Tracking Mycobacterium tuberculosis sequencing samples using unique spikes of random DNA.

Area of Science:

• Microbiology
• Infectious Diseases
• Genomic Epidemiology

Background:

• Tuberculosis (TB) diagnosis in the Netherlands relies on primary testing by local laboratories.
• Positive Mycobacterium tuberculosis complex cultures are referred to the National Institute for Public Health and the Environment (RIVM).
• RIVM performs species identification, epidemiological typing, and Whole Genome Sequencing (WGS) for resistance screening.

Purpose of the Study:

• To highlight the importance of internal controls in TB diagnostic workflows.
• To address the risks associated with sample-swaps and cross-contaminations.
• To ensure accurate diagnoses and appropriate patient treatment.

Main Methods:

• Review of diagnostic procedures for tuberculosis in the Netherlands.
• Analysis of potential error sources in sample handling and processing.
• Emphasis on the role of internal quality control measures.

Main Results:

• Sample-swaps and cross-contaminations are recognized issues in diagnostic procedures.
• Such errors can lead to misdiagnoses.
• Misdiagnoses may result in suboptimal or unnecessary patient treatment.

Conclusions:

• Robust internal controls are essential for early detection of errors in tuberculosis diagnostics.
• Effective quality management systems are vital to prevent incorrect diagnoses and ensure patient safety.
• Continuous monitoring of diagnostic processes is necessary to maintain high standards of care.