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No. 1, 2013


Laboratory Capacity Team and APHL Conduct Pilot Training: Essentials for the Mycobacteriology Laboratory: Training Modules Promoting Quality Practices

Members of the Laboratory Capacity Team (LCT) within the Laboratory Branch of DTBE, in collaboration with the Association of Public Health Laboratories (APHL) and invited faculty, successfully piloted TB laboratory training sessions in three U.S. states in fall 2012 and winter 2013. The full-day, hands-on regional training sessions provided participants with information on fundamental principles and procedures regarding specimen collection, handling, and processing for performing concentrated acid fast bacilli (AFB) smear microscopy. Quality control measures and biosafety topics related to all procedures introduced were discussed.

picture of lab training Recognizing that the laboratory is a critical partner in the diagnosis of TB and that rapid, reliable results are essential for early detection of Mycobacterium tuberculosis, LCT and APHL began to address the expressed need for hands-on laboratory trainings that could be taken “on the road” and conducted at public health laboratories with training lab capabilities. A work group composed of subject matter experts from LCT and APHL, and representatives from U.S. public health laboratories developed the content and presentations included in the training module. The course was intended for clinical, commercial, and public health laboratorians with a minimum of 6 months experience in AFB microscopy. Lectures, demonstrations, and hands-on exercises were taught by public health and clinical laboratory experts. Attendees were provided training materials and gained the skills necessary to introduce appropriate quality assurance measures within their own laboratories.

Pilot sessions were held at the Pennsylvania Bureau of Laboratories in October 2012, the New Mexico Department of Health's Scientific Laboratory in November 2012, and the Los Angeles County Department of Public Health Laboratory in January 2013. Invited faculty differed at each location and included Lisa Dettinger (Pennsylvania Bureau of Laboratories), Julie Tans-Kersten (Wisconsin State Laboratory of Hygiene), Mary DeMartino (State Hygienic Laboratory of the University of Iowa), Olarae Giger (Main Line Health Laboratories, Pennsylvania), Janet Pettegrew (New Mexico Scientific Laboratory), Bill Slanta (Arizona Bureau of State Laboratory Services), Michael Pentella (State Hygienic Laboratory of the University of Iowa), Nicole Green (Los Angeles County Department of Public Health Laboratory), Melanie Osby (Los Angeles County-University of Southern California Medical Center), and David Warshauer (Wisconsin State Laboratory of Hygiene). Kelly Wroblewski and Will Murtaugh of APHL served as facilitators; Kelly attended the PA and NM trainings, and Will, all three. Tracy Dalton, Cortney Stafford, Angela Starks, and Frances Tyrrell of the LCT, who serve as laboratory consultants to the U.S. public health TB laboratories receiving Cooperative Agreement funding, rotated at the trainings in their roles as site facilitators.

Participants indicated picture of lab trainingthrough their course evaluations that they found the lectures, discussions, and especially the laboratory exercises to be “excellent” or “good.” The majority of respondents indicated that they would make or recommend changes in the operations of their own laboratories based on the information they learned in the course. APHL and LCT will use the feedback from these pilots to convert the course into a web-based training module available to all laboratorians. Additional trainings and web-based modules are under development for TB laboratory testing practices including culture, identification, and drug susceptibility testing.

—Submitted by Frances Tyrrell, MPH, MT (ASCP), SM, and Tracy Dalton, PhD
Div of TB Elimination

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