User Manual - Scotland's Health on the Web
Contents
1. PD MYB R UM_SMRL Version 5 0 Issue date 19 08 2013 Review date 19 08 2015 Author Dr I F Laurenson amp Mike Smith NB THIS IS AN ELECTRONIC DOCUMENT WHICH IS UNCONTROLLED WHEN PRINTED Sample types and containers for mycobacteria investigation Specimen type Containers and transport Comments Sputum up to 5ml Disposable plastic sterile universal container Decontaminated and neutralised samples may lose viability during transit Induced sputum Disposable plastic sterile universal container Bronchoalveolar lavage Disposable plastic sterile universal container BAL Bronchial Washings Pleural fluids amp Disposable plastic sterile universal container aspirates Biopsy material Disposable plastic sterile universal container DO NOT USE add a few drops of preservative free 0 9 FORMOL SALINE sterile saline to keep sample moist OR FORMALIN Tissues including heart Disposable plastic sterile universal container DO NOT USE valves FORMOL SALINE OR FORMALIN Early Morning Urine Sterile 500ml bottles filled up to 2 3 full Send EMU bottles available three samples on successive days on request from the stores department Astley Ainsley Hospital Edinburgh for Lothian users Blood Myco F lytic Blood culture bottles available from SMRL Bone marrow Use Myco F lytic blood culture bottles available from SMRL or disposable plastic ste2. PD MYB R UM_SMRL Version 5 0 Issue date 19 08 2013 Review date 19 08 2015 Author Dr I F Laurenson amp Mike Smith NB THIS IS AN ELECTRONIC DOCUMENT WHICH IS UNCONTROLLED WHEN PRINTED Test Method Test frequency and turn Comments Costs around time Microscopy Auramine Within 1 working day of receipt All specimens examined by for acid fast bacilli AFB Phenol staining Mon Fri AP microscopy are cultured for mycobacteria detection Costs indicated below against Primary culture include primary specimen microscopy Primary Solid modified Daily Usually available 2 6 Results from 25 50 for NHS users Culture LJ pyruvate egg weeks after receipt of sample contaminated slope and rapid Cultures are reported negative at specimens may be liquid culture 8 weeks if appropriate but kept delayed Free for NHS Lothian users MGIT for 12 weeks in total Species Molecular Twice weekly Tues Fri 1 7 Additional molecular identification identification days or phenotypic methods of cultures methods may be required for some strains and this may cause delay Drug Liquid or solid Set up daily or weekly Tests for 2 and 3 susceptibility culture broth depending on methodology line TB drugs set up on testing of slow microdilution request or when there growing for MOTT is resistance to any first mycobacteria line drug Drug Broth As required 3 days incubation For rapidly growing s
3. and Health and Safety advice ccceeeeeeeeeeeeeeeeeeeeeeteeeeeeees 13 Clinical epidemiological and infection Control AAVICE cccecceeeeeeeeeeeeeeeeeeeeeeeeeeeees 13 Training and Education uaa tiette ttt ait eeeteesteeah tilde canbe vient eaeealt ones Uns 14 Re searchiand AUdI Fess occ cues tudeceis edad veteues A andthe dase E EAEE abana 14 Q ality ASSUraNGE iiini Richton hisi hit aero sith aia aiae 14 Antimicrobial Assays lt 2 sec beaters tt iti eskintd Uee th eae ett eben eel ae eet ees 15 SCOTTISH MYCOBACTERIA REFERENCE LABORATORY FORM 006 16 2 PD MYB R UM_SMRL Version 5 0 Issue date 19 08 2013 Review date 19 08 2015 Author Dr I F Laurenson amp Mike Smith NB THIS IS AN ELECTRONIC DOCUMENT WHICH IS UNCONTROLLED WHEN PRINTED Scottish Mycobacteria Reference Laboratory The Scottish Mycobacteria Reference Laboratory SMRL is the Scottish Reference Laboratory for Mycobacteriology particularly for the identification drug susceptibility testing and strain typing of Mycobacterium tuberculosis complex MTBC and non tuberculous mycobacteria NTM The laboratory receives approximately 1 000 mycobacterial cultures per year mainly from Scottish NHS laboratories The service is also funded to perform rapid detection of mycobacteria and screening for drug resistance on acid fast bacilli AFB smear positive respiratory samples Further advice is also available as detailed on page 13 The laboratory is ba
