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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.
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| Test: |
AFB MDDR Susceptibility Testing
Supplemental Forms Required – Mycobacterium tuberculosis (MTB) Supplemental
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| Synonym: |
MTB DST, TB, Tuberculosis, MTBC
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| Method: |
Targeted DNA Sequencing (Pyrosequencing or Sanger sequencing based on submission criteria provided by submitter), Agar Proportion DST, MGIT 960 Pyrazinamide (PZA) also performed for sediments and isolates,
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| Availability: |
Monday - Thursday
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| Specimen: |
Nucleic Acid Amplification positive (NAA+) sediment; pure culture isolate on solid medium or in broth culture; Mixed cultures known to contain MTBC; DNA
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| Collection Device: |
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
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| Volume: |
0.5 mL (sediment)
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| Storage/Transport: |
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: 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/
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| Unacceptable: |
Sediment should not be shipped frozen.
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| Specimen Stability: |
Sediment should be refrigerate at 2-8°C, keep isolate at room temperature.
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| Reference Interval: |
Susceptible or Resistant
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| Reportable Disease: |
MTB susceptibilities will be reported immediately to local or state health department. Refer to Nebraska DHHS Title 173, Communicable Diseases.
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| Comments: |
Pre-approval is required for this test using the Molecular Detection of Drug Resistance Request Form
Samples with low numbers of MTBC may not amplify; Heteroresistance may not be detected; the results of MDDR assay should not be used to rule out the presence of MTBC in a sample. TAT ranges from 1-6 calendar days
Molecular Detection of Drug Resistance Request Form (CDC-002-00220) http://www.cdc.gov/tb/topic/laboratory/MDDRsubmissionform.pdf . Provide the following Specimen Information on the CDC 50.34 Specimen Submission Form.
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| Revised: |
9/4/2020 |
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If you have questions about proper specimen collection, please call NPHL Client Services at (402) 559-2440 or toll free at (866) 290-1406.
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