Drug-resistant TB is a real threat to public health
Tuberculosis is the second-leading infectious disease killer in the world. Moreover, the microorganism that causes tuberculosis, Mycobacterium tuberculosis, is becoming resistant to the drugs used to combat it.
Investigations of four multi-drug-resistant tuberculosis (MDR-TB) outbreaks in hospitals in Florida and New York City demonstrated that most cases of MDR-TB occurred among individuals known to be infected with HIV. The case fatality rate was high (72-89%) and the median interval between diagnosis and death was short (4-16 weeks).
Identification of tuberculosis must be swift. If delayed, subsequent steps to confine contagious patients are likewise delayed, risking spread of the infection among patients and healthcare workers.
The program’s goal is to continuously improve laboratory testing and practices
Laboratories that perform drug susceptibility testing around the world must maintain the highest level of competency. One means of maintaining competency is to participate in the Centers for Disease Control’s M. tuberculosis Drug Susceptibility Performance Evaluation Program. The program provides participating laboratories with a panel of tuberculosis cultures for which the results are not known to the laboratory. Test results are submitted to the program and the laboratory can compare their results with those of other participating laboratories.
CSC’s team provides much of the program’s logistical support. CSC maintains a database of approximately 150 laboratories worldwide that are currently enrolled in this program. Three months prior to each shipment, CSC conducts a Strain Selection Conference Call with a panel of experts in the field of tuberculosis drug susceptibility testing to choose the strain of TB that will be sent to participating laboratories. The selected strains are subcultured by CSC team members in preparation for being shipped to the participating laboratories. Panels of four live cultures of M. tuberculosis and one culture of a non-tuberculous mycobacteria are shipped to participating laboratories twice a year by the CSC team. Participating laboratories perform drug susceptibility testing on the isolates and send the results to CDC. Once test results have been submitted by the participating laboratories, CSC performs quality control checks on the data and then submits the data to the CDC Project Officer who generates a biannual report. CSC then distributes the reports to the participating laboratories.
Through this program, the laboratories can determine their success rate in identifying the strain of mycobacterium and the drug-resistance pattern. The program’s goal is to continuously improve the public's health through ongoing improvement of laboratory testing and practices focusing on tests of high public health impact. CSC is proud to participate in this important mission.