CHANGING PRACTICES IN MYCOBACTERIOLOGY - A FOLLOW-UP SURVEY OF STATE AND TERRITORIAL PUBLIC-HEALTH LABORATORIES

The resurgence of tuberculosis, which includes an increase in the isol ation of multidrug-resistant strains of Mycobacterium tuberculosis, em phasizes the need for more rapid laboratory testing for identification of the etiological agent of the disease. In December 1991, state adn territorial public health laboratories were surveyed to determine the methods that they were using for testing and reporting of M. tuberculo sis. A follow-up survey was conducted in June 1994 to measure changes in the testing and reporting practices that had occurred as a result o f efforts focused in the disease and on laboratory improvement. Comple ted questionnaires were received from 51 of 55 laboratories. Comparati ve data indicate that the proportion of laboratories reporting testing results within the number of days recommended by the Centers for Dise ase Control and Prevention has increased. Starting from the time at wh ich the laboratory received the specimen, the proportion of laboratori es reporting the results of microscopic smear examination within the r ecommended 24 h has increased from 52.1 to 77.6%; the proportion repor ting isolation and identification within 21 days has increased from 22 .1 and 72.9%; and the proportion reporting results of isolation, ident ification, and drug susceptibility testing within 28 days has increase d from 16.7 to 48.9%. Use of the recommended rapid testing methods has also increased: the proportion of laboratories using fluorescence sta ining for acid-fast microscopy has increased from 71.4 to 85.7%, the p roportion using BACTEC for primary culture has increased from 27.1 to 79.6%, the proportion using rapid methods for M. tuberculosis identifi cation has increased from 74.5 to 100.0%, and the proportion using BAC TEC for primary drug susceptibility testing has increased from 26.2 to 73.3%. By implementing the recommended methods for M. tuberculosis te sting and reporting, state and territorial public health laboratories are now able to transmit results to physicians more rapidly.