TB Notes Newsletter
No. 3, 2012
LABORATORY BRANCH UPDATES
Dr. Kim Musser wins the 2012 NTCA Ed Desmond Laboratorian of the Year Award
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| Dr. Kim Musser won the 2012 Laboratorian award. |
This year, the NTCA Ed Desmond Laboratorian of the Year Award was given to Dr. Kim Musser, of the Wadsworth Center Laboratory. DTBE congratulates Dr. Musser on her award. Dr. Musser was not able to be present at the NTCA meeting to accept the award, but Dr. Vincent Escuyer was on hand to accept on her behalf. Dr. Escuyer kindly provided this brief accolade acknowledging Dr. Musser’s contributions to TB elimination efforts:
Dr. Kim Musser is the Chief of Bacterial Diseases and Director of the bacteriology laboratory at Wadsworth Center–New York State Department of Health (NYSDOH). She leads the Molecular Development group, which has been involved in the development of numerous molecular assays for diagnostics and detection of drug resistance for a broad range of bacterial diseases. Four of these assays are directly related to TB testing and include real-time PCR assays for detection and identification of the different members of the TB complex and pyrosequencing for early detection of resistance to rifampin and isoniazid. Kim Musser is the driving force of this group and is always eager to incorporate the newest cutting-edge molecular technologies into the daily clinical testing. Furthermore, she always has a global public health vision emphasized by a constant willingness to share protocols and reagents with her colleagues from other public health laboratories. As a result, several of these laboratories have now implemented into their workflow the assays developed at Wadsworth Center and significantly improved their molecular testing capacity. The impact of Kim Musser’s work goes beyond New York State and can be felt at the national level. For these reasons she is richly deserving of this award.
—Submitted by Dr. Vincent E. Escuyer, Director, Mycobacteriology Laboratory
Wadsworth Center, NYSDOH
APHL Awards Funds to Public Health Laboratories for Improving Laboratory Practices
The Association of Public Health Laboratories (APHL), in collaboration with CDC/DTBE’s Laboratory Branch (LB), recently provided two separate one-time funding opportunities aimed at 1) exploring novel approaches to shared laboratory services for TB, and 2) evaluating the effective use of molecular diagnostics. Seven grants were awarded through a competitive process benefitting a total of 15 U.S. public health laboratories (PHLs).
One funding opportunity allows PHLs to explore novel approaches to sharing TB laboratory services among a group of two or more laboratories. As TB cases and the volume of specimens being submitted for testing continues to decrease, maintaining all testing services becomes increasingly expensive per case identified. In addition, maintaining technical proficiency can potentially be more difficult. However, the true costs of sharing services and the potential effects to TB controllers, clinicians, and clinical laboratories have not been adequately examined. PHLs provided proposals indicating the type of TB laboratory service to be shared along with plans related to shipping, reporting, and collaboration with the jurisdictional TB control program. Laboratories are required to maintain the service in-house during the pilot phase. All awarded PHLs will document the challenges and successes associated with sharing services. Results from these projects will contribute to evidence-based practices essential for maintaining a comprehensive and efficient laboratory system, which is critical to the continued decline of TB in the United States.
The second funding opportunity allows PHLs to evaluate the performance of molecular diagnostic tests for TB and increase evidence-based knowledge regarding the most appropriate use of these assays in settings with both high and low burdens of TB. This funding is a follow-up to the one-time APHL/CDC grants that were awarded for the expansion of nucleic acid amplification testing (NAAT) in PHLs in 2010. NAAT has become the standard of practice for direct detection of M. tuberculosis complex (MTBC) from respiratory specimens and is now available to detect mutations associated with drug resistance. A variety of commercial and laboratory developed tests have become increasingly available for use in PHLs. However, despite CDC recommendations on the use of NAAT, there is considerable variability in how state TB control programs and PHLs use this testing, and there is no validated algorithm that directs its use at a programmatic level. Operational questions still surround the use of these technologies. Therefore, this funding opportunity was awarded as a mechanism for exploring and evaluating the best approaches to using these assays in their jurisdictions, considering their specific patient populations. Awardees will provide reports detailing how the funds are used and the impact and outcome of implementing either the shared services or the molecular diagnostic strategy. It is anticipated that awardee PHLs will contribute to published manuscripts detailing the benefits, challenges, and lessons learned based on these pilot programs.
—Submitted by Frances Tyrrell MPH, MT (ASCM), SM, and Tracy Dalton, PhD
Div of TB Elimination
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