Revised guidelines for Australian laboratories performing mycobacteriology testing.
Ivan Bastian1, Lisa Shephard1, Richard Lumb1
1SA Pathology, PO Box 14, Rundle Mall, Adelaide SA 5000.
Communicable Diseases Intelligence (2018)
|January 16, 2020
Summary
Revised guidelines enhance tuberculosis (TB) laboratory practices in Australia. Updated biosafety, molecular diagnostics like Xpert MTB/RIF, and biorisk assessments improve TB control and patient care.
Area of Science:
- Medical Microbiology
- Public Health Laboratory Science
- Infectious Disease Diagnostics
Background:
- Mycobacteriology laboratories are crucial for tuberculosis (TB) control through diagnostics, contact tracing, and international support.
- Previous guidelines from 2006 outlined requirements for safe, high-quality work in Australian mycobacteriology laboratories.
- These laboratories support TB control efforts in Australia and neighboring countries where TB is prevalent.
Purpose of the Study:
- To revise and update the 2006 National Tuberculosis Advisory Committee (NTAC) laboratory guidelines for Australian mycobacteriology laboratories.
- To incorporate advancements in biosafety, diagnostic technologies, and work practices.
- To ensure continued high-quality and safe laboratory operations for effective TB control.
Main Methods:
- Extensive peer review and consultation involving the Mycobacterium Reference Laboratory (MRL) network, Mycobacterium Special Interest Group (SIG) of the Australian Society for Microbiology (ASM), and other national bodies.
- Integration of new biosafety standards (AS/NZS 2243.3:2010) and a biorisk assessment approach.
- Inclusion of updated molecular diagnostic technologies such as MPT64-based immunochromatographic tests (ICTs) and the Xpert MTB/RIF assay.
Main Results:
- Revised guidelines reflect updated biosafety standards and promote a biorisk assessment approach for laboratory procedures.
- Recommendations allow for certain manipulations on positive TB cultures in enhanced PC2 laboratories based on biorisk assessment.
- Integration of rapid molecular tests like MPT64 ICTs and Xpert MTB/RIF into laboratory workflows is advised.
Conclusions:
- The revised guidelines provide updated standards for mycobacteriology laboratories, enhancing safety and diagnostic capabilities.
- Adoption of new technologies and biorisk assessment will improve the speed and accuracy of TB diagnosis and patient management.
- These updated guidelines supersede the 2006 publication and will be periodically reviewed for future technological advancements.
