title: Mycobacterium tuberculosis testing practices in hospital, commercial and state laboratories in the New England states.
abstract: METHODS
  The mycobacterial laboratory is assuming an increasingly important role in tuberculosis (TB) control in the United States today.
  
  
  OBJECTIVE
  To assess mycobacterial laboratory capacity and practices in the New England states, USA.
  
  
  METHODS
  We surveyed 143 hospital and commercial  laboratories and five of the six state public health laboratories in New England that offer testing services for Mycobacterium tuberculosis. The survey captured information on types of services offered and volume of testing, use of state laboratories for testing, and promptness of reporting  results to TB control programs.
  
  
  RESULTS
  State laboratories perform the majority of testing services, particularly for more specialized tests. All state laboratories surveyed perform species identification of acid-fast isolates, culture and first-line drug susceptibility testing. Less than  20% of hospital and commercial laboratories offer these services, and 78.6% of hospitals and commercial laboratories refer specimens to state laboratories for culture.
  
  
  CONCLUSIONS
  Surveys of M. tuberculosis testing capacities in a region can help decision makers ensure maintenance  of essential services. Hospital and commercial laboratories with lower testing volume might increase efficiency by referring more specimens to state laboratories. State health departments might consider organizing regional laboratory service networks to monitor the provision of services, improve  efficiency and oversee quality improvement initiatives.
authors.affiliation: Yale University, New Haven, Connecticut, USA. kara.livingston@tufts.edu
authors.forename: K A
authors.initials: KA
authors.lastname: Livingston
authors.forename: M N
authors.initials: MN
authors.lastname: Lobato
authors.forename: L E
authors.initials: LE
authors.lastname: Sosa
authors.forename: G E
authors.initials: GE
authors.lastname: Budnick
authors.forename: J
authors.initials: J
authors.lastname: Bernardo
mesh_terms: D000995:Antitubercular Agents / Q000494:pharmacology*; D001431:Bacteriological Techniques / Q000379:methods* / Q000706:statistics & numerical data; D003625:Data Collection; D006801:Humans; D059425:Interferon-gamma Release Tests / Q000706:statistics & numerical data; D007753:Laboratories / Q000706:statistics & numerical data; D007755:Laboratories, Hospital / Q000706:statistics & numerical data; D008826:Microbial Sensitivity Tests / Q000379:methods / Q000706:statistics & numerical data; D009169:Mycobacterium tuberculosis / Q000187:drug effects / Q000302:isolation & purification*; D009511:New England; D013183:Sputum; D014376:Tuberculosis / Q000175:diagnosis* / Q000382:microbiology
chemical_list: D000995:Antitubercular Agents