Perform Gram stain only. Select Survey D5, Gram Stain

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1 Bacteriology This flowchart is provided as a guide for ordering the appropriate Bacteriology Surveys for your laboratory s testing menu. In order to meet CLIA requirements for the subspecialty of bacteriology, five specimens must be reported for each mailing. If you have any questions, please contact the CAP Customer Contact Center at option 1. Begin Do you perform cultures, antigen detection, and Gram stains? Do you perform extensive microbiology procedures including: identification of aerobes and anaerobes isolation from multiple sites antimicrobial susceptibility testing Gram stain Yes antigen detection No No Perform Gram stain only. Select Survey D5, Gram Stain Do you perform limited Microbiology procedures which may include: throat, urine, blood, and GC cultures antimicrobial susceptibility testing Gram stain antigen detection No Do you perform Group B Streptococcus Antigen testing? No Do you perform Group A Streptococcus Antigen testing? Yes Do you perform bacteriology antigen detection only? Yes Yes Yes Select Survey D8 Group B Rapid Streptococcus Antigen Detection Select Survey D6 Rapid Strep Antigen Detection or Survey D9 Rapid Strep Antigen Detection, Waived Do you perform Chlamydia Antigen Detection? Yes Yes No Yes Select Survey D Comprehensive Bacteriology Yes Consider enrollment in LPX Laboratory Preparedness Exercise. This Survey is not designed to meet CLIA requirements Select from among Surveys: D1 Throat Culture D2 Urine Culture D3 GC Culture D4 Limited Bacteriology Survey (Throat, Urine, and GC Cultures) D7 Urine and Throat Culture BCS Blood Culture Consider Survey BAS for Bacterial Antigens. This Survey is not designed to meet CLIA requirements Select from: HC1 Chlamydia Antigen (DFA) Detection HC3 Chlamydia EIA HC5 Chlamydia Antigen Detection by DNA Probe HC6 Chlamydia Antigen Detection by Nucleic Acid Amplification 2008 Surveys & Anatomic Pathology Education Programs Bacteriology 123

2 Option 1 for Customer Contact Center Bacteriology Category 1 CME CE Analytes/procedures in bold type are regulated for proficiency testing by the Centers for Medicare & Medicaid Services (CMS). Bacteriology D Procedure D Challenges per Shipment Antimicrobial susceptibility testing 1-graded, 1-ungraded Bacterial antigen detection 2 Bacterial identification 5 Gram stain 1 Survey D is designed for laboratories performing extensive microbiology procedures (bacterial identification of aerobes and anaerobes, isolation from multiple sites, antimicrobial susceptibility testing, Gram stain, and antigen detection). Laboratories offering a more limited range of testing should consider enrolling in Bacteriology (Limited) Survey D4 or individual Surveys D1, D2, D3, D5, D6, D7, D8, and D9. Note: Concurrent enrollment in Survey D with Surveys D1-D9 is not recommended due to the duplication of some organisms. Each shipment will include five specimens, in duplicate, and two specimens for antigen detection. Antigen detection challenges will be offered in the following shipments: A - Clostridium difficile toxin/antigen and Spinal Fluid Meningitis Panel B - Clostridium difficile toxin/antigen and Group A Streptococcus C - Group A Streptococcus and Spinal Fluid Meningitis Panel An education activity is planned that includes reading material found in the Participant Summary/Final Critique and online learning assessment questions. All laboratory staff can participate individually and earn free CME/CE credit without leaving the laboratory. Handle with Care Specimens included in the Bacteriology Surveys may contain pathogens and must be handled with extreme care. These specimens must be dealt with and disposed of only by trained laboratory personnel. 124 Bacteriology College of American Pathologists

3 Throat, Urine, GC Cultures D1, D2, D3, D7 Procedure D1 D2 D3 D7 Challenges per Shipment Antimicrobial susceptibility testing 1 Bacterial identification 5 Gram stain 1 Culture source: Throat Urine Various sources Throat/urine Microbiologic level: Presence or Pathogens Presence or Combination absence of and/or absence of of two throat Group A contaminants Neisseria and three Streptococcus identified to the gonorrhoeae urine culture determination extent of your determination specimens laboratory s protocol Surveys D1, D2, D3, and D7 are designed for the laboratory performing a limited menu of microbiology procedures. Each shipment of Surveys D1, D2, D3, and D7 will contain five specimens in duplicate. Survey D7 will contain two throat and three urine culture specimens. Blood Culture BCS Analytes BCS Challenges per Shipment Blood culture bacterial identification 2 Survey BCS is designed for laboratories performing microbiology procedures for the detection and identification of organisms in blood cultures. Each shipment will contain two challenges for inoculation of blood culture bottles. Note: Since 5 specimens must be reported for each mailing for the subspecialty of bacteriology, participation in this Survey only will not meet CLIA regulatory requirements Surveys & Anatomic Pathology Education Programs Bacteriology 125

