RESUMO
SETTING: The mycobacterial laboratory is assuming an increasingly important role in tuberculosis (TB) control in the United States today. OBJECTIVE: To assess mycobacterial laboratory capacity and practices in the New England states, USA. DESIGN: We surveyed 143 hospital and commercial laboratories and five of the six state public health laboratories in New England that offer testing services for Mycobacterium tuberculosis. The survey captured information on types of services offered and volume of testing, use of state laboratories for testing, and promptness of reporting results to TB control programs. RESULTS: State laboratories perform the majority of testing services, particularly for more specialized tests. All state laboratories surveyed perform species identification of acid-fast isolates, culture and first-line drug susceptibility testing. Less than 20% of hospital and commercial laboratories offer these services, and 78.6% of hospitals and commercial laboratories refer specimens to state laboratories for culture. CONCLUSION: Surveys of M. tuberculosis testing capacities in a region can help decision makers ensure maintenance of essential services. Hospital and commercial laboratories with lower testing volume might increase efficiency by referring more specimens to state laboratories. State health departments might consider organizing regional laboratory service networks to monitor the provision of services, improve efficiency and oversee quality improvement initiatives.
Assuntos
Antituberculosos/farmacologia , Técnicas Bacteriológicas/métodos , Mycobacterium tuberculosis/isolamento & purificação , Tuberculose/diagnóstico , Técnicas Bacteriológicas/estatística & dados numéricos , Coleta de Dados , Humanos , Testes de Liberação de Interferon-gama/estatística & dados numéricos , Laboratórios/estatística & dados numéricos , Laboratórios Hospitalares/estatística & dados numéricos , Testes de Sensibilidade Microbiana/métodos , Testes de Sensibilidade Microbiana/estatística & dados numéricos , Mycobacterium tuberculosis/efeitos dos fármacos , New England , Escarro , Tuberculose/microbiologiaRESUMO
Enterolert (IDEXX Laboratories Inc., Westbrook, Maine), a semiautomated, most probable number method for enumeration of enterococci, was compared with the standard membrane filter method by parallel testing of 138 marine and freshwater recreational bathing water samples. No statistically significant difference and a strong linear correlation were found between methods. Culturing of 501 Enterolert test wells resulted in false-positive and false-negative rates of 5.1 and 0.4%, respectively. Less time for setup, incubation (24 versus 48 h), and reading of Enterolert permits more efficient monitoring of recreational bathing areas.
