Mycobacteria Diagnostic Testing in Manitoba. Dr. Michelle Alfa Medical Director, DSM Clin Micro Discipline
|
|
- Jessica Blake
- 5 years ago
- Views:
Transcription
1 Mycobacteria Diagnostic Testing in Manitoba Dr. Michelle Alfa Medical Director, DSM Clin Micro Discipline
2 Acknowlegements: Assunta Rendina: Charge Tech HSC Lab Joyce Wolf & Dr. Meenu Sharma: NML Dr. Kanchana Manickam: DSM Section Lead Mycobacteriology
3 Overview: Provincial TB services: - Sites offering services - Benchmarks for TATs Genetic resistance testing -new service Followup for TB patients: - Time to smear negative Future: Direct TB testing
4 TB. or Not TB?? That is the question Pathogen: M.tuberculosis Transmission: Airborne Disease: -Active TB disease - Latent TB Infection (LTBI) ~5% active TB Diagnosis of Active TB: Culture is the Gold standard Respiratory Non-Respiratory
5 TB Culture in Manitoba: DSM Cadham Provincial Lab: Rural site specimen referral point St. Boniface Hospital Site: AFB, Culture, Probe, ID & Sens HSC Health Sciences Centre Site: Full service: AFB, Culture, Probe, Sensitivity testing, ID NML National Microbiology Lab: M.tuberculosis ID Sensitivity testing
6 Processing & smear volumes to maintain competency [MMWR Nov 4, 2005;volume 54:RR-12] Competency Benchmarks: - Smears: AFB smears/week (~ /yr) - Cultures: 20 AFB cultures/week (~1000/yr) Manitoba: ~ 10,000 specimens processed/year - HSC: ~8000/year (includes rural, WL & Wpg private labs) - SBGH: ~2000/year
7 Specimen delivery time-frame Manitoba Sites Site: WRHA Winnipeg (private) Rural North of Gimli Rural South of Gimli Average # days for Specimen transit (range): 1 (1 day) 3 (1-8 days) 4 (1-9 days) 2 (1-7 days) Longer transit times cause delays in reporting risk of TB transmission
8 MTB Benchmarks for Transport & Turn Around Time CDC/ATS MMWR Nov 4, 2005;volume 54:RR-12 AFB Smear: 24 hours from receipt of specimen Culture (detect growth & identify isolate by probe): 21 days from receipt of specimen Antimicrobial Susceptibility Testing (AST) results: 30 days from receipt of specimen
9 Specimen Collection/Processing: Suspected Respiratory TB Three early morning sputum samples (refridgerate if transit > 24 hrs) Induced sputum Bronchoalveolar Lavage (BAL) Gastric aspirate Liquid & Solid media Automated: liquid culture Decontaminated & concentrated Microscopy Solid media: slow Kinyoun AFB stain
10 Index Cases: TB ~34% are AFB smear positive from concentrated sample Smear TAT meets 1 day benchmark except for weekends (range 1 3 days) Average time to detect growth: 16.6 days, MTB complex probe same day (meets 21 day benchmark) MP bottles sent to NML (Level III containment) for AST and ID of M.tuberculosis
11 Testing at NML: Subculture MP bottle to MGIT bottle After 3-5 days growth in MGIT: confirm ID as M.tuberculosis detect resistance mutations (takes ~3 days to complete) set up AST for 1 st line agents (takes 14 days to finalize) April 16, 2012 Genetic resistance mutations report issued
12 Testing at NML: Genetic resistance test:~ 7-10 days If no problems and all agents are susceptible: ~ 3 week TAT in total If resistance detected:ast testing must be repeated: ~ 4 5 week TAT in total
13 Molecular resistance reporting Rifampin: will be reported Isoniazid: will be reported Pyrazinamide: will be reported Ethambutol: will NOT be reported The correlation between the detection of mutations in embb gene and ethambutol resistance is ~65%. Da Silva PEA, Palomina JC Molecular basis and mechanisms of drug resistance in M.tuberculosis: classical and new drugs. J Antimicrob Chemother :
14 Wording on reports: Rifampin This isolate is suspected to be resistant due to genetic mutations in the rpob gene. An rpob mutation is present in 95% of rifampin resistant isolates. Isoniazid This isolate is suspected to be resistant due to genetic mutations in the inha or katg genes. An inha and/or katg mutation is present in approximately 80% of isoniazid resistant isolates Pyrazinamide This isolate is suspected to be resistant due to genetic mutations in the pnca gene. A pnca mutation is present in >95% of pyrazinamide resistant isolates. Comment added to all reports: For advice regarding interpretation of this report: contact the Microbiologist on call. For advice regarding TB therapy: contact the Respirology Service or the Infectious Diseases Service.
15 Molecular resistance Report Isoniazid This isolate is suspected to be resistant due to genetic mutations in the inha or katg genes. An inha and/or katg mutation is present in approximately 80% of isoniazid resistant isolates. Rifampin and Pyrazinamide: No molecular mutations associated with resistance were found. For advice regarding interpretation of this report: contact the Microbiologist on call. For advice regarding TB therapy: contact the Respirology Service or the Infectious Diseases Service. Further report to follow
16 Final Report 0.1 and 0.4 ug/ml R Isoniazid This isolate is suspected to be resistant due to genetic mutations in the inha or katg genes. An inha and/or katg mutation is present in approximately 80% of isoniazid resistant isolates. Rifampin and Pyrazinamide: No molecular mutations associated with resistance were found. For advice regarding interpretation of this report: contact the Microbiologist on call. For advice regarding TB therapy: contact the Respirology Service or the Infectious Diseases Service.
