TB Notes Newsletter
No. 4, 2013
LABORATORY BRANCH UPDATES
The Association of Public Health Laboratories (APHL), in collaboration with CDC, is excited to present a new training tool, "Essentials for the Mycobacteriology Laboratory: Promoting Quality Practices". This tool consists of a series of interactive web-based modules for laboratorians, and is now online and publicly available.
The modules are designed to enhance competency and to address those issues of common mycobacteriology laboratory practice affecting quality testing and safety of the laboratorian. There is no charge to access these trainings.
There are currently four training modules available:
- Overview of Tuberculosis
- Laboratory Safety: Work Practices for Mycobacterium tuberculosis
- Specimen Collection, Transport, Handling, and Processing
- AFB Smear Microscopy
In addition to the online modules, the website includes PDF versions of the content, as well as many additional resources to supplement each of the trainings. These tools can be utilized to suit individual laboratories’ training purposes. Please visit http://www.aphl.org/aphlprograms/infectious/tuberculosis/tb-core-curriculum/Pages/default.aspx to access the modules.
Collaborating with laboratory experts, including staff from CDC, APHL is continuing to develop new content for these training modules. Laboratories are encouraged to share the trainings within their networks with all who might benefit. The modules and other valuable TB resources can also be accessed through APHL’s homepage: http://www.aphl.org/Pages/default.aspx
At the end of July 2013, the Food and Drug Administration (FDA) granted market authorization to the Cepheid Xpert MTB/RIF assay. This nucleic acid amplification (NAA) test can simultaneously identify Mycobacterium tuberculosis complex (MTBC) and detect genetic mutations associated with resistance to rifampin from raw sputum and concentrated sputum sediments. A major advantage of this test is that results are available in less than 2 hours.
In October 2013, CDC published interim guidance in the Morbidity and Mortality Weekly Report (MMWR). The guidance describes the background of this NAA test, practical considerations for its use in clinical decision making, and considerations for its use in infection control. The MMWR article provides a table highlighting interpretation, as well as proposed minimum laboratory report language for results from the Xpert MTB/RIF assay. It also includes an analysis of results of sputum smear and NAA testing for infection control in health-care settings involving patients with suspected tuberculosis.http://www.cdc.gov/mmwr/preview/mmwrhtml/mm6241a1.htm?s_cid=mm6241a1_w
Recently, APHL’s TB Subcommittee published Laboratory Considerations for Use of Cepheid Xpert MTB/RIF Assay, which is intended to guide laboratories to integrate this assay into existing TB testing practices. The document emphasizes the use of the Xpert MTB/RIF assay as part of a comprehensive testing algorithm that includes acid-fast bacilli (AFB) smear and culture, as well as drug-susceptibility testing. Included within the document is a summary of the considerations each laboratory should make based on in-house testing capabilities. This document may be distributed to clinical laboratory partners and other laboratory stakeholders. It is important to emphasize that the Xpert MTB/RIF assay does not replace AFB smear and culture. Please see: http://www.aphl.org/AboutAPHL/publications/Documents/ID_2013Nov_Cepheid-Xpert-Fact-Sheet.pdf
Please contact APHL at email@example.com for more information.
—Reported by Frances Tyrrell, MPH, MT (ASCP), SM
Div of TB Elimination