Alkaline phosphatase (ALP)
When Tested Daily
Reference Ranges Male 0-2y: 25-95
2-24y: 25-250
>24y: 25-95
Female 0-2y: 25-95
2-19y: 25-250
>19y: 25-95
Units U/L
Contact 9342 2640
Test Amylase (Total & Pancreatic)

When Tested Daily
Reference Ranges Total: 30-125
Pancreatic: 5-90
Units U/L
Contact 9342 2640
Test Anti-gastric parietal cell antibodies

When Tested Weekly
Contact 9342 2644
Test Anti-mitochondrial antibodies

When Tested Weekly
Contact 9342 2644
Test Anti-nuclear (ANA) antibodies

When Tested Weekly
Contact 9342 2644
Test Anti-smooth muscle antibodies

When Tested Weekly
Contact 9342 2644
Test Aspartate aminotransferase (AST)

When Tested Daily
Units U/L
Contact 9342 2640
Page 11
Test Astrovirus by Electron Microscopy
Specimen Required Faeces (not frozen)
Contact 9342 2678
Test Australian encephalitis virus PCR (see

Flavivirus PCR for MVE)
Test Australian encephalitis Serology (see

Murray Valley encephalitis virus Serology)
Test Barmah Forest virus Serology (BFV)

Assay or Procedure IgG
IgM
When Tested Weekly
Contact 9342 2649/9342 2650
Test Bicarbonate (Total CO2)

Specimen Required Serum (clotted blood) or heparinised blood
When Tested Daily
See also: U&E
Reference Ranges 24.0 – 31.0
Units mmol/L
Contact 9342 2640
Test Billirubin (Total)

When Tested Daily
Total Ranges <17.0
Units mmol/L
Contact 9342 2640
Test BK virus PCR (See Polyomavirus PCR)
Page 12
Test Blood Culture (Bacterial)
Specimen Required 8-10 ml/’Bactec plus’ aerobic & anaerobic
bottles
When Tested Daily
Notes Please provide clinical details. Extended
incubation is required for query
endocarditis, brucellosis or fungal infection.
Contact 9342 2670
Test Blood Culture (Mycobacterial)

(see Mycobacterial blood culture)
Test Blood film (without FBE)

Specimen Required Blood (EDTA)
When Tested Daily
Contact 9342 2644
Test Blood group (ABO, RhD)

When Tested Daily
Contact 9342 2644
Test Blood group screen and hold

Blood (EDTA)
When Tested Daily
Contact 9342 2644
Test Bordetella pertussis Culture

Specimen Required Nasopharyngeal swab or aspirate.
(Transport medium available for swabs)
When Tested On request
Contact 9342 2670
Test Bordetella pertussis PCR

Specimen Required Any respiratory sample
Contact 9342 2628
Test Brucella Culture

Specimen Required 8-10 ml blood in blood culture bottle
Notes Contact Laboratory before sending
Contact 9342 2670
Page 13
Test Brucella spp Serology
Assay Rose Bengal (RB) agglutination (total)
Standard agglutination Test (SAT)
Anti-human globulin (Coombs) (IgG)
When Tested Weekly
Notes A negative RB test generally excludes a
diagnosis of Brucellosis. The SAT detects
IgM and complete IgG in acute disease.
The Coombs test detects ‘incomplete’ IgG
in chronic disease.
Contact 9342 2649/9342 2650
Test Calcium
When Tested Daily
Reference Ranges Serum: 2.00 – 2.63
Units mmol/L
Contact 9342 2640
Test Calicivirus by Electron Microscopy (see

Norovirus)
Test Campylobacter jejuni Serology

Assay IgA, IgG and IgM
When Tested Weekly
Contact 9342 2649/9342 2650
Test Carbamazepine
Reference Ranges 17 – 42
Units µmol/L
Contact 9342 2640
Notes The reference range applies to a trough
specimen collected just prior to the
morning dose. Serum peak level is
reached 6-12 hours after oral dose
administration.
Test Cardiac Enzymes:

(creatine kinase (CK), CK-MB subunit,
lactate dehydrogenase (LD))
See also: Individual tests
Reference Ranges CK: 15 – 140
CK-MB: <10
LD: 185 – 505
Page 14
Units U/L
Contact 9342 2640
Test Chlamydia Group Antigen
When Tested Daily
Notes Primary screening test for chlamydia
Contact 9342 2628
Test Chlamydia pneumoniae PCR

Specimen Required Any respiratory sample – data eg. sputum
Contact 9342 2628
Test Chlamydia pneumoniae Serology

When Tested x2-3 weekly
Notes Only performed on samples positive by the
Group Antigen screening test.
Contact 9342 2628
Test Chlamydia psittaci PCR

Specimen Required Any respiratory sample – data eg. sputum
Contact 9342 2628
Test Chlamydia psittaci Serology

When Tested x2 or x3 weekly
Notes Only performed on samples positive by the
Group Antigen screening test.
Contact 9342 2649/9342 2650
Test Chlamydia trachomatis PCR

Specimen Required Urine, endocervical, urethral, pharyngeal,
eye or rectal swabs.
When Tested Daily
Notes Use swabs collected in Amies/charcoal
transport medium. Transport at room
temperature.
Contact 9342 2670
Test Chlamydia trachomatis Serology

Assay or Procedure IgG & IgA
When Tested x2 Weekly
Contact 9342 2649/9342 2650
Page 15
Test Chloride
Specimen Required Serum (clotted blood) or blood
heparinised)
When Tested Daily
Reference Ranges 101 – 111 mmol/L
Contact 9342 2640
Test Cholesterol
When Tested Daily
See also: Lipids
Normal Ranges <5.5
Units mmol/L
Contact 9342 2640
Notes For accurate lipid determinations, the
patient should fast for 12 hours prior to
specimen collection.
Test Clostridium difficile cytotoxin

Assay Cell culture neutralisation assay
Specimen Required Faeces (no preservative)
Contact 9342 2670
Test CMV testing (see under Cytomegalovirus

for all procedures)
Test Coagulation profile

Specimen Required Blood, (sodium citrate, 3.8%)
When Tested Daily
See also: APTT and PTT
Contact 9342 2644
Test Cold agglutinins