17 Resistance in ANY First Line Agent Set up Second Line agents Report all Second Line agents tested
18 Second Line Agents: MGIT evaluation of susceptibility Second Line agent: Critical Concentration (μg/ml) < CC = Sensitive > CC = Resistant Amikacin 1 Capreomycin 2.5 Ethionamide 5 Kanamycin 2.5 Linezolid 1 Moxifloxacin 0.25 Ofloxacin 2 PAS 4 Rifabutin 0.5 Sharma M et al. Canadian multi-centre lab study for standardized second-line antimicrobial susceptibility testing for M.tuberculosis, JCM 2011; DOI /JCM
19 M.tuberculosis: Manitoba 2011 New MTB (+) patient isolates INH resistant MTB % (5/97 isolates) 2010; 9.7% (11/113 isolates) 2009; 4.7% ( 5/106 isolates) 2008; 3.4% ( 4/116 isolates) 2007; 10.6% ( 9/ 85 isolates) MDR-MTB: defined as resistance to at least INH & Rifampin 2011; 2.1% (2/97) 2010; 0.9% (also 1 XDR-TB) 2009; 0.0% 2008; 0.9% 2007; 0.0%
20 TB Cases: 2011:NEW TB Cases: 97 (34% smear Pos) Pulmonary TB Cases: 74 Non-pulmonary TB Cases: :NEW TB Cases: 119 Pulmonary TB Cases: 83 Non-pulmonary TB Cases: 36
21 Followup of Smear (+) patients: Duration of therapy to become Smear (-) Newly diagnosed cases (2010) AFB Smear Positive 42.2% Smear Positive: 1+ or 2+ Average # days to Smear (-) Median # days to Smear (-) Smear Positive: 3+ or 4+ Average # days to Smear (-) Median # days to Smear (-) Smear (+) proven to become Culture Negative 24 days 16 days 43 days 37 days 14.3%
22 Smear Positive 3+: Days to Smear Negative 78 Days to Smear Negative 2 Culture Positive 1 Negative 0 AFB Score 26-Mar 03-Apr 05-Apr 10-Apr 12-Apr 22-Jan 23-Jan 24-Jan 05-Feb 08-Feb 10-Feb 11-Feb 20-Feb 21-Feb 22-Feb 27-Feb 28-Feb 01-Mar 06-Mar 07-Mar 08-Mar 12-Mar 13-Mar 14-Mar 19-Mar 21-Mar 22-Mar 14 Days to Follow-Up Culture Smear Culture
23 Follow up of Patients who are AFB smear (+) AFB POS: 1 2 (+): initiate follow-up samples on day 12 of therapy AFB POS: 3 4 (+): initiate follow-up samples on day 19 of therapy If ANY of the 3 followup samples are AFB(+) wait 7 days then initiate another series of 3 followup samples.
24 Epidemiology: MIRU testing Frequency of MIRU-VNTR Pattern in % 2% 3% 5% MIRU report: ~ 30 days after ID of M.tuberculosis 46% 15% ?? Patterns with one occurrence in % Total culture submissions to NRCM/NML = 101
25 Manitoba Future: in the fight against TB???
26 Genetic Tests on Respiratory Specimens Test Method (# Specimens) RotorGene Concentrated (N = 220) GeneXpert Concentrated (N = 74) GeneXpert Direct (N = 74) Sensitivity 86% 100% for AFB smear (+) 63.2% for AFB smear (-) 88% 100% for AFB smear (+) 67% for AFB smear (-) 83% 100% for AFB smear (+) 56% for AFB smear (-) DSM Research funds for studies: Dr. Phillipe Lagace-Weins and Dr. Kanchana Manickam Specificity 98% 98%* 98%* * 2 PCR (+), Culture negative follow-up specimen; patient on TB therapy
27 GeneXpert MTB assay TARGET: High Risk patients in Rural sites
28 Direct PCR Testing: TB High Risk Index Patients: -WRHA - Rural hubs Add-on Test: Expedites diagnostic confirmation of M.tuberculosis -new service
29 Summary: Provincial TB services: - Sites offering services - Benchmarks for TATs Genetic resistance testing -new service Followup for TB patients: - Time to smear negative Future: Direct TB testing Diagnosis and follow-up testing for TB require integrated communication
30 Provincial services need to work together to provide optimal care for patients with TB
Ken Jost, BA, has the following disclosures to make:
Diagnosis of TB Disease: Laboratory Ken Jost, BA May 10, 2017 TB Intensive May 9-12, 2017 San Antonio, TX EXCELLENCE EXPERTISE INNOVATION Ken Jost, BA, has the following disclosures to make: No conflict
More informationOverview of Mycobacterial Culture, Identification, and Drug Susceptibility Testing
Overview of Mycobacterial Culture, Identification, and Drug Susceptibility Testing 1. Essentials for the Mycobacteriology Laboratory: Promoting Quality Practices 1.1 Overview: Mycobacterial Culture, Identification,
More informationRapid Diagnosis and Detection of Drug Resistance in Tuberculosis
Rapid Diagnosis and Detection of Drug Resistance in Tuberculosis YAM Wing-Cheong 任永昌 Department of Microbiology The University of Hong Kong Tuberculosis Re-emerging problem in industrialized countries
