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No. 1, 2009

MYCOBACTERIOLOGY LABORATORY BRANCH UPDATE

National Conference Sheds Light on Laboratory Issues

Rapid and reliable laboratory results are essential for the appropriate treatment of TB patients and the prevention of TB transmission. To shed light on important issues for the laboratory, the Association of Public Health Laboratories (APHL) and the Centers for Disease Control and Prevention (CDC) convened the 5th National Conference on Laboratory Aspects of TB in San Diego, CA, August 11-13, 2008.  More than 200 laboratorians, TB controllers, and physicians attended the 3-day conference.

The primary purpose of the conference was to provide a forum for discussion of a variety of topics including TB drug susceptibility testing practices and standards in the United States, the use of molecular diagnostics, and the importance of coordination between the laboratory and the TB control program.  The first session included a keynote address by Kenneth Castro, MD, Director of the Division of Tuberculosis Elimination at CDC, describing the current status of drug-resistant TB globally.  In addition, an overview of recommendations were presented from an APHL/ CDC expert panel to address issues regarding drug susceptibility testing of M. tuberculosis clinical isolates. Speakers provided information on validation of new molecular tests in the laboratory, efficient testing algorithms for nucleic acid amplification tests, and quality assurance and proficiency testing considerations.  The conference gave participants an opportunity to share perspectives and experiences among clinicians, TB controllers, and laboratorians during interactive discussions.  Additionally, attendees had the opportunity to network with other TB laboratorians, view posters displaying exciting advances in laboratory methods, and visit with vendors exhibiting the latest available technology in tuberculosis diagnostics. 

Over the course of the 3 days, several key themes emerged:
1) Communication between TB controllers, clinicians, and the laboratory is imperative to the successful diagnosis and treatment of TB patients.  Primary care physicians, who may not be familiar with TB, especially need to be educated about the definition of a high risk patient and available treatment options.
2) There is an undeniable need for more advanced and less expensive TB tests in the United States.  New technologies provide faster and often more accurate results than traditional methods, greatly increasing the speed of diagnosis and treatment, thereby reducing the transmission of TB. However, in many cases, these technologies are not available commercially in the United States; and when they are, high cost often prohibits smaller laboratories from adopting them.
3) The core functions of public health laboratories in the area of TB should be formally defined.  This will aid in the ability to identify gaps in lab capacity and provide data needed to support advocacy efforts.

Conference presentations are currently available on the APHL website.
 

—Submitted by Kelly Wroblewski, MPH, MT (ASCP),
Association of Public Health Laboratories, and
Angela Starks, PhD
Div of TB Elimination


 

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