When Tested Daily
Normal Ranges <20
Contact 9342 2640
Test Coombs (direct antiglobulin) test

When Tested Daily
Contact 9342 2644
Page 16
Test Coronavirus PCR
Specimen Required Any respiratory specimen. Sputum.
Notes Tests available for common cold associated
coronaviruses OC43 and 229E and the
SARS-related coronavirus. Ring laboratory
before requesting SARS PCR.
Contact 9342 2628
Test Coxsackie virus PCR (see Enterovirus PCR)
Test Creatinine
(heparinised)
When Tested Daily
See also: U&E
Units mmol/L
Contact 9342 2640
Test Creatine Kinase (CK)

When Tested Daily
See also: Cardiac enzymes
Units U/L
Contact 9342 2640
Test Creatinine Kinase – MB subunit

When Tested Request
Units U/L
Contact 9342 2640
Test Crimean-Congo haemorrhagic fever virus

PCR
Specimen Required Blood (ACD or EDTA), respiratory swabs
Notes This is a PC4 level pathogen. Requests for
testing must be discussed with the
laboratory in advance.
Contact 9342 2628
Page 17
Test Crimean-Congo haemorrhagic fever virus
Serology
testing must be discussed with the
laboratory in advance.
Contact 9342 2628
Test Cryptosporidium detection

Specimen Required Faeces
When Tested Daily
Contact 9342 2670
Test Cryptococcal antigen detection

Specimen Required CSF, Serum (clotted blood)
Contact 9342 2670
Test Cysticercosis (Taenia solium) Serology

Assay IgG
Contact 9342 2649/9342 2650
Test Cytomegalovirus (CMV) Genotyping for

drug resistance
Specimen Required Blood (ACD or EDTA)
Notes UL54 (pol) and UL97 (TK) sequenced
Contact 9342 2628
Test Cytomegalovirus (CMV) PCR

Specimen Required Saliva, CSF, urine, blood (ACD or EDTA),
BAL, faeces, tissue
When Tested Daily
Notes Qualitative assay, part of herpesvirus
multiplex PCR assay
Contact 9342 2628
Test Cytomegalovirus (CMV) Quantitation

Specimen Required Blood (ACD or EDTA as anticoagulant)
When Tested Testing only performed on plasma/serum
positive by cytomegalovirus PCR (above)
Contact 9342 2628
Page 18
Test Cytomegalovirus (CMV) Serology
Assay or Procedure IgG and IgM
IgG Avidity Index
Latex agglutination (total antibodies)
When Tested Weekly
Contact 9342 2649/9342 2650
Test Dengue virus PCR (see Flavivirus PCR)
Test Dengue virus Serology (see Flavivirus

Serology)
Test Differential Leucocyte Count (adult)

Normal Range Neutrophilis 2.0 – 7.5 x 109/L
Lymphocytes 1.5 – 4.0 x 109/L
Monocytes 0.2 – 0.8 x 109/L
Eosinophilis 0.04 – 0.4 x 109/L
Basophilis 0.01 – 0.1 x 109/L
When Tested Daily
See also: FBE
Contact 9342 2644
Test Digoxin
When Tested Request
Normal Ranges 1.0 – 2.8
Units nmol/L
Notes Preferred sampling time is at the end of a
24 hr dosing interval.
Contact 9342 2640
Test Ebola virus PCR

Specimen Required Blood (ACD or EDTA), respiratory swab
PCR must be discussed with the laboratory
in advance.
Contact 9342 2628
Test Echinococcus granulosis (hydatid) Serology

Assay Total antibodies (IHA)
When Tested x2 weekly
See also: Hydatid
Contact 9342 2649/9342 2650
Page 19
Test Echovirus PCR (see Enterovirus PCR)
Test Entamoeba histolytica Serology

Assay or Procedure Total antibodies (IHA)
EIA IgG - confirmation only
Contact 9342 2649/9342 2650
Test Enterovirus PCR

Specimen Required CSF, NTS, swab, faeces, blood
(ACD or EDTA)
When Tested Daily
Notes Detects enterovirus, coxsackie virus and
poliovirus genera.
Contact 9342 2628
Test Epstein-Barr virus PCR

Specimen Required CSF, blood, saliva, respiratory swabs
Contact 9342 2628
Test Epstein-Barr virus Serology (EBV)

Assay early antigen IgG, (IF)
early antigen IgM, (IF)
nuclear antigen IgG (EBNA)
viral capsid antigen IgG (VCA)
viral capsid antigen IgM (VCA)
When Tested x2 weekly (Immunofluorescence testing on
request)
Contact 9342 2649/9342 2650
Test Equine morbillivirus (EMV) PCR

Specimen Required Respiratory specimens, CSF
Contact 9342 2628
Test Equine morbillivirus (EMV) Serology

Assay or Procedure EIA for IgG
Contact 9342 2649/9342 2650
Page 20
Test Erythrocyte sedimentation rate (ESR)
Specimen Required Blood (EDTA) or vacu-tec tube
When Tested Daily
Normal Ranges Male: <10 mm
Female: 20 mm in first hour
Contact 9342 2644
Test Estradiol
When Tested Tue (am)
Fri (am)
Reference Ranges Male: <200
Female: foll: <420
Mid-Cy: 300 – 1500
Lut: 200 – 1000
Post m/pausal: <175
Contact 9342 2640
Test Eye, ear, nose or throat Culture

Specimen Required Swab. Provide smears for Gram stain of
eye and ear sites.
When Tested Daily
Notes Use swabs collected in Amies/Charcoal
temperature.
Contact 9342 2670
Test Faecal Culture and Microscopy (wet prep

only) (FMCS)
Specimen Required Faeces C&S supplied by VIDRL
When Tested Daily
Notes Microscopy of unconcentrated specimen
only. Maximum of 1 specimen tested per
7-day period.
Contact 9342 2670
Test Faecal Microscopy (only)

Specimen Required Faeces collected in SAF (supplied by
VIDRL)
When Tested Daily
Notes Includes microscopy for ova, cysts
trophozoites, cryptosporidia.
Contact 9342 2670
Test Faecal occult blood