More informationCDC s Approach to Fast Track Laboratory Diagnosis for Persons at Risk of Drug Resistant TB: Molecular Detection of Drug Resistance (MDDR) Service
CDC s Approach to Fast Track Laboratory Diagnosis for Persons at Risk of Drug Resistant TB: Molecular Detection of Drug Resistance (MDDR) Service Beverly Metchock, DrPH, D(ABMM) Team Lead, Reference Laboratory
More informationTB 101 Disease, Clinical Assessment and Lab Testing
TB 101 Disease, Clinical Assessment and Lab Testing Pacific Islands Tuberculosis Controllers Association Conference (PITCA) Clinical Laboratory Breakout None Disclosure Objectives Be able to list and explain
More informationTB/HIV 2 sides of the same coin. Dr. Shamma Shetye, MD Microbiology Metropolis Healthcare, Mumbai
TB/HIV 2 sides of the same coin Dr. Shamma Shetye, MD Microbiology Metropolis Healthcare, Mumbai Global- Tb new cases Diagnosis-Microscopy ZN,Flourescent microscopy(fm) Rapid, inexpensive test Specificity>95%
More informationTB Nurse Case Management. March 7-9, Diagnosis of TB: Ken Jost Wednesday March 7, 2012
TB Nurse Case Management San Antonio, Texas March 7-9, 2012 Diagnosis of TB: Laboratory Ken Jost Wednesday March 7, 2012 Ken Jost has the following disclosures to make: No conflict of interests No relevant
More informationWELCOME. Lab Talk: What a Nurse Hears. April 18, NTNC Annual Meeting Lab Talk: What a Nurse Hears
Lab Talk: What a Lab Talk: What a Max Salfinger, MD, FIDSA, FAAM Executive Director, Advanced Diagnostic Laboratories Laboratory Director, Mycobacteriology & Pharmacokinetics National Jewish Health Lisa
More informationNAAT in the Clinical Laboratory and Impact on Infection Control 9 th National Conference on Laboratory Aspects of Tuberculosis APHL
NAAT in the Clinical Laboratory and Impact on Infection Control 9 th National Conference on Laboratory Aspects of Tuberculosis APHL Susan Novak-Weekley, S(M), ASCP, Ph.D., D(ABMM) Director of Microbiology,
More informationFrances Morgan, PhD October 21, Comprehensive Care of Patients with Tuberculosis and Their Contacts October 19 22, 2015 Wichita, KS
The Laboratory s Role in Caring for Patients Diagnosed with TB Frances Morgan, PhD October 21, 2015 Comprehensive Care of Patients with Tuberculosis and Their Contacts October 19 22, 2015 Wichita, KS EXCELLENCE
More informationMIC = Many Inherent Challenges Sensititre MIC for Antimicrobial Susceptibility Testing of Mycobacterium tuberculosis complex
MIC = Many Inherent Challenges Sensititre MIC for Antimicrobial Susceptibility Testing of Mycobacterium tuberculosis complex Marie Claire Rowlinson, PhD D(ABMM) Florida Bureau of Public Health Laboratories
More informationStacy White, PhD May 12, TB for Community Providers. Phoenix, Arizona
Role of the Laboratory in TB Diagnosis Stacy White, PhD May 12, 2015 TB for Community Providers May 12, 2015 Phoenix, Arizona EXCELLENCE EXPERTISE INNOVATION Stacy White, PhD has the following disclosures
More informationTB Intensive San Antonio, Texas November 11 14, 2014
TB Intensive San Antonio, Texas November 11 14, 2014 Diagnosis of TB: Laboratory Ken Jost, BA November 12, 2014 Ken Jost, BA has the following disclosures to make: No conflict of interests No relevant
More informationDiagnosis of TB: Laboratory Ken Jost Tuesday April 1, 2014
TB Nurse Case Management San Antonio, Texas April 1 3, 2014 Diagnosis of TB: Laboratory Ken Jost Tuesday April 1, 2014 Ken Jost, BA has the following disclosures to make: No conflict of interests No relevant
More informationTB Laboratory for Nurses
TB Laboratory for Nurses Shea Rabley, RN, MN Consultant Mayo Clinic Center for Tuberculosis 2014 MFMER slide-1 Disclosures None 2014 MFMER slide-2 Objectives Participants will be able to: 1. Name 2 safety
More informationReceipt within 1 day of specimen collection. Report AFB b smear result within 1 day from receipt of specimen
Recommendation Promote rapid delivery of specimens to the laboratory Use fluorescent acid-fast staining and promptly transmit results by phone, FAX, or electronically Identify growth as acid-fast and use
More informationThe ABC s of AFB s Laboratory Testing for Tuberculosis. Gary Budnick Connecticut Department of Public Health Mycobacteriology Laboratory
