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A Model of Shared Mycobacteriology Testing Services: Lessons Learned.

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Sharing tuberculosis (TB) diagnostic services between public health laboratories (PHLs) is feasible. This collaboration demonstrated potential for faster testing and significant cost savings, offering a model for other PHLs.

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Area of Science:

  • Public Health Laboratory Services
  • Infectious Disease Diagnostics
  • Mycobacterium tuberculosis Complex

Background:

  • Public health laboratories (PHLs) face resource constraints, driving interest in shared diagnostic services.
  • Tuberculosis (TB) testing requires efficient and cost-effective methods for detection and characterization of Mycobacterium tuberculosis complex (MTBC).

Purpose of the Study:

  • To assess the feasibility of shared diagnostic services for MTBC detection and characterization between the New York State Department of Health Wadsworth Center and Rhode Island State Health Laboratories.
  • To evaluate turnaround times, shipping logistics, and cost-effectiveness of a TB testing service sharing model.

Main Methods:

  • Rhode Island State Health Laboratories shipped MTBC-positive specimens and isolates to Wadsworth Center for testing.
  • Assessed multiple aspects of shared services: shipping, testing turnaround times, reporting, and cost analysis.
  • Implemented an extended molecular testing panel and compared costs per specimen.

Main Results:

  • While overall testing turnaround times were similar, shipping added approximately four days for conventional drug susceptibility testing (DST).
  • Wadsworth Center offered an extended molecular testing panel, providing same-day detection and species determination, and 2.5-day molecular DST.
  • The cost per specimen at Wadsworth Center was $177.12 lower than at Rhode Island State Health Laboratories, excluding shipping costs.

Conclusions:

  • The collaboration established a successful model for shared TB testing services between public health laboratories.
  • The model demonstrated potential for improved patient management through rapid, cost-effective testing.
  • This approach could lead to significant cost and resource savings if adopted by other PHLs nationwide.