4 Option 1 for Customer Contact Center Bacteriology (Limited) D4 Procedure D4 Challenges per Shipment Antimicrobial susceptibility testing 1 Bacterial antigen detection 1 Bacterial identification 5 Gram stain 1 Culture types: Microbiologic level: Throat culture Presence or absence of Group A Streptococcus determined Urine culture Pathogens and/or contaminants identified to the extent of your laboratory s protocol GC culture Presence or absence of Neisseria gonorrhoeae determined Survey D4 is designed for the laboratory performing moderately comprehensive microbiology procedures. Each shipment of Survey D4 will contain five inoculated loop specimens, in duplicate, and one swab specimen for Group A Streptococcus antigen detection. Gram Stain D5 Procedure D5 Challenges per Shipment Gram stain 5 Survey D5 includes two purulent smear challenges per shipment. Each shipment will contain five air-dried, methanol-fixed, unstained glass slides. 126 Bacteriology College of American Pathologists

5 Rapid Strep Antigen Detection D6 Procedure D6 Challenges per Shipment Group A Streptococcus antigen detection 5 Each shipment will contain five swab specimens. Group B Strep Antigen Detection Analyte D8 Challenges per Shipment Group B Streptococcus antigen detection 5 D8 Each shipment will contain five swab specimens. Methicillin Resistant Staphylococcus aureus Screen MRS Analyte MRS Challenges per Shipment MRSA detection 2 New Survey MRS is designed for laboratories performing screening testing for the detection of Methicillin Resistant Staphylococcus aureus from a swab. Shiga Toxin ST Analyte ST Challenges per Shipment Shiga toxin 2 New Each shipment will include two liquid simulated stool specimens for direct shiga toxin testing Surveys & Anatomic Pathology Education Programs Bacteriology 127

6 Option 1 for Customer Contact Center Rapid Strep A Antigen Detection, Waived D9 Procedure D9 Challenges per Shipment Group A Streptococcus antigen detection 2 Survey D9 is designed for laboratories performing testing for the detection of Group A Streptococcus antigen using a waived method. Bacterial Antigen Detection BAS Challenges per Shipment Analyte BAS A B Legionella bronchoalveolar lavage 1 Bordetella pertussis/parapertussis nasal wash 1 1 Streptococcus pneumoniae urine 1 Survey BAS shipments will include lyophilized, liquid, or simulated clinical specimens for bacterial antigen detection by the methods commonly used for testing (eg, direct fluorescent antibody [DFA], enzyme immunoassay [EIA], latex agglutination, optical immunoassay [OIA]). Legionella Antigen Detection (Urine) LAS Analyte LAS Challenges per Shipment Legionella pneumophila 2 Each shipment will include two 0.5-mL liquid urine specimens to be used for detection of Legionella pneumophila antigen by enzyme immunoassay (EIA) or immuno-chromatographic methods. 128 Bacteriology College of American Pathologists

7 Helicobacter pylori Antigen, stool HPS Procedure HPS Challenges per Shipment Helicobacter pylori antigen detection 2 Survey HPS is designed for laboratories performing enzyme immunoassay (EIA) testing for Helicobacter pylori antigen in stool. Each shipment will include two 0.5-mL fecal suspensions. Vaginitis Screen Antigen Detection VS, VS1 Analyte VS VS1 Challenges per Shipment Gardnerella vaginalis 5 Candida sp. 5 Trichomonas vaginalis 5 Each shipment will include five simulated vaginal fluid specimens to be used for identification by DNA probe technology. Survey VS is intended for testing using the BD Affirm VP III antigen detection method. Survey VS1 is intended for testing using the Genzyme OSOM Trichomonas Rapid Test method. Product Fulfillment Group VS Laboratory Preparedness Exercise LPX Analyte/Procedure LPX Challenges per Shipment Live organisms 5 New The Laboratory Preparedness Exercise was developed as a collaborative effort between the College of American Pathologists, the Center for Disease Control and Prevention, and the Association of Public Health Laboratories. The exercise tests the preparedness of laboratories across the United States to handle potential public health emergencies related to bioterrorism agents. Laboratories will be sent live organisms that exhibit characteristics of bioterrorism agents and will be expected to respond following Laboratory Response Network protocols. All agents provided are excluded from the CDC s select agent list. These may include strains of Bacillus anthracis, Yersinia pestis, Francisella tularensis, and Brucella abortus that have been modified and are safe for testing in a laboratory that contains a certified, properly functioning Class II Biological Safety Cabinet and is capable of handling Category A and B agents Surveys & Anatomic Pathology Education Programs Bacteriology 129