4. set this up if you have such a secure laboratory address to automatically email each time there is an updated report Please contact Mike Smith or Shona Hannan in the first instance if you wish to use this means of reporting 12 PD MYB R UM_SMRL Version 5 0 Issue date 19 08 2013 Review date 19 08 2015 Author Dr I F Laurenson amp Mike Smith NB THIS IS AN ELECTRONIC DOCUMENT WHICH IS UNCONTROLLED WHEN PRINTED Written report formats Initial Report on specimens Microscopy results Acid Fast Bacilli NOT seen Culture report to follow Microscopy results Few Acid Fast Bacilli seen Culture report to follow Initial Reports on Cultures received Confirmation as a Mycobacterium and provisional species identification is reported in writing within 4 working days of receipt of culture This is achieved by AFB microscopy to confirm the presence of mycobacteria and rapid molecular methods for identification of cultures Final Report on Cultures received Confirmed species identification and first line sensitivity results may take from as little as one week to up to 12 weeks Molecular Typing M tuberculosis genotyping results are reported as they are done and comparisons of the genotypes of strains suspected to be clustered are reported to CPHM s quarterly at present Further comment analysis is available on discussion with a senior member of SMRL staff and a letter may be issued Paraffin sections Paraffin embedded tissues can
5. IS UNCONTROLLED WHEN PRINTED Levels of Service 1 National Services Scotland funded Remit SMRL receives cultures of presumed mycobacteria from all NHS laboratories in Scotland These cultures are tested to determine e Presence of mycobacteria Full species identification Susceptibility to standard anti mycobacterial drugs Susceptibility to second line anti mycobacterial drugs where appropriate Rapid liquid culture of smear positive respiratory samples Molecular typing and comparison of M tuberculosis complex strains Use of molecular tests on smear positive respiratory samples to rapidly identify the presence of mycobacteria and screen for drug resistance in M tuberculosis complex 2 Services available by charging users e Rapid liquid culture of samples from normally sterile sites e g CSF bone marrow tissue samples aspirates and bronchoalveolar lavage samples e Molecular tests on smear negative samples and smear positive non respiratory samples e Culture of smear negative samples e PCR for molecular detection of MTB complex in fixed paraffin sections 3 Services available by contract between requesting service and NHS Lothian e Processing of routine samples from patients for mycobacteria investigation Samples for mycobacterial investigations Microscopy All samples except blood and urine are routinely examined for direct AFB microscopy provided there is sufficient specimen Culture Our current practice is to inoc
6. NHS S ya Lothian LOTHIAN UNIVERSITY HOSPITALS DIVISION DEPARTMENT OF LABORATORY MEDICINE Scottish Mycobacteria Reference Laboratory amp Lothian Mycobacteria Laboratory User Manual August 2013 CPA Accredited 1 PD MYB R UM_SMRL Version 5 0 Issue date 19 08 2013 Review date 19 08 2015 Author Dr I F Laurenson amp Mike Smith NB THIS IS AN ELECTRONIC DOCUMENT WHICH IS UNCONTROLLED WHEN PRINTED INDEX Scottish Mycobacteria Reference Laboratory c cccccceeeeeeeeeeeeneeeeeeeeeeeeeeeeenneeeeeeees 3 Telephone Fax and Email ENqQuiries c ccccccceeceeeeeeeeneeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeenenaaees 3 oine e NIG les sieges cies cate cous teci cuss tnd eset uehcat E dL cece dea daca E 4 Packing and Transport of Infectious Substances ee eeeeeeeeeeeeeeseeseessseseeseeeeeeeeees 5 Levels of Service Ss iccsdoscnt Ses chee ss taiss vow eaves valet vee tbeek ene ues wvou upto enpeaeoyevduek osc aee bee 6 Samples for mycobacterial investigations cccceeeeeeeeeeeeeeeeeeeeeeeeeeeeesnnneeeeeeeees 6 Sample types and containers for mycobacteria investigation ccccceeeeeeeeeeeeeeeeees 9 Tests available turn around times and costs c ccccceceeeeeeeeeeeeeeeeeeeeeeeeeeeeeenaaeees 10 Molecular detection of mycobacteria in Specimens cceeeeeeeeeeeeeeeeeeeeeeeeeeeeteees 12 Reporting of Results ita cetas heat eae latent alt ett alah at 12 Technical Scientific