Specimen Required Freshly collected faecal specimen (no
transport medium)
Notes Chemical and immunological assays used.
Contact 9342 2670
Page 21
Test Faecal parasites (see parasite detection
(enteric))
Test FBE (full blood examination)

When Tested Daily
See also: Leucocyte count, Red Cell count,
Haemoglobin, PCV, MCV, MCH, MCHC
Contact 9342 2644
Test Ferritin
See also: Iron studies
Reference Ranges Male: 30 – 284
Female: 10 – 186
Units ng/mL
Contact 9342 2640
Test Fertility hormones (estradiol, follicle

stimulating hormone (FSH, Lutenizing
hormone, progesterone, prolactin,
testosterone) See individual tests.
Test Filariasis (Microfilaria detection in blood)

Notes Includes immunochromatography test
(ICT)
Contact 9342 2644
Test Flavivirus PCR

Specimen Required CSF, serum (clotted blood)
Notes This PCR will detect members of the
flavivirus genus including dengue, MVE,
West Nile, kunjin, yellow fever and
Japanese B viruses. Contact with the
laboratory is recommended before
requesting this test.
Contact 9342 2628
Page 22
Test Flavivirus Serology
Assay or Procedures Total antibodies and IgM (IF)
Notes Procedure detects antibodies to flaviviruses
including Murray Valley encephalitis,
dengue and Kunjin viruses. An assay
specific for antibodies to Murray Valley
encephalitis virus is also available.
Contact 9342 2649/9342 2650
Test Folate: serum and red blood cell

Specimen Required Serum (clotted blood) for detection of
serum folate.
Blood (EDTA) for detection of red cell
associated folate.
Reference Ranges S: 4.5 – 23.0
RC: >355
Units nmol/L
Contact 9342 2640
Test Follicle Stimulating Hormone (FSH)

Normal Ranges Male: 1 – 19
Female: foll: 4 – 9
Mid-Cy: 5 – 23
Lut: 2–5
Post m/pausal: 17 – 114
Units MIU/mL
Contact 9342 2640
Test Fungal Microscopy & Culture

Specimen Required Skin scrapings, nail clippings
Notes Collect skin scrapings from margin of
lesion. 20-30 flakes. Place in sterile urine
container.
Contact 9342 2670
Test Fungal Susceptibility Testing

Specimen Required Yeast isolates
Contact 9342 2670
Page 23
Test Gamma-glutamyl transferase (GGT)
When Tested Daily
Reference Ranges Male: <50
Female: <40
Units U/L
Contact 9342 2640
Test G6PD (Glucose 6 Phosphate

Dehydrogenase (Red Cell))
When Tested Daily
Normal Ranges <50 min
Contact 9342 2644
Test Glucose
Specimen Required Blood (NaF)
When Tested Daily
Reference Ranges Fasting: 3.3 – 6.0
Random: 3.3 – 7.8
Units mmol/L
Notes The specimen should be identified as a
fasting or random collection.
Contact 9342 2640
Test Glucose Tolerance Test

When Tested Daily
Reference Ranges Fasting: 3.3 – 6.0
One hour: 5.3 – 11.1
2 hour: 3.3 – 7.8
Units mmol/L
Notes Fasting protocol available from the
Laboratory
Contact 9342 2640
Test Gonorrhoea Culture

Specimen Required Endocervical, urethral pharyngeal or rectal
swabs. Provide smears for Gram Stain of
urethral or endocervical sites.
When Tested Daily
Notes Use swabs collected in Amies/charcoal
temperature.
Contact 9342 2670
Page 24
Test Gonorrhoea PCR
Specimen Required Urine, endocervical, urethral, pharyngeal or
rectal swabs
When Tested Daily
Notes Transport at room temperature. Culture is
preferred for pharyngeal specimens.
Contact 9342 2670
Test Haemoglobin (single estimation)

When Tested Daily
Normal Ranges Adult Male 130 – 180 g/L
Adult Female 115 – 165 g/L
Contact 9342 2644
Test Hantavirus PCR

Specimen Required Blood (ACD or EDTA), respiratory
specimens, CSF
Notes This PCR will detect members of the
Hantavirus genus including Hantaan and
Sin Nombre (4 corners) viruses. Contact
with the laboratory is recommended before
requesting this test.
Contact 9342 2628
Test Hantavirus Serology

Assay P.Aggl Total Ab
Contact 9342 2649/9342 2650
Test HDL Cholesterol

When Tested Daily
Reference Ranges Male: 0.7 – 1.9
Female: 0.9 – 2.4
Units mmol/L
Notes For accurate lipid level determination, the
specimen collection.
Contact 9342 2640
Test Helicobacter pylori Serology

When Tested Weekly
Contact 9342 2649/9342 2650
Page 25
Test Hendra virus PCR (see Equine morbillivirus
(EMV) PCR)
Test Hendra virus Serology (see Equine

morbillivirus (EMV) Serology)
Assay or Procedure EIA for IgG
Contact 9342 2649/9342 2650
Test Hepatitis A virus PCR

Specimen Required Serum (clotted blood),
Blood (ACD or EDTA)
Cut Off (lower limit 2,000 copies/ml
of detection)
Notes * Do not send heparinised blood
Contact 9342 2615
Test Hepatitis A virus Serology

Assay or Procedure Total Ab
IgM
When Tested Total Ab - daily
IgM - x3 weekly
Contact 9342 2649/9342 2650
Test Hepatitis B virus DNA

Assay or Procedure Hybrid capture
When Tested Weekly
Contact 9342 2649/9342 2650
Test Hepatitis B virus PCR

Blood (ACD or EDTA)
of detection
Contact 9342 2649/9342 2650
Test Hepatitis B virus Sequencing

Blood (ACD or EDTA)
Contact 9342 2615
Page 26
Test Hepatitis B virus Serology
Assay or Procedure core antibody total
core antibody IgM
e antibody
e antigen
surface antibody
surface antigen
When Tested x2 or x3 weekly
Contact 9342 2649/9342 2650
Test Hepatitis C virus Genotyping

