The Division of Tuberculosis Elimination (DTBE) Laboratory Branch (LB) provides services for the following tests on mycobacterial cultures. Any local health department, licensed physician’s office, licensed laboratory or licensed health care facility may submit cultures for testing but they must be routed through either their state health department or other authorized facility.
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
The LB performs drug susceptibility testing for selected Mycobacterium species referred from state or other authorized health facilities. Cultures of mycobacteria are tested by the indirect proportion method with antituberculosis drugs incorporated into 7H10 agar plates.
- Molecular Detection of Drug Resistance (MDDR) CDC offers a service for the molecular detection drug resistance to rapidly identify multidrug-resistant TB. This service utilizes DNA sequencing for detection of mutations most frequently associated with rifampin and isoniazid drug resistance. Additional testing will be conducted to identify mutations associated with resistance to the most effective second-line drugs; fluroquinolones, amikacin, kanamycin, and capreomycin.
- 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
- Association of Public Health Laboratories (APHL)External
- Resources for TB Programs – Genotyping