8 Option 1 for Customer Contact Center Mycobacteriology Analytes/procedures in bold type are regulated for proficiency testing by the Centers for Medicare & Medicaid Services (CMS). Mycobacteriology E Procedure E Challenges per Shipment Acid-fast smear 1 Antimycobacterial susceptibility testing 1 Mycobacterial identification 5 Survey E is designed for laboratories performing comprehensive mycobacteriology procedures. Each shipment will include five simulated clinical isolates for mycobacterial identification (one of which is to be used for antimycobacterial susceptibility testing), plus one specimen for performing an acid-fast bacillus (AFB) smear. Mycobacteriology (Limited) E1 Procedure E1 Challenges per Shipment Acid-fast smear 5 Mycobacterial culture 5 Survey E1 is designed for laboratories performing concentration for acid-fast bacillus (AFB) smears and/or isolating mycobacteria to be referred to another laboratory for identification. Each shipment will include five simulated sputum specimens for acid-fast smears and/or for the determination of the presence or absence of AFB by culture. 130 Mycobacteriology College of American Pathologists

9 Mycology Analytes/procedures in bold type are regulated for proficiency testing by the Centers for Medicare & Medicaid Services (CMS). Mycology F Procedure F Challenges per Shipment Antifungal susceptibility testing 1 Cryptococcal antigen detection 2 per year Mold and yeast identification 5 Category 1 CME CE Survey F is designed for laboratories performing more extensive mycology procedures, with challenges provided for yeast, dermatophytes, actinomycetes, and other molds. Laboratories offering a more limited range of testing should consider Survey F1. Note: Concurrent enrollment in Survey F and Survey F1 is not recommended due to duplication of some organisms. Each shipment will include five challenges, in duplicate, along with one antifungal susceptibility challenge. Two simulated cerebrospinal fluid (CSF) specimens will be provided per year for cryptococcal antigen detection. Challenges for cryptococcal antigen detection will be included in the A and B shipments. Note: Those laboratories performing India Ink preparations may now order the CAP s India Ink Survey IND, found on page 132. An education activity is planned that includes reading material found in the Participant Summary/Final Critique and online learning assessment questions. All laboratory staff can participate individually and earn CME/CE credit without leaving the laboratory. Yeast F1 Procedure F1 Challenges per Shipment Antifungal susceptibility testing 1 Cryptococcal antigen detection 2 per year Yeast identification 5 Survey F1 is designed for laboratories performing only yeast cultures and/or cryptococcal antigen detection. Each shipment will include five challenges, in duplicate, along with one antifungal susceptibility challenge. Two simulated cerebrospinal fluid (CSF) specimens will be provided per year for cryptococcal antigen detection. Challenges for cryptococcal antigen detection will be included in the A and B shipments. Note: Those laboratories performing India Ink preparations may now order the CAP s India Ink Survey IND, found on page Surveys & Anatomic Pathology Education Programs Mycology 131

10 Option 1 for Customer Contact Center India Ink IND Procedure IND Challenges per Shipment India Ink 2 Each shipment will include two specimens to be used for detection of capsule production. Note: Please see Mycology Surveys F and F1 described on page 131, which include challenges for cryptococcal antigen detection. Receive PT results faster with e-lab Solutions! Improve confidence in your laboratory s quality by accessing evaluations sooner online. Visit for more information. 132 Mycology College of American Pathologists