The ABC s of AFB s Laboratory Testing for Tuberculosis Gary Budnick Connecticut Department of Public Health Mycobacteriology Laboratory Laboratory TAT Goals Case Study Specimen Collection Testing Contact
More informationFrances Jamieson, MD and Kevin May, BSc November 15 th,
Frances Jamieson, MD and Kevin May, BSc November 15 th, 2016 1 TB Elimination: Back To Basics Financial Interest Disclosure (over the past 24 months) Dr. Frances amieson Company Speaker Advisory Research
More informationLaboratory Diagnosis and Antimicrobial Susceptibility Testing of Mycobacterium tuberculosis Complex. Objectives
Laboratory Diagnosis and Antimicrobial Susceptibility Testing of Mycobacterium tuberculosis Complex Marie-Claire Rowlinson, PhD D(ABMM) Calin Chiribau, PhD, MT(ASCP) Florida Bureau of Public Health Laboratories
More informationDiagnosis of TB: Laboratory Ken Jost Tuesday April 9, 2013
TB Nurse Case Management San Antonio, Texas April 9-11, 2013 Diagnosis of TB: Laboratory Ken Jost Tuesday April 9, 2013 Ken Jost has the following disclosures to make: No conflict of interests No relevant
More informationDiagnosis of drug resistant TB
Diagnosis of drug resistant TB Megan Murray, MD, ScD Harvard School of Public Health Brigham and Women s Hospital Harvard Medical School Broad Institute Global burden of TB 9 million new cases year 2 million
More informationMULTIDRUG- RESISTANT TUBERCULOSIS. Dean Tsukayama Hennepin County Medical Center Hennepin County Public Health Clinic
MULTIDRUG- RESISTANT TUBERCULOSIS Dean Tsukayama Hennepin County Medical Center Hennepin County Public Health Clinic I have no relevant financial relationships. Discussion includes off label use of: amikacin
More informationDrug susceptibility testing for tuberculosis KRISTEN DICKS, MD, MPH DUKE UNIVERSITY MEDICAL CENTER
Drug susceptibility testing for tuberculosis KRISTEN DICKS, MD, MPH DUKE UNIVERSITY MEDICAL CENTER Outline Drug resistant TB: definitions and epidemiology How does TB become resistant? Current drug susceptibility
More informationRapid Diagnostic Techniques for Identifying Tuberculosis Ken Jost November 13, 2008
Tuberculosis Updates for Clinicians San Antonio, Texas November 13, 2008 Rapid Diagnostic Techniques for Identifying Tuberculosis Ken Jost November 13, 2008 Rapid Diagnostic Techniques for Identifying
More informationCase presentation. Dr Connie Haley, MD, MPH Dr Gautam Kalyatanda, MD
Case presentation Dr Connie Haley, MD, MPH Dr Gautam Kalyatanda, MD History of presenting illness 20 Year old woman from Nigeria who came to study at Montgomery in August 2013 About 2 weeks after arriving,
More informationManaging Complex TB Cases Diana M. Nilsen, MD, RN
Managing Complex TB Cases Diana M. Nilsen, MD, RN Director of Medical Affairs NYC Department of Health & Mental Hygiene Bureau of TB Control Case #1 You are managing a patient who was seen at a private
More informationLaboratory Diagnosis for MDR TB
Laboratory Diagnosis for MDR TB Neha Shah MD MPH Centers for Disease Control and Prevention Division of Tuberculosis Elimination California Department of Public Health Guam March 07 Objectives Describe
More informationWSLH Testing and Surveillance Updates
WSLH Testing and Surveillance Updates Wisconsin Mycobacteriology Laboratory Network annual conference November 4, 2015, Madison, WI Updates Outline Collection and Transport Smear and Culture Nucleic Acid
More informationCDPH - CTCA Joint Guidelines Guideline for Micobacteriology Services In California
CDPH - CTCA Joint Guidelines Guideline for Micobacteriology Services In California These guidelines are intended to be used as an educational aid to help clinicians make informed decisions about patient
More informationMycobacterial cell wall. Cell Cycle Lengths. Outline of Laboratory Methods. Laboratory Methods
Laboratory Methods Cell Cycle Lengths Generation time (hrs) Days needed for 26 generations (colony) E. coli 0.33 0.36 Nancy Connell, PhD Professor, nfectious Disease Department of Medicine Center for Emerging
More informationElizabeth A. Talbot MD Assoc Professor, ID and Int l Health Deputy State Epidemiologist, NH GEISELMED.DARTMOUTH.EDU GEISELMED.DARTMOUTH.
