1. Regular Covid-19 PCR (on the request form LABHOH MMB mention “Covid-19 PCR”).
Request forms can be used for clinical, outpatient, general practitioner and other patients. The collected sample must be placed in a “Bio-hazard” bag.
Each sample should have a completely filled request form and handed in at the central office of the laboratory. If samples are handed in before 11am, the requesting doctor/ physician will obtain results the same day.

2. Urgent(SPOED) Covid-19 PCR (on the request form LABHOH MMB mention “URGENT Covid-19 PCR”).
Due to the worldwide shortages of diagnostics during this outbreak, LABHOH MMB as well as all labs in the Netherlands and the rest of the world acquires a very limited stock of these tests. This PCR test is also 4-10 times more expensive than the regular Covid-19 PCR. After sample is handed in at the central office of the laboratory, the results will be available in Labosys within 2 hours during office hours. Outside office hours, consult with the doctor-microbiologist on duty about the options.

Since the stock is very limited please only request the “URGENT Covid-19 PCR” in the following cases:

• If there is no medical history of Covid-19 of the patient and has to undergo a medical procedure.
• There is an acute shortage of beds for Covid suspected patients on B3.
• Patient must be flown out urgently requiring a “Covid-free” statement.
• In times of extreme bed shortage in HOH, the patient can be transferred within a few hours to another healthcare institution where a “Covid-free” statement is required.

Given that the number of “URGENT Covid-19 PCR” tests available worldwide is limited and the costs are high,  please understand the limitations in using Urgent PCR.

LABHOH Medical Microbiology (MMB)also has Covid-19 serological tests and Covid-19 serological rapid tests. Due to the problems around sensitivity, specificity, positive predictive value, negative predictive value of these serological tests in areas with low seroprevalence. Their use for clinical diagnostics is to this date not recommended by  RIVM, WHO and among others.

This serological diagnosis is therefore only carried out on a “research basis” in HOH after consultation between an infectiologist, medical microbiologist, intensivist and / or pulmonologist.

For further information, please contact the on-duty physician microbiologist at LABHOH. (DUTCH)

An request form must be completely filled before it can be processed. The patient data should be listed at the top left of the request form. It is also important to mention the clinical data and the use of antibiotics.

Clinical data is considered as following:

• first day of symptoms
• kind and duration of symptoms
• infection problem
• medical data and relevant data with regard to potential infection

In addition recent antibiotics should be mentioned, because it can affect the growth and / or interpretation. Suspected of importing viruses always mention place and duration of stay abroad together with the date of return to Aruba.

The Microbiology department uses the following request forms. There are two types of request forms available: purple application is intended for bacteriological & parasitological examination and the blue request form is intended for serological testing.

On the purple request form the question is divided by type of pathogen (bacteria, parasites, fungi). Under the heading of material, the type of material must be filled or mentioned. Each sample should have a completely filled request form.  The duration of a culture can vary from 2 days to 6 weeks depending on the kind of pathogen.

Blue request form is divided into viral, bacterial and parasitic serology. In addition, specific packages have been put together in which no changes can be made. The submitted sample can be serum, plasma, liquor, and sometimes urine. The duration of serological testing is particularly dependent on the material and may vary from 2 to 10 days.

The Microbiology Department has certain requirements for submitting materials:

Requirements:

• The sample must be removed, prior to initiating any antibiotics.
• The sample must be derived from the “infected body part”, and avoid contact with other parts of the body in order to prevent other non-relevant micro-organisms to be included.
• The sample must be aseptically removed / collected.
• The sample is to be collected and transported from time of collection as soon as possible to the  laboratory, since micro-organisms may die outside the body. In addition, it is possible that there are multiple types of micro-organisms (commensal and pathogenic) and that one species can grow faster, as a result of which the true pathogen is obstructed / overgrown, obtaining false results.
• For patients from general practitioners, the instruction forms should be consulted
• Clearly state the required research and the type of sample.
• The collected sample must be placed in a “Bio-hazard” bag and packaged with the request form.

Collection material:

Microbiological laboratory research puts emphasis on the importance in which the material is removed, the transport and the time it is delivered to the laboratory. Valuable material must be delivered directly to the laboratory by the physicians. Liquor is always treated as CITO. The material must be delivered to the central office of the laboratory at the hospital.

Blood cultures: Bring bottles immediately after collection to the central office of the laboratory. Vials are placed in the yellow bin designed and identified for the blood cultures.

Liquor: Immediately after collecting hand them in to the central office of the laboratory and inform the Bacteriology department. Bottles must be placed in the yellow bin and identified as OTHER. After 16:00 and in week-ends call the on duty analyst call.

Feces swabs/containers; sputum & urine: After collection, hand the sample in at the central office of the laboratory in a bio-hazard bag. Samples should be identified by patient’s name and birth date. Samples are placed in the refrigerator.

Materials required for the collection of samples can be ordered through the warehouse of FSLMA, via tel: 5274000.

For more information about specific tests click here.

Results are sent to the requesting doctor/ physician and ward where the patient is admitted. In addition, consult the results through the hospital system in the various departments (Cerner). General practitioners receive the results only electronically via Promedico.