11 Parasitology Analytes/procedures in bold type are regulated for proficiency testing by the Centers for Medicare & Medicaid Services (CMS). Parasitology P, P3, P4, P5 Challenges per Shipment Procedure P P3 P4 P5 Fecal suspension (wet mount) Fecal suspension (Giardia and/or Cryptosporidium immunoassay and modified acid fast stain) Giemsa-stained blood smear 1 Preserved slide (for permanent stain) 2 3 Parasitology Survey options have been designed to allow laboratories to choose the option that most closely matches their test menu and ensure compliance with CLIA requirements. To meet CLIA requirements for the subspecialty of parasitology, you must test five specimens per mailing. Each shipment will include: Survey P will include one thin and one thick film for blood or tissue parasite identification, two preserved slides, two 0.75-mL fecal suspensions for direct wet mount examination, and two 0.75-mL fecal suspensions for Giardia and/or Cryptosporidium immunoassay testing and modified acid fast stain. Survey P3 will include five 0.75-mL fecal suspensions for direct wet mount examination and one fecal suspension for Giardia and/or Cryptosporidium immunoassay testing and modified acid fast stain. Survey P4 will include two 0.75-mL fecal suspensions for direct wet mount examination, three preserved slides for permanent stain, and one 0.75-mL fecal suspension for Giardia and/or Cryptosporidium immunoassay testing and modified acid fast stain. Survey P5 will include five 0.75-mL fecal suspensions for Giardia and/or Cryptosporidium immunoassay and modified acid fast testing. Note: Laboratories that perform only Giemsa-stained blood smear should enroll in Survey BP found on page 134. Note: Modified acid fast stain results do not meet CLIA requirements for Parasite Identification. Product Fulfillment Group P Note: The proficiency materials used for Parasitology Survey contain formalin as a preservative. Check your methodology prior to ordering this Survey Surveys & Anatomic Pathology Education Programs Parasitology 133

12 Option 1 for Customer Contact Center Blood Parasite BP Procedure BP Challenges per Shipment Thick blood film, Giemsa-stained 5* Thin blood film, Giemsa-stained 5 Survey BP meets regulatory requirements for laboratories performing only blood parasite testing. Survey BP will consist of five thin blood films and five corresponding thick films (*when available) per shipment. The samples will include a variety of blood parasites, including Plasmodium, Babesia, Trypanosoma, and a variety of filarial worms. Thick film examination is the gold standard for detection of blood parasites, and this Survey will allow participants to compare the thick and thin film appearance of a wide variety of blood parasites. 134 Parasitology College of American Pathologists

13 Virology and Molecular Microbiology Testing This flowchart is provided as a guide for ordering the appropriate Virology and Molecular Microbiology Surveys for your laboratory s testing menu. In order to meet CLIA requirements for the subspecialty of virology, you must test five specimens per mailing. If you have any questions, please contact the CAP Customer Contact Center at option 1. Virology Molecular Microbiology Do you perform any of the following Virology testing: Virology Culture Virology Antigen Testing Virology Antibody Testing Yes Do you perform molecular testing Chlamydia or GC only Do you perform nucleic acid amplification other than GC? Do you perform viral load testing only? For Comprehensive Virology Culture Testing For Virology Antigen Testing by Immunofluorescence For Comprehensive Virology Antibody Testing For Viral Antibody Testing for Mumps, lgg For Virology Antigen by EIA or Latex Agglutination For Herpes Simplex Virus Antigen Detection by DFA For Herpes Simplex Virus Culture Testing Select VR1 Select VR2 Select VR3 Select VR3M Select VR4 Select HC2 Select HC4 Select from the following Surveys: HC5 Chlamydia/ GC DNA Probe or HC6 Chlamydia/ GC Nucleic Acid Amplification Yes Yes Yes Select ID, IDV Nucleic Acid Amplification Survey Select from the following Surveys: HIV, HV2 HIV Viral Load HCVN, HCV2, HBVL Hepatitis Viral Load VLS, CMV, BK, and EBV Viral Load Survey 2008 Surveys & Anatomic Pathology Education Programs Virology 135