Blood (ACD or EDTA)
Contact 9342 2615
Test Hepatitis C virus PCR

Blood (ACD or EDTA)
Cut Off (lower limit 50 1µ/ml
of detection)
Contact 9342 2615
Test Hepatitis C virus Quantitation

Blood (ACD or EDTA)
When Tested 1x fortnight
of detection)
Normal Ranges <5,000 to 7,000,000 1µ/ml
Contact 9342 2615
Test Hepatitis C virus Serology

Contact 9342 2649/9342 2650
Test Hepatitis D virus PCR

Blood (ACD or EDTA)
When Tested As requested
of detection)
Notes Do not send heparinised blood
Contact 9342 2615
Page 27
Test Hepatitis D virus Serology
Assay or Procedures Antigen
Antibody
When Tested Weekly
Contact 9342 2649/9342 2650
Test Hepatitis E virus PCR

Blood (ACD or EDTA)
of detection)
Contact 9342 2615
Test Hepatitis E virus Serology

When Tested Weekly
Contact 9342 2649
Test Hepatitis G virus PCR

Blood (ACD or EDTA)
of detection)
Contact 9342 2615
Test Herpes simplex virus (HSV) Phenotyping

for drug resistance
Specimen Required HSV isolate or specimen for HSV isolation
Notes Testing for acyclovir and foscarnet
susceptibility requires a virus isolate.
Specimen sent must be HSV PCR positive
before virus isolation is attempted.
Contact 9342 2628
Test Herpes simplex virus PCR

Specimen Required Swabs, tissue, CSF, saliva, urine, BAL,
blood (ACD or EDTA)
When Tested Daily
Notes Part of a multiplex herpesvirus assay. Test
distinguishes between HSV-1 and HSV-2
Contact 9342 2628
Page 28
Test Herpes simplex virus Serology (HSV)
Assay IgG
IgM
Contact 9342 2649/9342 2650
Test HIV (see under Human Immunodeficiency

Virus for all tests offered)
Test HTLV Serology (see under Human T

lymphotropic viruses)
Test Human herpesvirus 6 PCR

Specimen Required Blood (ACD or EDTA), CSF, swab, tissue
When Tested Weekly
Contact 9342 2628
Test Human herpesvirus 6 Serology

IgM
When Tested Weekly
Contact 9342 2649/9342 2650
Test Human herpesvirus 8 PCR

IgM
When Tested Weekly
Contact 9342 2615
Test Human immunodeficiency virus Serology

Screening
When Tested Daily
Notes Negative results are reported within 24
hours of specimen receipt.
Contact 9342 2649/9342 2650
Page 29
Test Human immunodeficiency virus Serology
Confirmation
Assay Procedure Western Blot
Notes Performed on repeatedly reactive samples
detected in the screening test and
specimens found to be reactive by other
laboratories.
Contact 9342 2649/9342 2650
Test Human immunodeficiency virus p24

antigen
When Tested Weekly
Contact 9342 2649/9342 2650
Test Human immunodeficiency virus Genotyping

for drug resistance
Notes Protease, RT and GP41 sequenced
Contact 9342 2623
Test Human immunodeficiency virus RNA

Quantitation (Virus Load, HIV-1))
Units RNA copies per ml of plasma
Notes Assay can also be performed on CSF.
An assay is also available for HIV-2.
Quantifiable range of this assay is 400 –
750,000 RNA copies/ml. The ultrasensition
quantitation assay (50-100,000 copies per
ml) is also available on blood specimens.
Contact 9342 2623
Test Human T lymphotropic viruses I and II

Serology
When Tested Weekly
Contact 9342 2647
Test Hydatid (Echinococcus granulosus)

Serology
Assay or Procedure Total Ab (IHA)
Contact 9342 2649/9342 2650
Page 30
Test Infectious mononucleosis (see Paul Bunnell
assay and Epstein-Barr virus testing
procedures)
Test Influenza virus PCR

Specimen Required Any respiratory sample, CSF
When Tested Daily
Notes Assay is part of Respiratory virus PCR.
Detects influenza types A and B
Contact 9342 2628
Test Influenza virus Serology

Assay or Procedure CFT
When Tested Weekly
Notes Detects antibodies to influenza types
A and B
Contact 9342 2649/9342 2650
Test Iron
When Tested Iron studies: daily
Female: 9.0 – 27.0
mmol/L
Contact 9342 2640
Test Iron studies

When Tested Iron, transferrin: daily
Ferritin: x2 weekly
Iron: Female: 9.0 – 27.0
Transferrin: 1.7 – 3.4
Units Iron: µmol/L: Trans: g/L;
Ferritin: ng/mL
Contact 9342 2640
Test Japanese B encephalitis virus PCR (see

Flavivirus PCR)
Test Japanese B encephalitis virus Serology

Assay or Procedure IF Total
IF IgM
When Tested Weekly
Contact 9342 2649/9342 2650
Page 31
Test JC virus PCR (see Polyomavirus PCR)
Test Kunjin virus Serology (see Flavivirus

Serology)
Test Kunjin virus PCR (see Flavivirus PCR)
Test Lactate dehydrogenase (LD)

When Tested Daily
Units U/L
Contact 9342 2640
Test Lactic acid (lactate)

When Tested Daily
See also: Lipids
Units mmol/L
Contact 9342 2640
Test LDL cholesterol

Specimen Required Not required
When Tested Calculated daily
See also: Lipids
Reference Ranges <3.5
Units mmol/L
Notes For accurate lipid determinations, the
specimen collection. LDL cholesterol is
determined using the Friedewald equation,
which is only reliable if the triglyceride
concentration is less than 4.6 mmol/L.
Contact 9342 2640
Test Legionella Culture

Specimen Required Respiratory specimen
Notes Preferably collected prior to antibiotic
therapy.
Contact 9342 2670
Page 32
Test Legionella PCR
Specimen Required Sputum, bronchial washings, aspirates and
lavages, pleural and other sterile-site body
fluids, and fresh biopsy specimens.
When Tested Weekly
Notes Duplex LightCycler real-time PCR to directly
detect L pneumophila and other Legionella
species by 16s rRNA gene sequence.
Contact 9342 2670
Test Legionella Serology (screen)

