|AFB Mycobacterium tuberculosis Direct Susceptibility Test Supplemental Forms Required – Mycobacterium tuberculosis (MTB) Supplemental
|DST, Pyrosequencing, PSQ
|Prosequencing of katG, inhA, ahpC, rpoB RRDR, gyrA and rrs genes.
|Monday - Thursday
|Nucleic Acid Amplification positive (NAA+) sediment; pure culture isolate on solid medium (isolate submitted for confirmation of an Xpert MTB/RIF should result as "RIF resistance detected")
|Sediment in centrifuge tube or leak-proof container. Isolate on Lowen-Stein Jensen media Specimen Labeling: Test subject to CLIA regulations and required 2 patient identifiers on specimen container and requisition forms
|0.5 mL (sediment)
Prior to and during shipment: Refrigerated at 2-8 °C. Place each individual specimen in a sealed bag.
Shipping instructions, including specimen-handling requirements during transport: Shipping instructions, including specimen-handling requirements during transport: Sender must contact the NPHL by email or phone before shipping. All screw-top tubes must be sealed with parafilm or tape. Vacutainer tubes do not require parafilm or tape to seal, Fluids that have potential to be Category A must be packaged UN 2814 Infectious Substances, affecting humans (Category A) and shipped via FedEx. Omaha & Lincoln laboratories can ship via NPHL ground courier by calling client services (866) 290-1406 to request exclusive Category A courier. See instructions and shipping address: http://nphl.org/
|Sediment should not be shipped frozen.
|Sediment should be refrigerate at 2-8°C, keep isolate at room temperature.
|Sensitive or Resistant
|MTB complex will be reported immediately to local or state health department. Refer to Nebraska DHHS Title 173, Communicable Diseases
|First-Line DST using MGIT with a panel of rifampin, isoniazid, pyrazinamide and ethambutol. Second-Line DST using MGIT with a panel of ethionomide, capreomycin, amikacin, moxifloxacin, kanamycin and rifabutin Molecular detection of drug resistance will be performed by pyrosequencing on specimen sediments and isolates from patients that meet pre-determined criteria for suspicion of drug resistance. Submitting laboratories should keep a small, 1 mL aliquot in their laboratory. Test performed at Microbial Diseases Laboratory California Department of Public Health 850 Marina Bay Parkway Richmond, CA