Beginning in 2018, the National TB Molecular Surveillance Center will begin performing whole genome sequencing (WGS) on isolates of Mycobacterium tuberculosis gathered from newly diagnosed patients in the United States. This technology can help target public health interventions and identify new drug-resistant TB strains as they emerge.
State or Local TB Control Programs
A genotyping laboratory, in Michigan is under contract with CDC to provide genotyping services to TB programs in the United States. Three genotyping methods to identify TB strains:
- Mycobacterial interspersed repetitive unit (MIRU) analysis
- IS6110-based restriction fragment length polymorphism (RFLP) analysis
For more information, view the Guide to the Application of Genotyping to Tuberculosis Prevention and Control.
DTBE epidemiologic investigations and surveillance activities
- The LB provides support for DTBE epidemiologic investigations and surveillance activities. TB genotyping results, when combined with epidemiologic data, help to distinguish TB patients who are involved in the same chain of recent transmission.
Drug Susceptibility Testing
CDC’s tuberculosis elimination laboratory work provides services for testing of Mycobacterium tuberculosis complex (either processed specimens or culture isolates). Any local health department, licensed physician’s office, licensed laboratory, or licensed health care facility may submit samples for testing, but they must be routed through either their state health department or other authorized facility.
Molecular Detection of Drug Resistance (MDDR) CDC offers a service to rapidly identify drug resistant, including multidrug-resistant, M. tuberculosis complex. This service utilizes DNA sequencing for detection of mutations most frequently associated with resistance to the most effective first and second-line drugs as well as new and repurposed drugs such as bedaquiline, clofazimine, and linezolid.
- Report of an Expert Consultation on the Uses of Nucleic Acid Amplification Tests for the Diagnosis of Tuberculosis
- Report of Expert Consultations on Rapid Molecular Testing to Detect Drug-Resistant Tuberculosis in the United States
- Model Performance Evaluation Program (MPEP)
- Interim Laboratory Biosafety Guidance for Extensively Drug-Resistant (XDR) Mycobacterium tuberculosis strains
- Guidelines for Using the QuantiFERON®-TB Gold Test for Detecting Mycobacterium tuberculosis Infection, United States
- Tuberculosis Laboratory Aggregate Reports
These reports contain annual workload and turnaround time data from public health laboratories supported in part by the TB Elimination Cooperative Agreement.
- Laboratory Guidelines
- Under the Microscope: A Closer Look at CDC’s Tuberculosis Laboratory pdf icon[PDF – 1 MB]
- CDC’s Molecular Detection of Drug Resistance Service: Rapid Test Results for Real-Time Patient Care pdf icon[PDF – 1 MB]
- Whole Genome Sequencing (WGS) – New Lab Technology Helps Fight an Old Disease pdf icon[PDF – 2 MB]
- Association of Public Health Laboratories (APHL)external icon