The image part with relationship ID rid2 was not found in the file. MDR TB Management Review of the Evolution (or Revolution?) Elizabeth A. Talbot MD Assoc Professor, ID and Int l Health Deputy State Epidemiologist,
More informationOptimising patient care in MDR TB with existing molecular screening tests in high burden countries
Optimising patient care in MDR TB with existing molecular screening tests in high burden countries Camilla Rodrigues MD Consultant Microbiologist Hinduja Hospital,India Outline What is the best empiric
More informationClinical Practice Guideline
ITBS LTBI ITBS Management 1 of 6 ITBS Contact ITBS Oversight ITBS Disease Professional Advisory 1.0 PURPOSE: 1.1 Provide clinical practice and operational guidance to Public Health Nurses to ensure consistency
More informationPublic Health Mycobacteriology (TB) Laboratory Testing Services
Public Health Mycobacteriology (TB) Laboratory Testing Services Gary Budnick Supervising Microbiologist Connecticut Department of Public Health Laboratory Branch Hartford, Connecticut Specimen Collection
More informationEpidemiology and diagnosis of MDR-TB in children H Simon Schaaf
Epidemiology and diagnosis of MDR-TB in children H Simon Schaaf Desmond Tutu TB Centre Department of Paediatrics and Child Health, Stellenbosch University, and Tygerberg Children s Hospital (TCH) Definitions
More informationHow best to structure a laboratory network with new technologies
How best to structure a laboratory network with new technologies Cristina Gutierrez, MD, PhD Uniting to scale up TB care in Central Asia 14 and 15 April 2011 Tashkent, Uzbekistan New laboratory diagnostics
More informationGeneral Session IV - Dale Schwab April 20, 2017
The Culture of Clinical Commercial Labs Presented by: Dale Schwab PhD, Senior Scientific Director, Infectious Disease April 20, 2017 Objectives Challenges for the reference laboratory in MTB diagnosis/opportunities
More informationTreatment of Active Tuberculosis
Treatment of Active Tuberculosis Jeremy Clain, MD Pulmonary & Critical Care Medicine Mayo Clinic October 16, 2017 2014 MFMER slide-1 Disclosures No relevant financial relationships No conflicts of interest
More informationObjectives. TB Laboratory Methods
TB Laboratory Methods Beverly Metchock, Dr.P.H., D(ABMM) Team Leader, Reference Laboratory, Mycobacteriology Laboratory Branch February 2011 Objectives General overview of mycobacteriology (TB) lab practices
More informationTB: Management in an era of multiple drug resistance. Bob Belknap M.D. Denver Public Health November 2012
TB: Management in an era of multiple drug resistance Bob Belknap M.D. Denver Public Health November 2012 Objectives: 1. Explain the steps for diagnosing latent and active TB role of interferon-gamma release
More informationRevised National Tuberculosis Control Programme (RNTCP) Dr.Kishore Yadav J Assistant Professor
Revised National Tuberculosis Control Programme (RNTCP) Dr.Kishore Yadav J Assistant Professor Global scenario*: Burden of TB Incidence : 9.6 million (58% SEAR and Western Pacific) Deaths : 1.5 million
More informationTuberculosis. Drug resistance in Canada. Reported susceptibility results of the Canadian Tuberculosis Laboratory Surveillance System
Public Health Agency of Canada Agence de la santé publique du Canada Tuberculosis Drug resistance in Canada Reported susceptibility results of the Canadian Tuberculosis Laboratory Surveillance System Our
More informationChapter 4 Diagnosis of Tuberculosis Disease
Chapter 4 Diagnosis of Tuberculosis Disease Table of Contents Chapter Objectives.... 75 Introduction.... 77 Medical Evaluation.......................................................... 78 Chapter Summary...
More informationDiagnosis and Management of Active Tuberculosis
Diagnosis and Management of Active Tuberculosis Zelalem Temesgen, MD FIDSA AAHIVS 2013 MFMER slide-1 Disclosures None 2013 MFMER slide-2 Objectives By the end of this session, participants should be able
More informationDST for detection of DR TB - roll out of Xpert in South Africa and overview of other technologies: what are the gaps?
DST for detection of DR TB - roll out of Xpert in South Africa and overview of other technologies: what are the gaps? Mark Nicol Division of Medical Microbiology and Institute for Infectious Diseases and
More informationPOSITIONING OF TB DX : TIERED SYSTEM, INTEGRATED APPROACH
POSITIONING OF TB DX : TIERED SYSTEM, INTEGRATED APPROACH Akos Somoskövi, M.D., Ph.D. and Giorgio Roscigno, M.D. ANNUAL GLI MEETING, 4 th OCTOBER 2010 MERIEUX FOUNDATION, ANNECY Integrated Laboratory Network
More informationAnalysis. Answers. Action. Saturday Night Fever. Shaka Brown Capital Congress
Saturday Night Fever Shaka Brown Capital Congress Shaka Zulu October 31, 2012 SICK SUCKS How my illness started October 2013 August to October 2013 Symptoms: Severe fatigue Night sweats Low grade fever
More informationUse of the Cepheid GeneXpert to Release Patients from Airborne Isolation
Use of the Cepheid GeneXpert to Release Patients from Airborne Isolation Dave Warshauer, PhD, D(ABMM) Deputy Director, Communicable Diseases Wisconsin State Laboratory of Hygiene WISCONSIN STATE LABORATORY
More informationTB BASICS: PRIORITIES AND CLASSIFICATIONS
TB CASE MANAGEMENT AND CONTACT INVESTIGATION INTENSIVE NOVEMBER 1-4, 2016 TB BASICS: PRIORITIES AND CLASSIFICATIONS LEARNING OBJECTIVES Upon completion of this session, participants will be able to: 1.