7. be examined for the molecular detection of MTBC Results are normally reported within 5 working days Cumulative reports Cumulative results on a patient with positive results can be produced on request Please contact senior BMS or medical staff at SMRL At present only Authorised Final reports on each test are available on SCI store Interim results are not available Technical Scientific and Health and Safety advice The technical and scientific staff at the SMRL are happy to provide advice on all laboratory aspects of microscopy and isolation of Mycobacteria and on the safe running and design of containment level 3 laboratories Please contact Mr Mike Smith BMS Team Manager Mrs Pauline Claxton or Mrs Christine Doig BMS Section Managers for technical help and advice Clinical epidemiological and infection control advice The primary source of medical advice for the diagnosis management and public health investigation of TB lies with the consultants in the relevant specialties in the local health board The 13 PD MYB R UM_SMRL Version 5 0 Issue date 19 08 2013 Review date 19 08 2015 Author Dr I F Laurenson amp Mike Smith NB THIS IS AN ELECTRONIC DOCUMENT WHICH IS UNCONTROLLED WHEN PRINTED consultant microbiologists attached to the SMRL are happy to complement this primary advice where appropriate Please contact Dr Ian Laurenson Director or Dr Ewan Olson Deputy Director for advice on issues such as
8. e is a WDA Centre of Expertise http www ctlabs co uk Pyrazinamide No longer provided due to closure of the London Medical Toxicology Unit at St Thomas Hospital Rifampicin Dr AM Lovering ARL Department of Microbiology Southmead Hospital Westbury on Trym Bristol BS10 5NB United Kingdom 0117 959 5653 0117 959 3217 andrew lovering nbt nhs uk Accredited http Awww bcare nbt nhs uk services clinical antimicrobial assays 15 PD MYB R UM_SMRL Version 5 0 Issue date 19 08 2013 Review date 19 08 2015 Author Dr I F Laurenson amp Mike Smith NB THIS IS AN ELECTRONIC DOCUMENT WHICH IS UNCONTROLLED WHEN PRINTED SCOTTISH MYCOBACTERIA REFERENCE LABORATORY FORM Microbiology Laboratory Telephone numbers Royal Infirmary of Edinburgh Enquiries 0131 242 6016 Little France Dr Ian F Laurenson 0131 242 6079 51 Little France Crescent Mike Smith BMS Team Manager 0131 242 6009 Edinburgh Laboratory 0131 242 6022 EH16 4SA Fax 0131 242 6008 Patient s Surname 2 0 00 seseesecee sresessee srsressce sesseseecseeseesenes Forename in terre neiaa ietie Sex M F Home AA S E ASS A TEA A E R AAE AA Date of Birth Iudis EAE Country Of Origin eee poeesiat uar ii n e Race or Ethnic Group csini ceeeesee ceeseeene roiret aaret Hospital or Clinic No eseese ceeceeeee seeeresse ceeeeeeees Laboratory Reference No n s cescceeee ceeceeees ceeseeeee sersrrsse CHI Number enean i Pe chee cal te ene ae ed e
9. ee eased dual T A edu A E cave A as Patients Hospital sorei en tee a eae aes Patient s Consultant ccc cece eee e eee Sending TLADOratOry eicere e e tea whe Se eet leech telat le he exter cae clelaces devsteh Ghd E A ndca veces ENE Ea Date of specimen or received date ee iiin AFB Microscopy of specimen POS NEG Sample Type Positive Culture or Primary Specimen Specimen type Isolation Site ane e pe eea eats sors ein Aaea Paio ns Aroa aT E E eae Antimicrobials at the time of sampling 0 seitaeesineeneen a erinin annei Ee EEEE Eea AEE aA AEAEE KEE En sE reai Comments From Local Laboratory 0 00 seesess cence ee cece eee serrert ssesers serrerr teresse ceaeee saetieeeaees The form below for SMRL use only AP Film of Specimen Neg Glycerol Date Pyruvate Date MGIT MB Date Sub to Date sub d BA Contaminated ZN Result E Sens required i Action Growth Pigment For SEQ Eord Y N Culture Identified as 16 PD MYB R UM_SMRL Version 5 0 Issue date 19 08 2013 Review date 19 08 2015 Author Dr I F Laurenson amp Mike Smith NB THIS IS AN ELECTRONIC DOCUMENT WHICH IS UNCONTROLLED WHEN PRINTED