Assay or Procedure IF Total
When Tested Daily. A supplementary test to enable
strain differentiation is done twice weekly.
Notes Testing detects response to L.longbeachae
and L.micdadei and pneumophila
Contact 9342 2649/9342 2650
Test Legionella urinary antigen detection

Specimen Required Urine
When Tested Daily
Notes Only detects L.pneumophila serogoup 1
antigen
Transport at room temperature
Contact 9342 2670
Test Leishmania spp (donovani) Serology

Specimen Required Total Ab (IHA)
Contact 9342 2649/9342 2650
Test Leprosy (Microscopy of ZN stained smears)

Specimen Required Skin snips, nasal secretions.
When tested On request
Notes See text (MRL section) for further details
Contact MRL Reference Lab: 9342 2674
Test Leptospira culture

Specimen Required Urine, blood (heparin or sodium oxalate
treated), CSF. Transport at room
temperature, avoid refrigeration.
Contact 9342 2670
Test Leucocyte Count

When Tested Daily
Normal Ranges Adult 4.0 – 11.0 x 10 9/L
Contact 9342 2644
Page 33
Test Lipids: (cholesterol, triglycerides, HDL,
LDL)
When Tested Daily
Normal Ranges HDL:
LDL: <3.5
C: <5.5
T: 0.4 – 1.9
Units mmol/L
Contact 9342 2640
Test Liver Function Tests (LFTs): AST, albumin,

ALP, bilirubin, GGT, total protein, ALT
When Tested Daily
Reference Ranges See Individual tests
Units See Individual tests
Contact 9342 2640
Test Lutenizing hormone

Reference Ranges Male: 1.9
Female: fol.: 2-11
Mid-Cy: 19-103
Lut: 1-13
Post m/pausal: 11-59
Units miu/mL
Contact 9342 2640
Test Magnesium
When Tested Daily
Units mmol/L
Contact 9342 2640
Test Malarial examination

Specimen Required Blood (EDTA) and/or thick & thin blood
films
When Tested Daily
Notes Test includes confirmation and typing
Contact 9342 2644
Test Malarial immuno-chromatography test

(ICT)
When Tested Daily
Contact 9342 2644
Page 34
Test Marburg haemorrhagic fever virus PCR
Specimen Required Blood, respiratory swabs
in advance.
Contact 9342 2628
Test Marburg haemorrhagic fever virus Serology

Specimen Required Serum (Clotted blood)
in advance.
Contact 9342 2628
Test Mean Corpuscular Haemoglobin

Concentration (MCHC)
When Tested Daily
Normal Ranges Adult 310 – 360 g/L
Contact 9342 2644
Test Mean Corpuscular Volume (MCV)

When Tested Daily
Normal Ranges Adult 76 – 96 fL.
Contact 9342 2644
Test Mean Corpuscular Haemoglobin (MCH)

When Tested Daily
Normal Ranges Adult 27 – 32 pg.
Contact 9342 2644
Test Mean Platelet Volume (MPV)

When Tested Daily
Normal Ranges 7.4 – 10.4µm3
Contact 9342 2644
Test Measles virus Genotyping

Specimen Required Blood (ACD or EDTA), NTS, urine, CSF
Notes For epidemiological purposes only.
Serology is the preferred method for
diagnosis.
Contact 9342 2628
Page 35
Test Measles virus PCR
Specimen Required Blood, NTS, urine, CSF
Notes Request when measles diagnosis is
required.
Contact 9342 2628
Test Measles virus Serology

Assay or Procedure IgG, IgM
When Tested Daily
Contact 9342 2649/9342 2650
Test Microsporidium detection

Specimen Required Faeces, urine, sputum, tissue sections, eye
swabs
Contact 9342 2670
Test Molluscum contagiosum by Electron

Microscopy
Specimen Required Vesicle fluid
Contact 9342 2678
Test Mumps virus Serology

Assay IgG
Igm
Contact 9342 2649/9342 2650
Test Murray Valley encephalitis virus (MVE) PCR

(see Flavivirus PCR)
Notes MVE specific PCR can be performed but
only if Flavivirus PCR positive.
Test Murray Valley encephalitis virus Serology

Assay Total Ab
IgM
When Tested Weekly
Notes See also, Flavivirus Serology
Contact 9342 2647
Page 36
Test Mycobacterial blood Culture
Specimen Required 1-5 mL of blood collected into a Myco/F
lytic blood culture bottle available from
MRL.
When Tested Daily
Contact 9342 2674
Test Mycobacterial identification and sensitivity

testing on a referred pure isolate
Specimen Required Slope or broth culture. Please provide ZN
or AR result from the original specimen.
When Tested Weekly
Contact 9342 2674
Test Mycobacterial Culture

Specimen Required Sputum, bronchial washings, gastric
lavage, CSF and other fluids, stain and
wound swabs, urine, faeces.
When Tested Daily
Contact 9342 2674
Test M tuberculosis complex PCR

Specimen Required Respiratory specimens, biopsies, whole CSF
(>1ml) and other fluids. Paraffin
embedded tissue sections (at least 6
sections, each 10-20 µm thick).
When Tested Weekly
Notes See text (MRL section) for further details.
Contact laboratory for suitability of
specimens. Current method: TaqMan real-
time PCR (IS6110 – based target).
Contact 9342 2674
Test Mycobacterium ulcerans PCR

Specimen Required Fresh tissue biopsy, dry swabs and
paraffin-embedded fixed tissue sections (at
least 6 sections, each 10-20 µm thick).
When Tested Weekly
Notes All specimens should be collected
aseptically and submitted to the laboratory
in sterile containers.
Current method: TaqMan real-time PCR.
Contact 9342 2674
Page 37
Test Mycobacterium genus PCR
Specimen Required Tissue biopsies, dry swabs, AFB positive
paraffin-embedded fixed tissue sections,
smear positive respiratory specimens which
are negative for M.tuberculosis
Notes See text (MRL section) for further
information. It is advisable to contact the
laboratory to check suitability prior to
submitting a specimen. Method; Nested
ITS region PCR and sequencing.
Contact 9342 2674
Test Mycoplasma pneumoniae PCR

Specimen Required Any respiratory sample
Contact 9342 2628
Test Mycoplasma pneumoniae Serology