More informationTuberculosis: update 2013
Tuberculosis: update 2013 William R. Bishai, MD, PhD Center for TB Research Division of Infectious Diseases Department of Medicine Johns Hopkins School of Medicine Question 1 A TB speaker at a major conference
More informationDiagnosis and Treatment of Tuberculosis, 2011
Diagnosis of TB Diagnosis and Treatment of Tuberculosis, 2011 Alfred Lardizabal, MD NJMS Global Tuberculosis Institute Diagnosis of TB, 2011 Diagnosis follows Suspicion When should we Think TB? Who is
More informationDNA FINGERPRINTING. Barry N. Kreiswirth, PhD Director, PHRI TB Center
DNA FINGERPRINTING Barry N. Kreiswirth, PhD Director, PHRI TB Center Molecular Epidemiology Local Epidemiology Are M. tuberculosis isolates recovered from localized cases of disease the same or different
More informationI. Demographic Information GENDER NUMBER OF CASES PERCENT OF CASES. Male % Female %
San Joaquin County (SJC) in 03, (N=43) County Rate = 6. Cases per 00,000 Population I. Demographic Information Table I-A: TB cases by gender, SJC, 03 (N=43) GENDER NUMBER OF CASES Male 6 60.5% Female 7
More informationManagement of Multidrug- Resistant TB in Children. Jennifer Furin, MD., PhD. Sentinel Project, Director of Capacity Building
Management of Multidrug- Resistant TB in Children Jennifer Furin, MD., PhD. Sentinel Project, Director of Capacity Building Objectives To review data on best practices for diagnosis, treatment and prevention
More informationLaboratory s Role in the Battle Against Drug Resistant Tuberculosis
Laboratory s Role in the Battle Against Drug Resistant Tuberculosis Angela M. Starks, Ph.D. Chief, Laboratory Branch Division of Tuberculosis Elimination June 6, 2016 National Center for HIV/AIDS, Viral
More informationPrinciples of laboratory diagnosis of M. tuberculosis. Anne-Marie Demers, MD, FRCPC 11 September 2017
Principles of laboratory diagnosis of M. tuberculosis Anne-Marie Demers, MD, FRCPC 11 September 2017 QUESTION Which statement is false? 1) A smear can only be on a concentrated specimen 2) It is normal
More informationTUBERCULOSIS IN NEW ZEALAND ANNUAL REPORT 2015
TUBERCULOSIS IN NEW ZEALAND ANNUAL REPORT 2015 PREPARED FOR: CLIENT REPORT No: PREPARED BY: Ministry of Health FW17009 PUBLISHED: September 2018 Health Intelligence Team, Health and Environment Group Institute
More informationHarmonizing the Use of Molecular & Culture-based DST of Mycobacterium tuberculosis
Harmonizing the Use of Molecular & Culture-based DST of Mycobacterium tuberculosis Grace Lin, MS. Research Scientist grace.lin@cdph.ca.gov APHL 8 th TB Lab Conference San Diego 8-19-13 Harmonizing? There
More informationMolecular tests for rapid detection of rifampicin and isoniazid resistance in Mycobacterium tuberculosis.
Title Molecular tests for rapid detection of rifampicin and isoniazid resistance in Mycobacterium. Author(s) Ho, PL; Yam, WC; Leung, CC; Yew, WW; Mok, TYW; Chan, KS; Tam, CM Citation Hong Kong Medical
More informationUpdate on Management of
Update on Management of DR TB Definitions Presumptive MDR-TB A patient suspected of drug-resistant TB, based on RNTCP criteria for submission of specimens for drug-susceptibility testing MDR-TB Case A
More informationTuberculosis. Drug resistance in Canada. Reported susceptibility results of the Canadian Tuberculosis Laboratory Surveillance System
Public Health Agency of Canada Agence de la santé publique du Canada Tuberculosis Drug resistance in Canada Reported susceptibility results of the Canadian Tuberculosis Laboratory Surveillance System Our
More informationNucleic Acid Amplification Test for Tuberculosis. Heidi Behm, RN, MPH Acting TB Controller HIV/STD/TB Program Oregon, Department of Health Services
Nucleic Acid Amplification Test for Tuberculosis Heidi Behm, RN, MPH Acting TB Controller HIV/STD/TB Program Oregon, Department of Health Services What is this test? Nucleic Acid Amplification Test (NAAT)
More informationMycobacteria & Tuberculosis PROF.HANAN HABIB & PROF ALI SOMILY DEPRTMENT OF PATHOLOGY, MICROBIOLOGY UNIT COLLEGE OF MEDICINE
Mycobacteria & Tuberculosis PROF.HANAN HABIB & PROF ALI SOMILY DEPRTMENT OF PATHOLOGY, MICROBIOLOGY UNIT COLLEGE OF MEDICINE Objectives l Recognize that tuberculosis as a chronic disease mainly affecting
More informationRecognizing MDR-TB in Children. Ma. Cecilia G. Ama, MD 23 rd PIDSP Annual Convention February 2016
Recognizing MDR-TB in Children Ma. Cecilia G. Ama, MD 23 rd PIDSP Annual Convention 17-18 February 2016 Objectives Review the definitions and categorization of drugresistant tuberculosis Understand the
More informationTargeted Testing and the Diagnosis of. Latent Tuberculosis. Infection and Tuberculosis Disease
Self-Study Study Modules on Tuberculosis Targeted Testing and the Diagnosis of Latent Tuberculosis Infection and Tuberculosis Disease 1 Module 3: Objectives At completion of this module, learners will
More informationThe Molecular Epidemiology of Tuberculosis
The Molecular Epidemiology of Tuberculosis Barry N. Kreiswirth,, PhD Director, PHRI TB Center Airborne pathogen, Mycobacterium tuberculosis Slow grower; doubles 24hrs; 3-4 weeks to culture 3-4 weeks for
More informationEssential Mycobacteriology Laboratory Services in the Era of MDR- and XDR-TB: A TB Controller s Perspective
Essential Mycobacteriology Laboratory Services in the Era of MDR- and XDR-TB: A TB Controller s Perspective James Watt, MD, MPH Acting Chief, Tuberculosis Control Branch California Department of Public
More informationRapid PCR TB Testing Results in 68.5% Reduction in Unnecessary Isolation Days in Smear Positive Patients.