10. ent to conform to the Transport of Dangerous Goods act The SMRL is a member of the Hays DX Specimen Delivery Service AN AWN For posting by Hays DX courier 1 Place the sealed specimen bag into a screw cap container from a DX box and put with it the corresponding request forms 2 Carefully place the destination address label provided on the green tracking label on the package taking care not to cover any of the peel off barcodes or tracking numbers Also leave some space next to the lines for receiver s Hays DX number and Exchange code Place some clear selotape over the label to ensure it is not easily removed or damaged by rain again avoiding covering any peel off labels 3 Fill in the Hays DX number and Exchange code of the destination 4 Peel off one of the two matching tracking numbers at the bottom of the Tracked Specimen label and stick it in the provided Hays DX logbook and fill in the receiver s details and date of dispatch 5 At the top of the Hays DX label fill in the sender s name sender s Hays DX number sender s exchange code and the name and contact number for the sender This information is written on a separate card at the front of the Hays DX logbook 6 Place the provided blue security seal sticker over the package closure and dispatch 5 PD MYB R UM_SMRL Version 5 0 Issue date 19 08 2013 Review date 19 08 2015 Author Dr I F Laurenson amp Mike Smith NB THIS IS AN ELECTRONIC DOCUMENT WHICH
11. irector Dr Ewan Olson Deputy Director or Dr Louise Seagar Clinical Scientist for discussions regarding research audit collaboration Quality Assurance The SMRL is committed to high quality laboratory analysis The laboratory participates in the UK National External Quality Assurance NEQAS scheme for Mycobacteria microscopy culture and molecular typing as well as Quality Control for Molecular Diagnostics QCMD for molecular detection in specimens The laboratory also participates in the WHO Drug Proficiency Testing Scheme an external QA scheme for sensitivity testing against first line anti tuberculous drugs We also carry out Internal Quality Assurance IQA SMRL is fully CPA accredited The SMRL Annual Report and User Manual are available on the HPS website 14 PD MYB R UM_SMRL Version 5 0 Issue date 19 08 2013 Review date 19 08 2015 Author Dr I F Laurenson amp Mike Smith NB THIS IS AN ELECTRONIC DOCUMENT WHICH IS UNCONTROLLED WHEN PRINTED Antimicrobial Assays The following information is for assays on first line TB therapy drugs Information on other anti mycobacterial drugs can be found at http www assayfinder com Isoniazid Rifampicin and Ethambutol Dr Alan Hutchings Toxicology Laboratory The Academic Centre Llandough Hospital Penarth CF64 2XX G gt a A 5 Ko Q fa 3 029 2071 6893 029 2035 0142 HutchingsAD cf ac uk Accredited The Therapeutics amp Toxicology Centr
12. microbiological diagnostic tests antibiotic susceptibility tests strain typing for contact tracing and infection control Training and Education Audit Study Day Every two years the laboratory hosts an Audit Study day to allow SMRL staff to meet and discuss various issues with reference laboratory users public health consultants chest physicians and Health Protection Scotland HPS representatives The last meeting was held in June 2012 The next meeting will be held in 2014 Attachments and visits Each year SMRL provides training attachments for staff from other laboratories including Biomedical Scientists Clinical Scientists and Trainee Doctors SMRL also provides support for undergraduate science and medical students MSc students and projects for