IgM
CFT – Total Ab
When Tested Daily (Total)
x2 weekly (IgM)
Contact 9342 2644
Test Neisseria gonorrhoeae PCR (see

Gonorrhoea PCR)
Test Neonatal Serology (post natal Serology, Rh

negative mothers)
Specimen Required Serum (clotted blood) for mother; blood
(EDTA) or serum (clotted blood) for
neonate
When Tested Daily
Contact 9342 2649/9342 2650
Test Norovirus PCR

When Tested Contact Laboratory
Notes Detects genogroups 1 and 2
Contact 9342 2678
Test Norovirus by Electron Microscopy

When Tested Contact Laboratory
Contact 9342 2678
Page 38
Test Norwalk virus – (see Norovirus)
Test Occult blood

Specimen Required Faeces (no transport medium)
Contact 9342 2644
Test Orf virus – see Poxvirus by Electron

Microscopy
Test Packed Cell Volume (PCV) Haematocrit

When Tested Daily
Normal Ranges Adult Male 0.4 – 0.54
Adult Female 0.37 – 0.47
Contact 9342 2644
Test Parainfluenza virus detection (see

Respiratory viruses by PCR and
Immunofluoresence)
Test Parasite detection (see Faecal Microscopy)

Contact 9342 2670
Test Parasite detection (enteric)

Specimen Required Faeces in SAF transport medium
(Para-Pak supplied by VIDRL)
When Tested Daily
Note Faecal microscopy with concentration &
fixed stains for ova, cysts, trophozoites,
Cryptosporidium and Microsporidium.
Maximum 2 specimens tested per 7-day
period.
Contact 9342 2670
Test Parasite detection (urinary) (see

Schistosoma haematobium microscopy)
Test Parasite Identification (ecto- or endo-

parasites)
Specimen Required Parasite – fresh or in 60% ethanol
Avoid crushing
Note Please provide source information
Contact 9342 2670
Page 39
Test Parvovirus B19 PCR
Specimen Required Blood (ACD or EDTA), amniotic fluid
When Tested Weekly, Friday
Contact 9342 2628
Test Parvovirus B19 Serology

IgM
Contact 9342 2649/9342 2650
Test Paul Bunnell test

When Tested Daily
Normal Ranges <1:20
Contact 9342 2644
Test Phenytoin
When Tested Request
Units µmol/L
Notes Preferred sampling time is immediately
before the first morning dose
Contact 9342 2640
Test Phosphate
When Tested Daily
Reference Ranges Serum: 0.80 – 1.50
Units mmol/L
Contact 9342 2640
Test Picornavirus (see Enterovirus PCR and

Respiratory virus PCR)
Contact 9342 2628
Test Platelet Count

When Tested Daily
Normal Ranges 150 – 400 x 10 9/L
Contact 9342 2644
Page 40
Test Pneumocystis carinii detection
Specimen Required Induced sputum, bronchial washing, BAL
(cytospin preparation – contact lab first)
Notes Methods: Toluidine Blue O Stain, Direct
Immunofluorescence
Contact 9342 2670
Test Polyomavirus PCR (BK and JC viruses)

Specimen Required Urine, CSF, serum
When Tested Weekly
Contact 9342 2615
Test Poliovirus Detection

Test method Cell culture
Identification using neutralising antibodies
EIA
Nucleic acid probe
RT-PCR
Specimen Required Two faecal specimens collected 24-48
hours apart within 14 days of onset of
symptoms
When Tested Daily
Contact 9342 2607
Test organism Poliovirus 1, 2, 3 Serology

Specimen Required Serum (clotted blood) or blood (ACD or
EDTA)
Notes Poliovirus serology is only performed if
there is a clinical indication of acute
infection in a susceptible person. Discuss
with laboratory staff before specimens are
sent.
Contact 9342 2607
Test Potassium
(heparinised)
When Tested Daily
See also: U&E
Normal Ranges Serum 3.5 – 4.8
Units mmol/L
Notes The specimen must not be haemolysed
and there should be minimal statis before
and during blood collection.
Contact 9342 2640
Page 41
Test Poxvirus PCR
Specimen Required Vesicle fluid/swab
Notes Assay detects ‘old world’ pox viruses
including variola (smallpox), vaccinia,
monkey pox, cowpox, buffalo pox and
camel pox. Requests for PCR must be
discussed in advance with the laboratory.
Contact 9342 2628
Test Poxvirus by Electron Microscopy

Specimen Required Vesicle fluid, skin scraping
Notes Requests must be discussed in advance
with the laboratory.
Contact 9342 2678
Test Pregnancy test (qualitative)

When Tested Daily
Contact 9342 2644
Test Progesterone
Female: foll: 1.0 – 4.9
Lut: 16.5 – 60.0
Post m/pausal: 0.0 – 2.5
Pregnant (1st Tri) 150 – 162.0
Units mmol/l
Contact 9342 2640
Test Prolactin
Reference Ranges Male: 40 – 275
Female: 40 – 420
Units mlU/L
Contact 9342 2640
Test Prostate Specific antigen

Units ng/mL
Contact 9342 2640
Page 42
Test Prothrombin time/ratio (PTT, PR, INR)
Specimen Required Blood (sodium citrate 3.8%)
When Tested Daily
Normal Ranges Ratio: <1.2 INR:
Therapeutic range
INR: 2.0 – 4.0
Contact 9342 2644
Test Q Fever (Coxiella burneti) Phase 1 Serology

Assay CFT Total Ab
When Tested Weekly
Contact 9342 2649/9342 2650
Test Q Fever (Coxiella burneti) Phase 2 Serology

Assay Total Ab, IgM
When Tested Total Daily, IgM x2 weekly
Contact 9342 2649/9342 2650
Test Q Fever (Coxiella burneti) Phase 2

Serology, (pre-vaccination screen)
Assay CFT Total Ab
When Tested X2 Weekly
Contact 9342 2649/9342 2650
Test QuantiFERON ® -TB Gold assay

(Gamma-IFN response to MTB antigens)
Specimen Required Heparinised blood, minimum 5 mL
When Tested Weekly
Notes See text (MRL section) for further
information. The specimen must be
processed within 10 hours of collection. Do
not centrifuge, refrigerate or freeze the
specimen
Contact 9342 2670
Test Random Distribution Width (RDW)