Rapid PCR TB Testing Results in 68.5% Reduction in Unnecessary Isolation Days in Smear Positive Patients. Item Type Thesis Authors Patel, Ravikumar Publisher The University of Arizona. Rights Copyright
More informationWhite Paper Application
White Paper Application Project Title: Whole genome sequencing of clinical strains of Mycobacterium tuberculosis Authors: David Alland, Jerrold Ellner, Susan Dorman, Moses Joloba, Clifton Barry Primary
More informationXpert MTB/RIF Ultra: Understanding this new diagnostic and who will have access to it
Xpert MTB/RIF Ultra: Understanding this new diagnostic and who will have access to it Angela Starks, PhD Chief, Laboratory Branch Division of TB Elimination Matt Bankowski, PhD, MS, D(ABMM), HCLD/CC(ABB)
More informationResearch Methods for TB Diagnostics. Kathy DeRiemer, PhD, MPH University of California, Davis Shanghai, China: May 8, 2012
Research Methods for TB Diagnostics Kathy DeRiemer, PhD, MPH University of California, Davis Shanghai, China: May 8, 2012 Overview Why do we need good TB diagnostics? What works? What doesn t work? How
More informationTB is Local. Barry Chin, Boston Globe, 10/15/2008. * BUT only in appropriate setting
Diagnosis of Tuberculosis 2012 New Tools, Tricks, Thinking? John Bernardo, M.D. Pulmonary Section, Boston University School of Medicine Massachusetts Department of Public Health Objectives To review the
More informationNEW YORK STATE DEPARTMENT OF HEALTH CLINICAL LABORATORY EVALUATION PROGRAM
Crosswalk of Proposed Revision to Standards Any standards not addressed here remain in effect. (changes are underlined) Practice 8 (TB S8): Smears Only Permit Category - Specimen Submission and Result
More informationTB In Detroit 2011* Early TB: Smudge Sign. Who is at risk for exposure to or infection with TB? Who is at risk for TB after exposure or infection?
Those oral antibiotics are just not working! Inpatient Standards of Care & Discharge Planning S/He s in the Hospital: Now What Do I Do? Dana G. Kissner, MD TB Intensive Workshop, Lansing, MI 2012 Objectives:
More informationPediatric Tuberculosis Lisa Y. Armitige, MD, PhD September 14, 2017
Pediatric Tuberculosis Lisa Y. Armitige, MD, PhD September 14, 2017 TB Nurse Case Management September 12 14, 2017 EXCELLENCE EXPERTISE INNOVATION Lisa Y. Armitige, MD, PhD has the following disclosures
More informationTB BASICS: PRIORITIES AND CLASSIFICATIONS
TB CASE MANAGEMENT AND CONTACT INVESTIGATION INTENSIVE MAY 8-11, 2018 TB BASICS: PRIORITIES AND CLASSIFICATIONS LEARNING OBJECTIVES Upon completion of this session, participants will be able to: 1. List
More informationNucleic Acid Amplification Testing for the Diagnosis of TB
Roche Nucleic Acid Amplification Testing for the Diagnosis of TB David Warshauer, PhD Deputy Director, Communicable Diseases Wisconsin State Laboratory of Hygiene 19 th /20 th Century Traditional Algorithm
More informationWhen good genes go bad
When good genes go bad Dr Kessendri Reddy NHLS Tygerberg Hospital Division of Clinical Microbiology Fakulteit Geneeskunde en Gesondheidswetenskappe Faculty of Medicine and Health Sciences Overview Cases
More informationCase Study: TB-HIV co-infection
Case Study: TB-HIV co-infection Julia Greenleaf, RN, MPH Public Health Nurse Public Health Madison & Dane County With guest appearance by Julie Tans-Kersten, MS, BSMT (ASCP) Director, WI TB Program 33
More informationEvolution of XDR-TB. A. Willem Sturm Interim Director K-RITH Nelson R Mandela School of Medicine University of KwaZulu-Natal
Evolution of XDR-TB in KwaZulu-Natal A. Willem Sturm Interim Director K-RITH Nelson R Mandela School of Medicine University of KwaZulu-Natal Drug resistance among culture positive TB cases by South African
More informationTuberculosis Treatment, Prevention, and Management in Manitoba: A Population- Based Investigation
Tuberculosis Treatment, Prevention, and Management in Manitoba: A Population- Based Investigation Lisa Lix and Pierre Plourde (on behalf of the Deliverable Team) Evidence to Action: MCHP s Annual Workshop
More informationCommunicable Disease Control Manual Chapter 4: Tuberculosis
Provincial TB Services 655 West 12th Avenue Vancouver, BC V5Z 4R4 www.bccdc.ca Communicable Disease Control Manual Definitions Page 1 2.0 DEFINITIONS Many of the definitions that follow are taken from
More informationMolecular assays in Tuberculosis. Jatin Yegurla Junior resident
Molecular assays in Tuberculosis Jatin Yegurla Junior resident 17-3-2018 Contents Introduction TB-PCR Line Probe assay (LPA) GenoType MTBDRsl test (Second line LPA) Xpert MTB/RIF (GeneXpert) (CB-NAAT)
More informationResearch in Tuberculosis: Translation into Practice
Case History Research in Tuberculosis: Translation into Practice This is a 6-year6 year-old Bosnian male, who presented to ER with one-week history of fever and occasional vomiting. No cough, difficulty