Trainee Doctors Visits and lectures by SMRL staff to other institutions Staff at SMRL provide teaching and advice at local and national level on invitation particularly in the areas of diagnosis patient management and molecular epidemiology Contact details To discuss short visits to SMRL for training purposes please contact Mr Mike Smith BMS Team Manager in the first instance Research and Audit Staff are willing to collaborate in relevant audit and research activities This may take the form of simple data searches to more formal grant applications dependent on ethical approval where relevant and availability of resources Contact details Please contact Dr Ian Laurenson D
13. nce 3 PD MYB R UM_SMRL Version 5 0 Issue date 19 08 2013 Review date 19 08 2015 Author Dr I F Laurenson amp Mike Smith NB THIS IS AN ELECTRONIC DOCUMENT WHICH IS UNCONTROLLED WHEN PRINTED Contact list Name and Designation Telephone Numbers and e mail Address Mrs Shona Hannan Reference Laboratory Administrator Dr Ian Laurenson Director Dr Ewan Olson Deputy Director Mr Mike Smith BMS Team Manager Mrs Pauline Claxton BMS Section Manager Mrs Christine Doig BMS Section Manager BMS Specialists Mr Gary Davidson Mr Lukman Elabor Mrs Fiona Mathewson Ms Sandra Houston Mr Neil McMinn MTO Mrs Jane Greig Advanced BSW Dr Louise Seagar Clinical Scientist Tel 0131 242 6016 Shona Hannan luht scot nhs uk Tel 0131 242 6079 Tan Laurenson luht scot nhs uk Tel 0131 242 6072 Ewan Olson luht scot nhs uk Tel 0131 242 6009 Michael Smith luht scot nhs uk Tel 0131 242 6009 Pauline Claxton luht scot nhs uk Tel 0131 242 6009 Christine Doig luht scot nhs uk Tel 0131 242 6022 6023 Tel 0131 242 6009 Louise Seagar luht scot nhs uk The service is managed overall by NHS Lothian If we are unable to deal with an issue and you wish to discuss a matter with NHS Lothian Management then contact Mr Ian King Tel 0131 242 7051 mailto Ian King luht scot nhs uk Healthcare Science Manager Cell Sciences NHS Lothian 4 PD MYB R UM_SMRL Version 5 0 Issue da
14. on of MTBC from formalin fixed tissues specimens is available by arrangement Results have to be interpreted with caution Real time PCR using FFPE tissue is a developmental test for which limited technical validation has been performed Accuracy is partly dependant on avoiding laboratory cross contamination not only in microbiology and the PCR suite but also in histopathology Results to date suggest approximately 66 of MTB complex will be detected by this method as compared with concurrent mycobacterial culture FFPE specimens are not suitable for culture Reporting of Results Policy and procedures for telephoned results Previously unknown AFB smear positive or discrepant samples are telephoned as soon as possible usually within 1 working day of receipt New positive cultures obtained from smear negative samples are also phoned as soon as possible after the presence of mycobacteria is confirmed in the culture The following examples will also be telephoned results of direct rapid molecular tests on specimens if findings are unexpected clinically important identification or drug susceptibility test results e g primary resistance to first line drugs acquired new resistance unexpected mycobacterial species new positive cultures from smear negative specimen blood Emailing of reports to secure nhs net accounts is set up already for some user laboratories In some instances no other written report is sent out We can