When Tested Daily
Normal Ranges 11.5 – 14.5%
Contact 9342 2644
Test Red Cell Count

When Tested Daily
Normal Ranges Adult Male: 4.0 – 6.0 x 10 12/L
Adult Female: 3.5 – 5.5 x 1012/L
Contact 9342 2644
Page 43
Test Respiratory Syncytial virus PCR (see
Respiratory virus PCR)
Test Respiratory Syncytial virus Serology

Assay or Procedure CFT Total Ab
When Tested Weekly
Contact 9342 2649/9342 2650
Test Respiratory virus antigens by

Immunofluorescence
Specimen Required NPA, BAL
When Tested Daily
Notes Specimen required at laboratory by midday
for same day results. Antigens detected
are influenza A, influenza B, parainfluenza
1, 2 and 3, RSV and adenovirus.
Contact 9342 2628
Test Respiratory virus PCR

Specimen Required Any respiratory specimen
When Tested Daily
Units Specimen must be in the laboratory by
9:00 am for same day result.
Notes Test detects influenza A & B, parainfluenza
1,2,3, picornavirus, (enterovirus and
rhinovirus) RSV and adenovirus.
Contact 9342 2628
Test Reticulocytes
When Tested Daily
Normal Ranges 0.5 – 2.5%
Contact 9342 2644
Test Rheumatoid Factor (qualitative &

quantitative)
When Tested Daily
Contact 9342 2644
Test Rhinovirus PCR (see Respiratory viruses by

PCR)
Page 44
Test Rickettsia spp screen Serology
IgM
When Tested Weekly
Notes Testing detects response to Spotted Fever,
Typhus and Scrub Typhus groups.
Contact 9342 2649/9342 2650
Test Rift Valley fever virus PCR

Specimen Required Blood (ACD or EDTA), NTS, Swab
Notes Rift Valley fever virus is a PC4 level
pathogen. Requests for PCR must be
discussed with the laboratory in advance.
Contact 9342 2628
Test Rift Valley fever virus Serology

Notes Rift Valley fever is a PC4 level pathogen.
Requests for PCR must be discussed with
the laboratory in advance.
Contact 9342 2628
Test Ross River virus Serology

IgM
Contact 9342 2649/9342 2650
Test Rotavirus by electron microscopy

When Tested Contact laboratory
Contact 9342 2678
Test RSV PCR (See: Respiratory viruses by PCR)
Test Rubella virus PCR

Specimen Required Blood (ACD or EDTA), swab, NTS, amniotic
fluid
Contact 9342 2628
Page 45
Test Rubella virus Serology
Assay IgG
IgM
HI Total Ab
HI IgM
When Tested Daily
Daily
X1 weekly
Request (confirmatory)
Contact 9342 2649/9342 2650
Test SARS-associated Coronavirus PCR (see

Coronavirus PCR)
Test SARS - Coronavirus Serology

Notes Test only available for SARS-associated
coronavirus. Patient must satisfy WHO
case definition for testing to proceed.
Contact 9342 264728
Test Schistosoma haematobium Microscopy

Specimen Required Terminal urine or semen sample (collected
between 10am – 2pm)
Contact 9342 2670
Test Schistosoma spp (mansoni) Serology

Assay or Procedure IHA Total Ab
Contact 9342 2649/9342 2650
Test Simian B virus (herpes simiae) PCR

Specimen Required Lesion swab, CSF
Notes Contact laboratory before sending
specimen.
Contact 9342 2628
Test Smallpox virus PCR (see poxvirus PCR)
Page 46
Test Sodium
Specimen Required Serum (clotted blood) or Blood heparinised
When Tested Daily
See also: U&E
Reference Ranges Serum: 130 – 145
Units mmol/L
Contact 9342 2640
Test Sputum Culture and Microscopy

Specimen Required Sputum
When Tested Daily
Notes Optimum specimen collected early
morning. Check quality. Avoid presence
of saliva.
Contact 9342 2670
Test Strongyloides Stercoralis Serology

Assay IgG
When Tested Weekly
Contact 9342 2649/9342 2650
Test Syphilis Serology

Assay or Procedure RPR
TPPA
EIA – Total Ab
FTA
EIA IgM
Specimen Required Serum (clotted blood), CSF (0.5 ml)
When Tested Daily
Daily
Daily
x2 weekly
Weekly
Contact 9342 2649/9342 2650
Test Synovial Fluid Culture, Microscopy and

Polarised Light Microscopy
Specimen Required Fluid collected into a plain tube; also small
volume in heparinised (non sterile) tube for
cell count.
Contact 9342 2670
Page 47
Test T cells counts (reference range)
Reference Range CD3 (Total T Cells) 760-2480/µl
CD4 (Helper T Cells) 400-1630/µl
CD8 (Suppressor T Cells) 175-900/µl
CD19 (B Cells) 80-560/µl
CD56/16 (NK Cells) 90-500/µl
CD4:CD8 Ratio 0.8-5.3 (no units)
Specimen Required Blood (EDTA or heparin)
When Tested Daily
Contact 9342 2644
Test Testosterone
Female: 0.6 – 3.0
Units nmol/L
Contact 9342 2640
Test Thyroid Function Tests:

(free thyroxine, FT4),
Thyroid Stimulating Hormone (TSH)
Reference Ranges FT4: 7 – 19
TSH: 0.3 – 4.1
Units FT4: pmol/L
TSH: mIU/µL
Contact 9342 2640
Test Thyroid Stimulating Hormone (TSH) (see

Thyroid Function Tests
Test Thyroxine (see thyroid function tests)
Test Toxoplasma PCR

Specimen Required CSF, tissue, vitreous fluid
Contact 9342 2628
Page 48
Test Toxoplasma Serology
IgM
IF Total Ab
IF IgM
x2 weekly
(Confirmatory)
(Confirmatory)
Contact 9342 2649/9342 2650
Test Transferrin
When Tested Daily
See also: Iron studies
Units G/L
Contact 9342 2640
Test Trichomonas detection