More informationThe Molecular MDR Screen is an Important Tool in the Diagnosis and Initiation of Appropriate Therapy in TB Patients in the State of Florida
The Molecular MDR Screen is an Important Tool in the Diagnosis and Initiation of Appropriate Therapy in TB Patients in the State of Florida Calin B. Chiribau, 1 M-C. Rowlinson, 1 S.Crowe, 1 B. Jones, 1
More informationLaboratory Diagnostic Techniques. Hugo Donaldson Consultant Microbiologist Imperial College Healthcare NHS Trust
Laboratory Diagnostic Techniques Hugo Donaldson Consultant Microbiologist Imperial College Healthcare NHS Trust Learning Objectives 1) When to consider a diagnosis of TB 2) When to consider a referral
More informationSupplementary Appendix
Supplementary Appendix This appendix has been provided by the authors to give readers additional information about their work. Supplement to: Mitnick CD, Shin SS, Seung KJ, et al. Comprehensive treatment
More informationTUBERCULOSIS IN NEW ZEALAND 2014
SURVEILLANCE REPORT TUBERCULOSIS IN NEW ZEALAND 2014 Prepared as part of a Ministry of Health contract for scientific services by the Health Intelligence Team, Institute of Environmental Science and Research
More informationFinal Results from Stage 1 of a Double-Blind, Placebo- Controlled Trial with TMC207 in Patients with Multi- Drug Resistant (MDR)
Final Results from Stage 1 of a Double-Blind, Placebo- Controlled Trial with TMC207 in Patients with Multi- Drug Resistant (MDR) Tuberculosis (TB). AH Diacon*, A Pym**, MP Grobusch, G. Churchyard, T De
More informationDNA sequencing for the confirmation of rifampin resistance detected by Cepheid Xpert
JCM Accepted Manuscript Posted Online 4 March 2015 J. Clin. Microbiol. doi:10.1128/jcm.03433-14 Copyright 2015, American Society for Microbiology. All Rights Reserved. 1 2 DNA sequencing for the confirmation
More informationMaha R Farhat, MD MSc Massachusetts General Hospital Harvard Medical School. I have no financial or other potential conflicts of interest to disclose
Maha R Farhat, MD MSc Massachusetts General Hospital Harvard Medical School I have no financial or other potential conflicts of interest to disclose Update on the epidemiology of TB drug resistance Success
More informationTuberculosis Reporting, Waco-McLennan County Public Health District TB Control WMCPHD (254)
Tuberculosis Reporting, Waco-McLennan County Public Health District TB Control WMCPHD (254)-750-5496 Local health care providers, including physicians offices, labs and hospitals, are required by law to
More informationGlobal epidemiology of drug-resistant tuberculosis. Factors contributing to the epidemic of MDR/XDR-TB. CHIANG Chen-Yuan MD, MPH, DrPhilos
Global epidemiology of drug-resistant tuberculosis Factors contributing to the epidemic of MDR/XDR-TB CHIANG Chen-Yuan MD, MPH, DrPhilos By the end of this presentation, participants would be able to describe
More informationTOG The Way Forward
TOG 2016- The Way Forward Main Changes in Diagnostic algorithm Definition (Type, Classification, Outcome) Registration at the time of Diagnosis (PHI level Notification Register) Long term follow up (till
More informationTUBERCULOSIS. Presented By: Public Health Madison & Dane County
TUBERCULOSIS Presented By: Public Health Madison & Dane County What is Tuberculosis? Tuberculosis, or TB, is a disease caused by a bacteria called Mycobacterium tuberculosis. The bacteria can attack any
More informationMy heart is racing. Managing Complex Cases. Case 1. Case 1
Managing Complex Cases My heart is racing Amee Patrawalla, MD April 7, 2017 Case 1 Rutgers, The State University of New Jersey Rutgers, The State University of New Jersey Case 1 29 year old physician from
More informationNorthwestern Polytechnic University
Clinical Tuberculosis Assessment by Health Care Provider Clinicians should review and verify the information in the Tuberculosis (TB) Screening Questionnaire (attached). Persons answering YES to any questions
More informationCommunication between clinician and laboratory Molecular detection of M. tuberculosis complex
3 Laboratory 3rd edition contributors: PENNAN M. BARRY, MD, MPH & SHOU-YEAN GRACE LIN, MS General information on TB laboratory work..................... 32 Molecular methods for detection of M. tuberculosis
More information7. Are you currently engaged in research that could support new TB diagnostic assay development? Yes No
Determining Future TB Reference Material Requirements WHO/TDR TB Expert & End-User Survey Properly handled samples from well-characterized patients with suspected tuberculosis from disease endemic countries
More informationScott Lindquist MD MPH Tuberculosis Medical Consultant Washington State DOH and Kitsap County Health Officer
Tuberculosis in the 21 st Century Scott Lindquist MD MPH Tuberculosis Medical Consultant Washington State DOH and Kitsap County Health Officer Feedback Poll In my opinion, the recent media coverage of
More information