TB Notes Newsletter
No. 2, 2014
LABORATORY BRANCH UPDATES
Laboratory Webinar: Best Practices for Genotyping Submission
On April 10, 2014, DTBE’s Laboratory Branch and the Michigan Department of Community Health (MDCH), Bureau of Laboratories, hosted a webinar highlighting the proper shipping of specimens to MDCH for genotyping. The webinar also showcased the work that the Michigan public health laboratory performs under its contract with CDC to provide genotyping services to TB programs in the United States. TB programs may submit one isolate from each patient culture positive for TB within their jurisdictions to the Michigan laboratory as part of the CDC Tuberculosis Genotyping Program.
MDCH has a long history with the TB genotyping program, beginning in 1996 as a participant in the National Genotyping and Surveillance Network. At that time, MDCH performed IS6110-based restriction fragment length polymorphism (RFLP) analysis and spoligotyping. In 2003, Michigan was one of two states awarded a contract with CDC to perform spoligotyping, mycobacterial interspersed repetitive unit - variable number of tandem repeat analysis (MIRU-VNTR), and RFLP testing for TB programs in all states east of the Mississippi. In October of 2013, Michigan was awarded the sole contract to perform MIRU-VNTR for all TB programs in the United States. The new model requires Michigan to receive approximately 9,000 isolates per year, extract DNA, perform MIRU-VNTR, and send a portion of the DNA to CDC for spoligotyping. The goal of MDCH is to provide MIRU-VNTR results within 5 days of receipt in the laboratory.
The genotyping webinar served as a refresher for public health laboratories to highlight the best practices for shipping isolates of M. tuberculosis complex (MTBC) to MDCH for genotyping. Sending isolates that are correctly prepared, identified, packaged, and shipped serves to facilitate the prompt testing of these isolates and also ensures the safety of testing personnel. Isolates of MTBC are considered Category A Infectious Substances, and as such, their transport is governed by rules set forth by both the Department of Transportation and International Air Transport Association.
Some of the information provided in the webinar included:
- Types of cultures to send for best results, including proper media, growth requirements, and age of isolates;
- Proper use of Category A shipping containers;
- Paperwork needed prior to testing, including shipping forms and TB GIMS sheets;
- Appropriate use of the CDC Fed-Ex account for no-cost shipping;
- Conditions for return of shipping containers; and
- Explanation of MIRU protocol and turnaround time.
Personnel from MDCH presented an informative and interesting webinar that was well attended by state and local public health laboratories across the county. If you missed the webinar, and would like the handouts associated with the presentation, please contact: Frances Tyrrell, firstname.lastname@example.org
—Submitted by Angie Schooley, MT (ASCP)
and James Rudrik, Ph.D.
Michigan Department of Community Health
and Frances Tyrrell, MT, MPH, CDC/DTBE