15. ould be contacted by phone see contact list above or by fax 0131 242 6008 We will issue a receipt or report within one working day from receipt of cultures or samples A completed SMRL request form see page 16 must accompany every culture or specimen Wherever possible please time the posting of samples and cultures to minimise the possibility of these lying unattended over weekends and holidays All requests must provide the following Minimum Data Set information Forms 1 Patient Identifier Number CHI for Scottish patients 2 Postcode of patient where available 3 Sender s Laboratory Number 4 Surname 5 Forename 6 Date of Birth 7 Gender 8 Location of Sender 9 Specimen type or if culture isolate specimen type from which the culture was isolated 7 PD MYB R UM_SMRL Version 5 0 Issue date 19 08 2013 Review date 19 08 2015 Author Dr I F Laurenson amp Mike Smith NB THIS IS AN ELECTRONIC DOCUMENT WHICH IS UNCONTROLLED WHEN PRINTED 10 Any relevant clinical information If results need to be telephoned please supply contact details 11 If possible patient s hospital and consultant Sample Minimum data are also required on the sample container 1 Surname 2 Forename 3 Date of Birth 4 Sample date and time 5 Sample type and site 6 Location of patient 7 Sending Laboratory number if applicable Vials On culture vials patient name and the sender s Laboratory Number are required asa minimum 8
16. rile universal container CSF Disposable plastic sterile universal container Recommended minimum volume of 6mls Stools Disposable plastic sterile universal container with spoon PM specimens Disposable plastic sterile universal container DO NOT USE or larger screw capped sterile container if FORMOL SALINE appropriate OR FORMALIN Cultures Egg medium slopes or aliquots of liquid medium At least 5mls required if grown in liquid medium Paraffin sections for PCR Block section sliced in uncontaminated manner 9 PD MYB R UM_SMRL Version 5 0 Issue date 19 08 2013 Review date 19 08 2015 Author Dr I F Laurenson amp Mike Smith NB THIS IS AN ELECTRONIC DOCUMENT WHICH IS UNCONTROLLED WHEN PRINTED Tests available turn around times and costs Turnaround times for cultures are dependent on receipt of a pure culture containing sufficient mycobacteria for analysis The time interval between receipt of a culture and the issue of the final identification and first line sensitivity report varies greatly from 1 12 weeks depending on factors such as the nature of the culture medium used by the sending laboratory paucity of organisms in the culture the species of Mycobacteria and the presence or absence of contamination The costs for NHS users indicated on page 11 will be reviewed annually They may vary without notice Costs for private tests are available on request 10
17. sed within the Royal Infirmary of Edinburgh Little France Crescent Edinburgh EH16 4SA It is fully integrated with the combined laboratories of the University Hospitals Division of NHS Lothian SMRL is funded through an agreement between National Service Scotland and NHS Lothian University Hospitals Division Some services have been developed which are available at a charge to the user This manual covers three levels of service 1 National Reference services funded by National Services Scotland NSS Services paid for by charging the users per test 3 Local services funded by NHS boards currently NHS Lothian NHS Borders NHS Dumfries and Galloway NHS Highland and NHS Tayside Telephone Fax and Email Enquiries TB Laboratory Tel 0131 242 6022 23 TB Office Tel 0131 242 6016 Confidential Fax in Microbiology Office 0131 242 6008 Shona Hannan luht scot nhs uk Michael Smith luht scot nhs uk Core hours The core laboratory hours are 9am to 5pm Monday to Friday but not weekends Christmas and New Year holidays At other times Lothian laboratory users can discuss urgent AFB microscopy via the Consultant Specialist Registrar on call for clinical bacteriology contact RIE switchboard Tel 0131 536 1000 There is no out of hours AFB screening or Reference Laboratory service For urgent enquiries out of hours the on call Consultant Microbiologist may be contacted through the RIE switchboard Tel 0131 536 1000 in the first insta