Specimen Required Vaginal swab
When Tested Daily
transport medium. Alternatively contact
laboratory for broth medium for direct
inoculation. Transport at room
temperature.
Contact 9342 2670
Test Triglycerides
When Tested Daily
See also: Lipids
Units mmol/L
Contact 9342 2640
Test Trypanosoma cruzi (American

Trypanosomiasis) Serology
Assay or Procedure IF Total Ab
Contact 9342 2649/9342 2650
Test Trypanosoma gambiense (African

Trypanosomiasis) Serology
Assay or Procedure IHA Total Ab
Contact 9342 2649/9342 2650
Page 49
Test Urate/Uric acid
When Tested Daily
Normal Ranges Male: 0.21 – 0.45
Female: 0.15 – 0.40
Units mmol/L
Contact 9342 2640
Test Urea and Electrolytes (U&E): Sodium,

Potassium, Chloride, Bicarbonates, Urea
and Creatinine
Specimen Required Serum (clotted blood) or Blood
(heparinised)
When Tested Daily
Normal Ranges See individual tests
Units mmol/L
Contact 9342 2640
Test Urea
When Tested Daily
See also: U&E
Normal Ranges 2.0 – 7.8
Units mmol/L
Contact 9342 2640
Test Urine Culture

Specimen Required Mid stream urine
When Tested Daily
Notes Refrigerate specimen if delay in transport
(> 2 hr) is expected
Contact 9342 2670
Test Vaginal Culture and Microscopy

Specimen Required Vaginal swab. Provide smear for Gram
Stain.
When Tested Daily
temperature. Includes diagnosis of
Trichomonas, Gardnerella and Candidiasis
Contact 9342 2670
Page 50
Test Valproate
Normal Ranges 277 – 346 (trough)
300 – 600 (peak)
Units µmol/L
Notes Both trough and peak levels are
recommended.
Contact 9342 2640
Test Varicella zoster virus PCR

Specimen Required Swabs, CSF, urine, blood, saliva
When Tested Daily
Contact 9342 2628
Test Varicella zoster virus Serology

Assay or Procedure EIA IgG
EIA IgM
Latex Total Ab
x2 weekly
Request
Contact 9342 2649/9342 2650
Test Vitamin B12

Normal Ranges 130 – 675
Units pmol/L
Contact 9342 2640
Test Wound culture

Specimen Required Use swabs with Amies/charcoal transport
medium. Provide smear for Gram stain.
When Tested Daily
Contact 9342 2670
Test Yellow fever virus Serology

Assay or Procedure Total Ab & IgM (IF)
When Tested Weekly
Contact 9342 2649/9342 2650
Test Yellow fever virus PCR (see Flavivirus PCR)
Page 51

VIDRL Test Handbook

Загружено:

Сведения о документе

Исходное описание:

Авторское право

Доступные форматы

Поделиться этим документом

Поделиться или встроить документ

Параметры публикации

Этот документ был вам полезен?

Это неприемлемый материал?

Авторское право:

Доступные форматы

VIDRL Test Handbook

Загружено:

Авторское право:

Доступные форматы

Victorian Infectious Diseases Reference Laboratory

A receptacle for specimen deliveries after hours is available at this address.

VIDRL Contact numbers:

Area Codes: within Australia (03) International (613)

General Enquiries (24 hours) Phone 9342 2600

Pathologist on call (Australia only) Phone 0438 599 437

An on-call service is provided at other times and a pathologist is available for

The following information should be included with test requests:

2. Specimens for Virus Detection

For detection of viraemias anticoagulated blood is the preferred specimen. This

3. Specimens for Infectious Diseases Serology.

Serum is the specimen of choice for serological testing. A minimum of 10 ml of

4. Specimens for Haematology

Notes: Some substances may depress numbers of eggs or destroy protozoan

Faecal Specimens for Vibrio

If infection with Vibrio species is suspected (eg Cholera or enteric infections

Legionella from respiratory specimens. Suitable specimens include

Legionella antigen detection. Legionella pneumophila serogroup 1 can be

6. Mycobacterium Reference Laboratory

It is essential that the following information be supplied for all Mycobacteriology

In addition to the usual information required (see section 1) the following

Blood Cultures for Mycobacteria

Specimens for PCR and related tests to detect Mycobacteria

Specimen Types for Mycobacterial Culture

Laryngeal Swab. These are taken as an alternative to the examination of gastric

Serous Fluids. These include inter-alia, cerebrospinal, pleural, pericardial, ascitic

Sputum. Three single, early morning samples of expectorated sputa collected on

Tissue. Any tissue to be processed must be collected aseptically and transported to

Examinations for Leprosy (Hansen's Disease)

QuantiFERON ® -TB Gold assay notes

7. Collection and Transport of Specimens from a Patient with

When a patient with suspected quarantinable viral haemorrhagic fever (VHF)

A completed Shipper’s Declaration for Dangerous Goods form should be attached to

In most instances, biological material contained in packages shipped to VIDRL will be

Test Activated Partial Thromboplastin Time

Test Adenovirus PCR

Test Adenovirus Serology

Test Alanine aminotransferase (ALT)

Test Amylase (Total & Pancreatic)

Test Anti-gastric parietal cell antibodies

Test Anti-mitochondrial antibodies

Test Anti-nuclear (ANA) antibodies

Test Anti-smooth muscle antibodies

Test Aspartate aminotransferase (AST)

Test Australian encephalitis virus PCR (see

Test Australian encephalitis Serology (see

Test Barmah Forest virus Serology (BFV)

Test Bicarbonate (Total CO2)

Test Billirubin (Total)

Test BK virus PCR (See Polyomavirus PCR)

Test Blood Culture (Mycobacterial)

Test Blood film (without FBE)

Test Blood group (ABO, RhD)

Test Blood group screen and hold

Test Bordetella pertussis Culture

Test Bordetella pertussis PCR

Test Brucella Culture

Test Calicivirus by Electron Microscopy (see

Test Campylobacter jejuni Serology

Test Cardiac Enzymes:

Test Chlamydia pneumoniae PCR

Test Chlamydia pneumoniae Serology

Test Chlamydia psittaci PCR