14 Option 1 for Customer Contact Center Virology Analytes/procedures in bold type are regulated for proficiency testing by the Centers for Medicare & Medicaid Services (CMS). Virology Culture VR1 Procedure VR1 Challenges per Shipment Chlamydia trachomatis culture 1 Viral isolation/identification 5 Survey VR1 may include the following viral cultures: adenoviruses, influenza viruses, parainfluenza viruses, respiratory syncytial virus (RSV), cytomegalovirus (CMV), herpes simplex viruses (HSV), enteroviruses, varicella-zoster virus (VZV), and Chlamydia trachomatis. Each shipment will contain five 2.0-mL specimens for viral isolation and identification, and one 1.0-mL specimen for Chlamydia trachomatis culture. Virology Antigen Detection (DFA) VR2 Challenges per Shipment Analyte VR2 VR2-A VR2-B VR2-C Adenovirus antigen 1 1 Cytomegalovirus antigen 1 1 Herpes simplex virus (HSV) antigen 1 1 Influenza A antigen 1 1 Influenza B antigen 1 Parainfluenza antigen 1 1 Respiratory syncytial virus (RSV) antigen 1 1 Varicella-zoster antigen 1 1 Survey VR2 is designed for participants using direct immunofluorescence (DFA) methods for viral antigen detection. Challenges are distributed in shipments as indicated above. Each shipment will contain five 5-well slides. Handle with Care Specimens included in the Virology Surveys may contain pathogens and must be handled with extreme care. These specimens must be dealt with and disposed of only by trained laboratory personnel. 136 Virology College of American Pathologists

15 Virology Antibody Detection VR3, VR3M Analyte VR3 VR3M Challenges per Shipment Cytomegalovirus (CMV) IgG, IgM, and total antibodies 1 Epstein-Barr virus (EBV) 1 VCA: IgG, IgM EBNA: IgG, IgM, and total antibodies EA-IgG Helicobacter pylori IgG, IgA, and total antibodies 1 Herpes simplex virus (HSV) IgG antibody 1 Mycoplasma pneumoniae IgG, IgM, and total antibodies 1 Mumps IgG NEW 1 Rubeola virus IgG antibody 1 Toxoplasma gondii IgG, IgM, and total antibodies 1 Varicella-zoster virus IgG and total antibodies 1 VR3 will contain eight 0.5-mL lyophilized plasma specimens. VR3M will contain one 0.5-mL lyophilized plasma specimen. Product Fulfillment Group VR3 Virology Antigen Detection VR4 Analyte VR4 Challenges per Shipment Adenovirus (Respiratory) antigen 5 Influenza A antigen 5 Influenza B antigen 5 Respiratory syncytial virus (RSV) antigen 5 Rotavirus antigen 5 Survey VR4 is designed for participants using enzyme immunoassay and/or latex agglutination methods for viral antigen detection. Challenges may be tested for any or all of the listed viruses. Each shipment will contain five specimens. Participants are instructed to test for all viruses tested in their laboratories Surveys & Anatomic Pathology Education Programs Virology 137

16 Option 1 for Customer Contact Center Tick-Transmitted Diseases TTD Analyte TTD Challenges per Shipment Antibody to tick-transmitted disease organisms 5 Survey TTD includes educational critiques, as well as challenging sera for the detection of antibodies to Borrelia burgdorferi, Babesia microti, and Anaplasma phagocytophilum. Each shipment will include five to 0.50-mL liquid serum specimens. Want to stay tuned to the latest developments in laboratory medicine? Be sure to read CAP TODAY! This monthly publication, recognized as the premier publication for laboratory information, is filled with important and relevant articles on a myriad of topics, ranging from new technological developments to health care market dynamics, and many other topics. Free to all qualified laboratorians. 138 Virology College of American Pathologists

17 C. trachomatis, Herpes, N. gonorrhoeae HC1-HC6, HC6X Procedure HC1 HC2 HC3 HC4 HC5 HC6 HC6X Challenges per Shipment Chlamydia trachomatis Antigen detection (DFA) 5 Enzyme immunoassay (EIA) 5 DNA probe 5 Nucleic acid amplification (NAA) 5 Herpes simplex virus (HSV) Antigen detection (DFA) 5 Culture 5 Neisseria gonorrhoeae DNA probe 5 Nucleic acid amplification (NAA) 5 Note: Biohazard warning refers to Surveys HC4, HC5, and HC6 Concurrent enrollment in Surveys HC2 and HC4 is not recommended. (Laboratories confirming HSV cultures by direct immunofluorescent methods should enroll in Survey HC4 only.) Survey HC5 cannot be used for nucleic acid amplification (NAA) methods; laboratories using NAA technology for C. trachomatis and N. gonorrhoeae should order Survey HC6. Laboratories using nucleic acid probe (NAP) methods for C. trachomatis and N. gonorrhoeae should order Survey HC5. HC1 C. trachomatis antigen detection (DFA) Five 5-well slides HC2 Herpes simplex virus antigen detection (DFA) Five 5-well slides HC3 C. trachomatis enzyme immunoassay Five 2.0-mL liquid specimens (EIA only) HC4 Herpes simplex virus culture Five 2.0-mL viral suspensions HC5 C. trachomatis and N. gonorrhoeae Five swab specimens* by DNA probe HC6 C. trachomatis and N. gonorrhoeae Three swab specimens* and two simulated by nucleic acid amplification urine specimens HC6X C. trachomatis and N. gonorrhoeae Three swab specimens* and two by nucleic acid amplification simulated urine specimens (each sent in duplicate) for those methods that require additional volume. * For Surveys HC5 and HC6, each swab is used to perform both C. trachomatis and N. gonorrhoeae testing Surveys & Anatomic Pathology Education Programs Virology 139

