PHLS mycobacteriology reference services in England and Wales

Area of Science:

• Medical Microbiology
• Infectious Diseases
• Public Health

Background:

• Tuberculosis (TB) remains a leading global infectious disease with increasing incidence and drug resistance.
• Nosocomial outbreaks of drug-sensitive and drug-resistant TB necessitate enhanced public health response.
• The Public Health Laboratory Service (PHLS) prioritizes TB control and surveillance.

Purpose of the Study:

• To review the enhanced mycobacteriology reference services provided by the PHLS in England and Wales.
• To highlight advancements in diagnostic and surveillance capabilities for TB.
• To underscore the role of reference services in combating drug-resistant TB.

Main Methods:

• Microscopy and culture on solid and liquid media.
• Rapid culture systems and identification using phenotypic characteristics.
• Molecular DNA analysis, including rapid DNA amplification techniques.
• Drug susceptibility testing of isolates by PHLS Regional Centres.

Main Results:

• The Mycobacterium Reference Unit (MRU) offers rapid molecular identification of Mycobacterium tuberculosis.
• All four PHLS Regional Centres perform drug susceptibility testing.
• MRU serves as a World Health Organisation reference centre for global TB drug resistance surveillance.
• The 'Mycobnet' surveillance scheme collates national drug resistance data.

Conclusions:

• Enhanced reference services, including advanced diagnostics and surveillance, are crucial for TB control.
• The MRU and PHLS collaborate effectively for national and global TB drug resistance monitoring.
• These services are vital in addressing the challenges posed by drug-resistant tuberculosis.