2019

Dear colleagues,

with 1^st June 2019 we have adapted our analyses of lymphocyte subpopulations.

Instead of testing for various individual queries, we now offer you the choice of either a small or a full immune status. We also continue to offer the analysis of regulatory T-cells as well as chronic T-cell activating markers. This way, you can specifically request the necessary tests to match the patients’ needs.

For all analyses, we will need fresh EDTA whole blood from you, as usual. To determine the absolute cell count, we will automatically prepare a full blood count. For requesting this laboratory analysis we would ask that you notify us on the request form as to whether you would like a full or a small immune status.

Should you have any further questions regarding this, please call Dr. rer. nat. Juliane Fazio on telephone 05222 8076-207.

Kind regards,
Labor Krone

Dear colleagues,

Sensitivity testing of pathogens in our laboratory is carried out in accordance with the rules and regulations of the clinical & laboratory standards institute (CLSI). Here, changes were recently made to the testing of enterobacteria and pseudomonas aeruginosa, which were implemented by us as of 1st April 2019. In more detail, the minimum inhibition concentration (MIC) for the testing of ciprofloxacin and levofloxacin was reduced.

This change may have an impact on your therapeutic considerations on the one hand; on the other hand, more strains could be classified as 3MRGN in future. Further information can be found in the original tables as below:

Table 1 and 2: Current MIC values as of 1st April 2019

Table 3: Previous MIC values

Please do not hesitate to contact us, if you have any further queries.

Dr. med. Patricia Wehmeier
Fachärztin für Mikrobiologie, Virologie und Infektionsepidemiologie
Fachärztin für Innere Medizin, ABS-Expertin (DGI)
Tel. +49 5222 8076-324

Update of the analyses program

Dear colleagues,

We constantly adjust our diagnostics for neural antibodies to the latest findings and diagnostic possibilities. Hence we update our analyses program as of the 11th February 2019. Please note the following important changes we would like to point out:

Changes to the standard program: Serum VGKC-complex antibodies (RIA) are no longer tested as part of the standard program. Meanwhile there is sufficient evidence that increased VGCK-complex antibodies without demonstration of antibodies against LGI1 and CASPR2 have no clinical relevance in primary diagnosis (further information). However, individual requests are still possible. In addition to the cell-based assay, which is included in the standard program, testing for mGluR1-antibodies is carried out (further information). These changes do not result in a price increase.

Additional information on the request form (Formtype 18): The individual request for classical onconeural antibodies (immunoblot) in the category “Autoimmune encephalitides” is omitted. The test alone is insufficient for this indication and already included in the standard program. Within the section “Polyneuropathy/Immune neuropathy” the classical onconeural antibodies are still available as separate requests. The new test available in our diagnostic spectrum is myositis-specific and myositis-associated antibodies by immunoblot. A detailed list of the parameters included can be found under the indication “Myositis”. Within the category “Polyneuropathy/Immune neuropathy” we also have a screening for paranodal antibodies by tissue-based assay on offer.

Please order your desired quantity of the newest request form (Formtype 18) by e-mail to neuroak@laborkrone.de or by telephone: +49 5222 8076-259. Please do not use the previous form any longer. We are also happy to answer any of your queries about neural antibody requests. Shipping material can be ordered via telephone +49 5222 8076-444.

According to current data of the WHO, gonorrhea is the third most common sexually transmitted infection (STI) worldwide.  Unfortunately, there is no reliable epidemiological data from Germany as gonococcus infections do not fall under the mandatory reporting obligation. In addition to this, a global increase in resistance is observed. For the collection of valid data regarding the resistance situation in Germany, in 2013, project GORENET, in which Labor Krone takes part, was established.

In view of the resistance situation in our region, we can follow the recommendations of the S2k-guidelines for empiric therapy: In our submissions, sensitivity for ceftriaxone is at 100 % (OWL alone at 100 %) and azithromycin at 88 % (OWL alone at 93 %). It should be noted, that administration of azithromycin in the empiric treatment rather aims at the co-infection with chlamydia.

An alternative ciprofloxacin therapy should only be used after previous testing, as the current resistance situation is insufficient for empiric treatment. The exact resistance situation is listed in the table below.

Conclusion: The guideline-oriented empiric therapy with ceftriaxone and azithromycin is recommended for this region. Prior to therapy commencement, swab diagnostics for gonococcus-PCR and gonococcus cultures (CAUTION: different swab kits!) should be carried out. Pathogen demonstration by PCR is more sensitive than a culture; however, resistance testing is only possible for culture-bred pathogens. Therapy monitoring can be in consideration of clinical aspects, if necessary, a swab for gonococcus culture 3 – 7 days after the end of therapy can be taken. Testing via PCR only makes sense a minimum of 2 weeks after the end of treatment, as otherwise avital pathogens could be detected. Partners should also be treated!

Resistances for Neisseria gonorrhoeae in OWL, or total number of returns from Labor Krone, period: 01.01.16 – 31.12.2018

Please do not hesitate to contact us if you have any further questions.

Department of microbiology

Dr. med. Patricia Wehmeier, Dipl.-Biol. Andreas Groß, telephone +49 5222 8076-0