18. te 19 08 2013 Review date 19 08 2015 Author Dr I F Laurenson amp Mike Smith NB THIS IS AN ELECTRONIC DOCUMENT WHICH IS UNCONTROLLED WHEN PRINTED Packing and Transport of Infectious Substances Postal Address DX Address Scottish Mycobacteria Reference Laboratory Exchange Edinburgh 96 EH Department of Laboratory Medicine DX Number DX6231201 Royal Infirmary of Edinburgh 51 Little France Crescent Old Dalkeith Road Edinburgh EH16 4SA NB Infectious substances may only be transported in packaging which meets the U N Class 6 2 specifications and the 602 packing requirements All Cultures must be sent by DX NOT by post Packaging Mycobacteria Cultures or Samples 1 Remove any water of condensation from the solid culture vial s taking normal safety precautions for handling cultures 2 Seal the cap with parafilm 3 Wrap individual vials in sufficient absorbent material to absorb all the liquid in the vial and to protect it from breakage 4 Seal this package twice in plastic bags For posting by First Class Post Samples Only Place the wrapped sample inside the inner container of the packaging and tighten the lid Place the inner container into the outer cardboard box Close the box and secure with tape Stick address label on the top of the box Stick From label with senders address on the bottom of the box Post by First Class Post or courier such as DX for samples Cultures must be sent by DX or equival
19. ulate all specimens into liquid and solid media Drug susceptibility testing Susceptibilities are routinely performed on the first isolate from each patient and then only repeated at 3 month intervals Molecular tests Smear positive respiratory samples are tested by rapid molecular tests if sufficient quantity is received Immunology Interferon Gamma Release Assay IGRA Testing is not currently performed in house Alternative providers for IGRA testing using the Quantiferon TB Gold In Tube Assay are 6 PD MYB R UM_SMRL Version 5 0 Issue date 19 08 2013 Review date 19 08 2015 Author Dr I F Laurenson amp Mike Smith NB THIS IS AN ELECTRONIC DOCUMENT WHICH IS UNCONTROLLED WHEN PRINTED 1 National Mycobacterium Reference Laboratory Abernethy Building Institute of Cell and Molecular Science ICMS 2 Newark Street Whitechapel London El 2AT Tel 020 7377 5895 mailto v nikolayevskyy qmul ac uk 2 Newcastle HPA Regional Mycobacterial Reference Laboratory Level 2 Freeman Hospital High Heaton Newcastle upon Tyne NE7 7DN Tel 0191 282 1150 anne barrett hpa org uk The T spot assay is another IGRA which is available from Oxford Immunotec 115D Milton Park Abingdon Oxfordshire OX14 4RZ Tel 44 0 1235 442 780 Fax 44 0 1235 442 781 www oxfordimmunotec com Users should inform us in advance of cultures or specimens that are being sent by post or courier A staff member of the SMRL sh
20. usceptibility microdilution mycobacteria testing of Rapid Growers Rapid Real Time PCR Weekly Tuesday Test is only validated First smear ve respiratory molecular pm Wednesday pm for respiratory samples samples are free to NHS detection of Scotland users otherwise the MTBC charge is 130 Rapid Genotype Weekly Wednesday rifampicin and MTBDR plus pm Thursday am isoniazid resistance detection Molecular Weekly All new TB patients genotyping of isolates are typed M tuberculosis Currently 24 locus MIRU VNTR Newer technologies such as next generation sequencing may become available shortly Media QC On request 6 8 weeks Paraffin Real Time PCR Weekly Tuesday 78 for NHS users sections for pm Wednesday pm on request molecular detection of MTBC 11 PD MYB R UM_SMRL Version 5 0 Issue date 19 08 2013 Review date 19 08 2015 Author Dr I F Laurenson amp Mike Smith NB THIS IS AN ELECTRONIC DOCUMENT WHICH IS UNCONTROLLED WHEN PRINTED Molecular detection of mycobacteria in specimens Note on rapid molecular tests False negatives and false positives can and do occur We currently use an in house real time PCR for the direct detection of MTBC in specimens and we continue to use the Genotype MTBDRplus kit Hain Lifescience for the direct detection of rifampicin and isoniazid resistance in samples From time to time alternative methods such as the Cepheid X Pert may be used Direct detecti
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