STATEWIDE SURVEY OF LABORATORIES PERFORMING MYCOBACTERIUM-TUBERCULOSIS TESTING IN MINNESOTA

RAPID AND ACCURATE laboratory detection and identification of Mycobact erium tuberculosis, particularly multidrug-resistant strains, is criti cal to both public health control measures and patient management. The authors surveyed microbiology laboratories to evaluate whether their methods met national guidelines, As needed, laboratories received indi vidualized recommendations for improvement. The laboratories were resu rveyed a year later to assess changes in methods. Current guidelines r ecommend fluorochrome acid-fast smears, broth cultures, identification by nucleic acid probe or BACTEC-NAP, and BACTEC primary susceptibilit y panels, which should include pyrazinamide. Of 27 laboratories perfor ming acid-fast smears, 15 used fluorochrome methods, Six of 16 laborat ories performing mycobacterial cultures used broth media, Of six labor atories performing species identification, five used nucleic acid prob es or BACTEC-NAP. Of five laboratories evaluating drug sensitivity, tw o used BACTEC and two included pyrazinamide in their protocols. Overal l, 24 (89%) laboratories needed improvements; a year later 16 (67%) of those had altered their methods or made definite plans to do so. Surv ey results suggest that health departments can facilitate improvements in laboratory testing for pathogens of public health importance.