Montana Laboratory Sentinel

Updates from the MT Laboratory Services Bureau
Phone: 800-821-7284 Fax: 406-444-1802
Lab Website

Lab Manual 

(Please reference this for testing or submission questions.)

January, 2025

News and Updates

Financial

• Online Payments

  • Online payments now require an account to be created before payment can be made. If you do not want to create an account to pay your invoice online please reach out to our billing office at 406-444-2642 to pay your invoice. Credit/Debit card information will be required over the phone as well as phone number, billing address and an email address to send the receipt to. Remember a small fee is charged for paying with a credit/debit card. If you decide not to pay invoices with a credit/debit card we are still accepting payment by check and that can be mailed to:
    • DPHHS – Laboratory
      PO Box 4369
      1400 Broadway Room B206
      Helena, MT 59604-4369

Newborn Screening

• MTPHL to begin testing SCID/SMA in-house in January

  • Severe Combined Immunodeficiency (SCID) and Spinal Muscular Atrophy (SMA) assays will be performed at the Montana Public Health Laboratory beginning on January 14, 2025.  In-house SCID and SMA testing will show under a new header on the report in addition to Panel 1 and Panel 2.

Serology

• Brucella/Tularemia Serology No Longer performed in-house

  • Beginning January 2025, the Montana Public Health Laboratory will no longer perform the Brucella and Tularemia serology assays in-house because it is unable to obtain a positive control. Laboratories are encouraged to send samples to the larger reference laboratories.

IT Corner

• Sign-out of the Lab Portal

  • Please remember to sign-out of the lab portal when you are finished in the system. By not signing out of the system it leaves cookies open in your browser. This causes multiple cookies to be open per user, causing extra licenses to be used. We recently almost ran out of licenses. 

  • Sign-out by going to the top right hand corner, select the arrow next to the user icon, and scroll down to sign-out. 

• SSO OKTA

  • You will see a new button on the lab portal login screen called “Sign in with OKTA.” This is in preparation for onboarding users to the state single sign-on system. Do not use the button and log in normally until directed otherwise.  Once users are onboarded to OKTA, they will be able to use the button to log in. Using the button before then will cause a failed login. We will be onboarding users starting in January. More information will be provided as this process begins.

• Password Managers

  • Browser password managers can cause problems when signing into our lab portal. Especially for people who change computers regularly. When updating your password the password manager only saves the password on that computer for that browser. Please make sure that if you are using a browser password manager that you have updated the password throughout all the computers you are using. 

Molecular

• Influenza

  • We Need Your Help!

    • As more clinical laboratories attain molecular testing capabilities, the surveillance role of sentinel laboratories becomes even more critical. The Montana Public Health Laboratory (MTPHL) and the Communicable Disease Epidemiology (CDEpi) program at the Department of Public Health and Human Services (DPHHS) participate in year-round surveillance activities that rely heavily on timely and accurate disease reporting, as well as timely specimen submission. MTPHL is not simply “confirming” the work you have already performed but needs these specimens for further surveillance testing and epidemiological studies. In addition, a representative number of specimens are referred to and are requested by the Centers of Disease Control and Prevention (CDC) for National surveillance activities. 

    • Also, if there is anything we can do to help make the submission process easier, please let us know! We truly value your participation.

    • To learn more about how submitting specimens contributes to surveillance efforts, click here for the Big Respiratory Virus Picture. 

Preparedness

• Select Agent Delisting

  • The Federal Select Agent Program (FSAP) has announced that the US Departments of Health and Human Services (HHS) and Agriculture (USDA) have published parallel Final Rules in the Federal Register which set forth changes to the select agent and toxin list.

  • Three Brucella species, B. abortus, B. melitensis, and B. suis, have been removed from the list of regulated select agents and toxins.

  • The change will take effect on January 16, 2025.

  • More information will be shared in the future as the FSAP reaches out to those entities impacted by the change.

Dear Lab-by While this testing did not occur at the state lab, I wonder if you can still answer this question... I have had two cases where the urine of symptomatic patients contained no bacteria, yet a urine culture was indicated. Why is a culture required if no bacteria were seen? Is this an error? Sincerely, Just checking Dear Checking, No, this is not an error. Bacteria may not always be present in a urinalysis or the corresponding sediment, especially if the urine is diluted or the patient has recently begun antimicrobial therapy. Because the instrument’s values are based on user-defined parameters, the detection limit might rule out bacteria, even though it is seen in the sediment. A urine culture can be reflexed for several reasons, including a positive leukocyte esterase, positive nitrite, and even the number of white blood cells present. Since white blood cells are a central part of the body’s immune system, increased levels in urine may indicate an underlying infection. Untreated urinary tract infections can affect the bladder, urethra, and kidneys and can even cause a patient to become septic. Urine cultures for asymptomatic patients are not routinely indicated because they can result in unnecessary treatment, antimicrobial resistance, and extra costs. Your patients were symptomatic, meaning they may have had symptoms such as increased urinary frequency, painful urination, or blood in the urine. You also indicated in a follow-up email that the patients’ leukocyte esterase results were positive. This combination, in addition to a positive nitrite and the presence of red blood cells in urine, is a good indicator that a urinary tract infection is possible. Each laboratory has or should have an algorithm for reflexing urine samples for culture. They must work with their infection preventionists to determine what is considered normal and abnormal based on the patient population and trends in antimicrobial resistance. This is an important aspect of good antimicrobial stewardship: ensuring that only true infections are treated with antimicrobials and those antimicrobials will be effective. Sincerely, Lab-by

Reminders:

• Lab Portal Information

  • All of our lab portal procedures and access paperwork can be found on our website. Here is the link to the direct page with all of our forms and procedures: https://dphhs.mt.gov/publichealth/LaboratoryServices/onlineorderingandresults.

  • There is also a link in our lab portal that will take you directly to this page. This link can be found under quick links. "MT PHL Lab Portal Procedures and Forms". 

• Courier 

  • Please click here for our full courier schedule.

• Previous Laboratory Sentinels 

  • All previous Laboratory Sentinels can be found on our website on the column on the left hand side by selecting "Public Health Laboratory Newsletter". Here is a link to all our previous Laboratory Sentinels.