AFB / Mycobacterium Identification  

 
IMPORTANT! Pre-approval needed from state or local health department. Local or State Health Department. Send approval to NPHL@unmc.edu or call (402) 559-9444.

NPHL has moved to an electronic ordering system, NUlirt, and it is now the preferred method to order all tests. Once ordered, print a "batch list" (see NUlirt Guide).

Forms Required - Nulirt batch list or NPHL Test Request Form (completed in entirety) must accompany the specimen to include the following information: symptoms and date of onset, pregnancy status, travel and vaccine history. Testing will not be performed without all required information.

Please call NPHL Client Services at (402) 559-2440 or toll free at (800) 334-0459 for further clarification.

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Test: AFB / Mycobacterium Identification 
Order in NUlirt or complete NPHL Test Order Form with
Supplemental Forms  – NPHL MTB Supplemental Form.pdf  
Synonym: Acid-fast bacteria identification, MTB confirmation   
Method: Standard method for identification of AFB; DNA probes available for M. tuberculosis complex, M. avium-intracellulare complex, and M. gordonae, as indicated; sequencing available for rapid growers  
Availability: Test performed Monday - Friday   
Specimen: Actively growing isolated organism in pure culture  
Collection Device: Actively growing isolated organism, in pure culture on Middlebrook 7H10, 7H11, or Lowenstein-Jensen agar slants or AFB automated system bottle (ESP, Bactec, Septi-check).
Specimen Labeling: Test subject to CLIA regulations and required 2 patient identifiers on specimen container and requisition forms  
Volume:  Not Applicable  
Storage/Transport:

Prior to and during shipment: Ambient 15-25°C

 

Shipping instructions, including specimen-handling requirements during transport:  Seal screw-top tubes with Parafilm™ or tape and place in biohazard bag with absorbent material.

 

Shippers must be certified in DOT Division 6.2 before shipping UN2814 Category A and recertified every 2 years.

All potential MTB complex isolates must be packed in an approved Category A shipping container. The isolate is placed inside a leak proof secondary container (biohazard bag and if transporting by air, use Tyvek™ Envelope or other KpA95 approved) with adsorbent material. Position NUlirt packing list or NPHL Test Order form between secondary container and box lid. Seal with tape. Attach airway bill and Shippers Declaration to top of box. Outer box must be labeled “UN 2814 Infectious Substances, affecting humans.”   Ship by FedEx; follow appropriate DOT/IATA Regulation Guidelines.  For assistance, call NPHL State Training Coordinator at (402) 559-3590. Omaha & Lincoln laboratories can ship via NPHL ground courier by calling client services (866) 290-1406 and request exclusive Category A courier.

 

Rapid Mycobacterium growers or probable non-MTB can be packaged and shipped as UN3373 Category B, Biological Substance via NPHL ground courier.  Place specimen inside leak proof secondary container with adsorbent material. The secondary container must be packed inside an approved Category B shipping container.  Position NUlirt packing list or NPHL Test Order form between secondary container and box lid. Seal with tape.  Label outer box as UN3373 Category B, Biological Substance. Transport by NPHL ground courier. If courier not available, ship by FedEx, UPS, or USPS (1st Class, Priority or Express Mail). Follow appropriate DOT/IATA Regulation Guidelines.  For assistance, call NPHL State Training Coordinator at (402) 559-3590.

 

NUlirt packing list or appropriate paperwork (completed in entirety) must accompany specimens.

 
Unacceptable: Non-viable organism, mixed culture, leaking container, swabs   
Specimen Stability: Stable at  Ambient 15-25°C  
Reference Interval: Complete identification of clinically-significant isolates   
Reportable Disease: MTB is reportable immediately to state or local health department    
Comments: Indicate source of specimen and any other pertinent information.
Include patient's PPD status, BCG immunization history, and prior anti-tuberculosis therapy, growth rate of organism
Indicate if Mycobacteria other than tuberculosis (MOTT) are suspected.  
Revised: 6/8/2021 
If you have questions about proper specimen collection, please call NPHL Client Services at (402) 559-2440 or toll free at (800) 334-0459.

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