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Test Code EHRAN Ehrlichia/Anaplasma, Molecular Detection, PCR, Blood

Reporting Name

Ehrlichia/Anaplasma PCR, B

Useful For

Evaluating patients suspected of acute anaplasmosis or ehrlichiosis

Performing Laboratory

Mayo Clinic Laboratories in Rochester

Specimen Type

Whole Blood EDTA


Specimen Required


Container/Tube: Lavender top (EDTA)

Specimen Volume: 1 mL


Specimen Minimum Volume

0.3 mL

Specimen Stability Information

Specimen Type Temperature Time Special Container
Whole Blood EDTA Refrigerated 7 days

Reference Values

Negative

Day(s) and Time(s) Performed

Monday through Saturday; Varies

Test Classification

This test was developed and its performance characteristics determined by Mayo Clinic in a manner consistent with CLIA requirements. This test has not been cleared or approved by the U.S. Food and Drug Administration.

CPT Code Information

87798 x 4

LOINC Code Information

Test ID Test Order Name Order LOINC Value
EHRL Ehrlichia/Anaplasma PCR, B 87548-4

 

Result ID Test Result Name Result LOINC Value
84319 Anaplasma phagocytophilum 87558-3
23663 Ehrlichia chaffeensis 87559-1
23664 Ehrlichia ewingii/canis 87560-9
32010 Ehrlichia muris eauclairensis 87561-7

Clinical Reference

1. Bakken JS, Dunler JS: Human granulocytic ehrlichiosis. Clin Infect Dis 2000 Aug;31(2):554-560

2. Dunler JS, Bakken JS: Human ehrlichioses: newly recognized infections transmitted by ticks. Ann Rev Med 1998;49:201-213

3. Krause PJ, McKay K, Thompson CA, et al: Disease-specific diagnosis of coinfecting tickborne zoonoses: babesiosis, human granulocytic ehrlichiosis, and Lyme disease. Clin Infect Dis 1999 May 1;34(9):1184-1191

4. McQuiston JH, Paddock CD, Holman RC, Childs JE: The human ehrlichioses in the United States. Emerging Infect Dis 1999 Sept-Oct;5(5):635-642

5. Pritt BS, Sloan LM, Johnson DK, et al: Emergence of a new pathogenic Ehrlichia species, Wisconsin and Minnesota, 2009. N Engl J Med 2011 Aug 4;365(5):422-429

6. Johnson DK, Schiffman E, Davis JP, et al. Human infection with Ehrlichia muris-like Pathogen, United States, 2007-2013. Emerging Infect Dis 2015; 21(10):1794-99

Method Description

Nucleic acid is extracted from the pathogens in blood using the automated MagNA Pure LC system. The extract is then transferred to a 96-well Lightcycler 480 dish for amplification. The LightCycler 480 is an automated instrument that amplifies and monitors the development of target nucleic acid (amplicon) after each cycle of PCR. The DNA target for PCR assay is groEL, the open reading frame gene segment of the heat-shock protein operon (groEL), which is present at a frequency of 1 copy per organism in pathogenic species of Anaplasma and Ehrlichia. A specific base pair DNA target sequence is amplified by PCR. The detection of amplicon is based on fluorescence resonance energy transfer (FRET), which utilizes a hybridization probe with a donor fluorophore, fluorescein, at the 3' end and a second hybridization probe with an acceptor fluorophore, LC-Red 640, at the 5' end. When the target amplicon is present, the LC-Red 640 emits a measurable and quantifiable light signal at a specific wavelength. Presence of the specific organism nucleic acid may be confirmed by performing a melting curve analysis of the amplicon. Using features of the melting curve analysis, the assay primers and specific hybridization probes are able to detect and differentiate among Anaplasma phagocytophilum, Ehrlichiosis chaffeensis, Ehrlichia muris eauclairensis, and Ehrlichia ewingii/canis. Due to close proximity of the melting curves of Ehrlichia ewingii and Ehrlichia canis, this assay cannot distinguish between these 2 organisms.(Cockerill FR, Uhl FR: Applications and challenges of real-time PCR for the clinical microbiology laboratory. In Rapid Cycle Real-Time PCR. Edited by U Reischl, C Wittwer, F Cockerill. Springer, NY, 2002)

Analytic Time

Same day/1 day

Reject Due To

Gross hemolysis OK
Gross lipemia Reject

Method Name

Real-Time Polymerase Chain Reaction (PCR)/DNA Probe Hybridization

Forms

For all ordering locations except for Eau Claire.

 

If not ordering electronically, complete, print, and send 1 of the following forms with the specimen:

-General Request (T239)

-Microbiology Test Request (T244)

Secondary ID

84319