The Use of a Shared Services Model for Mycobacteriology Testing: Lessons Learned

Area of Science:

• Public Health
• Microbiology
• Clinical Laboratory Science

Background:

• Public health laboratories (PHLs) are crucial for diagnosing and surveilling diseases like tuberculosis (TB).
• High-quality laboratory testing is essential for TB case detection and reduction in the US.
• The Shared Services Project explored collaborative TB testing among PHLs.

Purpose of the Study:

• To investigate the practical aspects of sharing tuberculosis testing services between public health laboratories.
• To evaluate the feasibility and outcomes of a collaborative model for specialized TB diagnostics.

Main Methods:

• A 9-month project (2012-2013) funded by APHL and CDC involved three PHL consortiums.
• Participating PHLs performed in-house testing while sending specimens to reference labs for parallel testing.
• Turnaround times for both methods were compared to assess efficiency.

Main Results:

• 107 Mycobacterium tuberculosis complex submissions were processed for drug susceptibility and molecular resistance testing.
• Median transit time for specimens was 1.0 day.
• Median turnaround time for in-house drug susceptibility testing was 31.0 days vs. 43.0 days for reference labs.
• Median turnaround time for molecular detection of drug resistance was 1.0 day at reference labs.

Conclusions:

• The shared services model demonstrates potential for specialized tuberculosis testing.
• Successful implementation requires careful consideration of quality, timeliness, efficiency, communication, and costs.