18 Option 1 for Customer Contact Center Molecular Microbiology Analytes/procedures in bold type are regulated for proficiency testing by the Centers for Medicare & Medicaid Services (CMS). HIV Viral Load HIV, HV2 Analyte/Procedure HIV HV2 Challenges per Shipment HIV-RNA 5 HIV genotyping 1 Survey HIV is designed for laboratories performing analysis of human immunodeficiency virus (HIV) by nucleic acid amplification and will include quantitative challenges. Survey HV2 is an available option with additional material for users of methods requiring a testing volume greater than 0.5-mL. Surveys HIV and HV2 are also available for laboratories performing genotyping. Each shipment of Survey HIV will contain five 0.5-mL specimens. Each shipment of Survey HV2 will contain five 2.5-mL specimens. Product Fulfillment Group HIV Hepatitis Viral Load HCVN, HCV2, HBVL Analyte HCVN HCV2 HBVL Challenges per Shipment HCV viral load 5 HCV genotyping 1 HCV, qualitative 1 HBV viral load 1 Survey HCVN is designed for laboratories performing analysis of hepatitis virus by nucleic acid amplification and will include quantitative challenges. Survey HCV2 is an available option with additional material for users of methods requiring a testing volume greater than 0.5-mL. Surveys HCVN and HCV2 may also be used by laboratories performing qualitative analysis and genotyping. Each shipment of Survey HCVN will contain five 0.5-mL liquid specimens. Each shipment of Survey HCV2 will contain five 1.5-mL liquid simulated plasma specimens. Survey HBVL allows laboratories to perform quantitative testing for Hepatitis B virus by nucleic acid amplification. Each shipment of HBVL will contain one plasma specimen. Product Fulfillment Group HVL 140 Molecular Microbiology College of American Pathologists

19 CMV and EBV Viral Load VLS Analyte VLS Challenges per Shipment CMV viral load 2 EBV viral load 2 BK viral load NEW 2 Survey VLS is designed for laboratories performing analysis of viral load by nucleic acid amplification and will include quantitative challenges. Each shipment will include six 0.5-mL EDTA plasma specimens Surveys & Anatomic Pathology Education Programs Molecular Microbiology 141

20 Option 1 for Customer Contact Center Nucleic Acid Amplification ID, IDV Analyte/Procedure ID IDV Challenges per Shipment Bordetella pertussis/parapertussis 1 Cytomegalovirus 1 Enterovirus 1 Hepatitis B virus 1 Herpes simplex virus (HSV) 1 Mec A detection 1 Molecular typing (bacterial isolates) 1 Mycobacterium tuberculosis 1 Adenovirus 1 Epstein Barr virus 1 HHV6 1 HHV8 1 Influenza 1 Metapneumovirus 1 Norovirus 1 Parvovirus B19 1 Varicella zoster virus 1 New Surveys ID and IDV are intended for advanced clinical microbiology or special-function laboratories performing nucleic acid amplification techniques (ie, PCR, LCR, bdna, NASBA). These Surveys are not intended to meet requirements for procedures regulated for proficiency testing. Each shipment will contain serum, plasma, or simulated clinical isolate specimens. Human Papillomavirus HPV Analyte HPV Challenges per Shipment Human papillomavirus 2 Survey HPV is for laboratories performing nucleic acid amplification techniques for HPV. Each shipment will include simulated cervical specimens contained in Digene transport media. Note: This survey is not intended to meet requirements for procedures regulated for proficiency testing. 142 Molecular Microbiology College of American Pathologists