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Guide to the Application of Genotyping to Tuberculosis Prevention
and Control
Return to Genotyping Main Menu
CDC Tuberculosis Genotyping Laboratory Procedures
Suspected False-Positive Cultures
If a submitting laboratory suspects that an isolate represents
a false-positive culture, they should indicate this suspicion on
the TB Genotyping Isolate Submission Form by entering “Yes” in the
column labeled “Suspected False+.” If the submitting laboratory
identifies a possible source for the false-positive culture (which
could be one of the isolates in the current shipment, a previously
submitted isolate, or a laboratory control strain), this information
should be listed in the “Comments” field of the suspected false-positive
isolate. In some instances, there may be a set of isolates that
are suspect. All of these should be indicated by a “Yes” in the
column labeled “Suspected False+” on the submission spreadsheet.
These isolates will be genotyped in the usual manner, matched against
all isolates from that program, and assigned cluster designations.
The genotyping laboratory will report the results to the TB program
as usual. In addition, the genotyping laboratory will report the
spoligotype and MIRU type and the results of the comparison with
possible source isolates to the submitting laboratory as “the suspect
isolate does (or does not) match the possible source isolate(s).”
If there is a match, the cluster designation will also be reported.
The genotyping laboratory will not report the result as confirming
a false-positive culture. The submitting laboratory, clinician,
and TB program must make that determination after considering all
available information. A standard disclaimer will be included stating
that genotyping methods are research procedures.
Because previous episodes of false-positive cultures resulted from
cross-contamination by the H37Rv/Ra M. tuberculosis control
strain, the genotyping laboratory will follow special procedures
to ensure that cross-contamination by this strain is identified
automatically. The PCR type for the H37Rv/Ra strain will be included
by the genotyping laboratory in the file for each program and will
be assigned the cluster designation “H37.” If a patient isolate
is, in fact, the result of cross-contamination with this control
strain, the genotyping process will assign it the H37 cluster number
automatically. This is the only instance when the genotyping laboratory
will report an isolate as being the result of a possible false-positive
culture.
Last Reviewed: 05/18/2008 Content Source: Division of Tuberculosis Elimination
National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention
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