Special Bacteriology Reference Laboratory (SBRL)

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Specimen submission requirements for CDC Infectious Diseases Clinical Laboratory Improvement Amendments (CLIA) diagnostic testing are being updated.

All submissions to CDC for CLIA diagnostic testing require pre-approval by the CDC Infectious Diseases Laboratory point of contact (POC) for the testing being requested. Updates could affect the acceptable specimen types, storage conditions, shipping conditions, and documentation. Unfortunately, submissions not meeting the updated requirements cannot be accepted.

For general questions, please contact the Infectious Diseases Specimen Submission (IDSS) Help Desk at CDC_ID_lab_info@cdc.gov. Questions regarding the detailed information for a test should be addressed to the CDC POC for that test as listed in the CDC Test Directory.

Laboratory Activities

The Special Bacteriology Reference Laboratory (SBRL) provides reference identification services for the following unusual, rare, or novel Gram-positive or Gram-negative bacteria:

  • Aerobic actinomycetes (such as Nocardia spp. which cause Nocardiosis, Streptomyces spp.)
  • Filamentous/branching Gram-positive bacteria (including Streptomyces sp., Kroppenstedtia spp.)
  • Fastidious bacteria (such as Capnocytophaga spp., Streptobacillus spp.)
  • Gram-positive coryneform rods (such as Corynebacterium spp. EXCEPT C. diptheriae)
  • Gram-positive bacteria (such as Bacillus spp., Paenibacillus spp.)
  • Gram-negative non-fermentative rods (such as Stenotrophomonas spp., Elizabethkingia spp., Wohlfahrtiimonas spp., Ignatzschineria spp.)

In addition, SBRL performs antimicrobial susceptibility testing services for aerobic actinomycetes according to CLSI guidelines upon request.

SBRL accepts specimens from state public health laboratories and other federal agencies for analysis. Private healthcare providers and institutions should contact their local or state health department laboratory (state, county, city) to ensure appropriate processing.

  1. NOTE: SBRL does not provide services for select agents, anaerobic bacteria, or culture-negative specimens derived from putative bacterial infections. Zoonotic select agents such as Bacillus anthracis, Brucella abortus, Brucella melitensis, Brucella suis, Burkholderia mallei, and Burkholderia pseudomallei are handled by the CDC’s Zoonoses and Select Agent Laboratory, and anaerobic bacteria are handled by CDC’s Division of Healthcare Quality Promotion. Other bacterial HHS select agents are addressed by CDC’s Division of Vector-borne Diseases (Coxiella burnetii, Francisella tularensis, Rickettsia prowazekii) and Division of Foodborne, Waterborne, and Environmental Diseases (botulinum neurotoxin producing species of Clostridium).

General Methodology

SBRL provides reference identification of pure bacterial isolates. Our multi-faceted identification approach includes macro- and microscopic assessment of cultures, traditional biochemical testing, sequencing of ribosomal and other DNA targets, and Matrix-Assisted Laser Desorption/Ionization Time of Flight (MALDI-TOF) analysis.

Specimens for Testing

State public health laboratories may request testing using the test order codes found in the CDC Test Directory.

Click the relevant test code below for a link to the CDC Test Directory with detailed submission requirements.
Test Name Test Code
Actinomycetes- Aerobic- ID and AST CDC-10149
Nocardia species ID and AST CDC-10151
Nocardia species ID CDC-10150
Actinomycetes-Aerobic ID CDC-10148
Bacillus species ID (Not B. anthracis) CDC-10142
Bordetella spp. ID (no B. pertussis/parapertussis) CDC-10143
Burkholderia spp. ID (not B. mallei/pseudomallei) CDC-10144
Gram Negative Bacillus (non-enteric/nonfermenter) ID CDC-10135
Corynebacterium species ID (not C. diptheriae) CDC-10136
Gram Negative Coccus (not GC or meningococcus) ID CDC-10138
Neisseria species (not GC or meningococcus) ID CDC-10139
Gram Positive Bacillus ID CDC-10137
Haemophilus species (not H. influenza/H. ducrey) ID CDC-10141
Moraxella species ID CDC-10140
Bacterial ID of Unknown Isolate (not strict anaerobe) CDC-10145
Bacterial ID from Clincial Specimens (16S rRNA PCR) CDC-10146
Special Bacteriology Pathogen Study CDC-10147

Specimen Rejection Criteria

Please review the rejection criteria below prior to submission. SBRL may reject specimens that are improperly labeled or submitted, or that are in unacceptable condition.

Unacceptable specimen labeling:

  • No labeling
  • Only one unique identifier on the specimen container
  • No submission form (50.34)
  • Unique identifiers on the specimen container do not match the form
  • Multiple labels on container with conflicting patient identifiers

Unacceptable specimen submission process:

  • Submitter is not authorized by state law (i.e. submitter is not on the state’s list of authorized persons)
  • Test requested is not performed at CDC
  • Specimen was sent to CDC in error

Unacceptable specimen or condition:

  • Specimen has leaked
  • Specimen is of poor quality
  • The volume of the specimen submitted was insufficient
  • The specimen type/site of collection is unacceptable for the testing requested
  • Specimen collection device or transport media are unacceptable
  • Specimen is improperly processed (e.g. serum collection tube not spun down)
  • Specimen is received in an expired specimen collection device
  • Specimen was shipped using unacceptable transport condition
  • Specimen is submitted in an unacceptable timeframe

In addition to the criteria above, the CDC CLIA Technical Supervisor may determine that a specimen should be rejected based on the following:

  • Required submission information not provided as specified according to the CDC Test Directory
  • Improperly completed 50.34 form
  • Specimens submitted directly to CDC without authorization by the jurisdictional public health laboratory
  • Specimen is submitted in an inappropriate manner

Shipping Isolates

Shipping and packing instructions can be found here.

All isolates for analysis by SBRL should be sent and processed through the state public health laboratory. Pure bacterial isolates should be grown on solid media in tightly sealed containers (e.g., slants) and sent to the CDC Specimen Triage and Tracking Team (STATT) accompanied by CDC Form 50.34. Isolates submission to SBRL should be sent to STATT Unit #17.

CDC does not accept routine shipments on weekends or holidays. Please make sure packages arrive Monday–Friday. All samples must be shipped in accordance with all applicable local, state and federal regulations.

The shipping address for Routine/Reference specimens is:

Centers for Disease Control and Prevention
(Attn: Special Bacteriology Reference Laboratory)
RDSB/STATT [Unit #17]
1600 Clifton Road, NE
Atlanta, GA 30329
[Insert CDC Point of Contact] [Insert CDC Point of Contact’s Telephone Number]

Additional Information

If additional information is needed about the reference activities performed at SBRL, please call 1-800-CDC-INFO (1-800-232-4636).