The Centers for Disease Control and Prevention (CDC) Antibiotic Resistance Laboratory Network has announced support to establish the National Tuberculosis Molecular Surveillance Center (NTMSC), at the Michigan Public Health Laboratory. The NTMSC will perform whole genome sequencing (WGS) for all isolates of Mycobacterium tuberculosis (Mtb) received from newly diagnosed patients. WGS is a type of genotypic testing that provides a full picture of an isolate’s entire genome. The United States will be one of a handful of countries to offer WGS on a national level.
The NTMSC advances the ability of CDC and state and local partners to investigate outbreaks of tuberculosis (TB) by identifying related isolates within possible transmission networks. This will allow TB control programs to target limited public health resources on more effective public health interventions.
The NTMSC will also allow for national surveillance of molecular drug resistance and aid the potential establishment of new testing algorithms that could be used to develop new diagnostics or programs to aid clinical decision making. Alerts will be integrated into data analysis tools such that CDC is notified when resistance to rifampin, the most important first-line anti-tuberculosis drug, is detected. CDC will notify state partners to ensure isolates from patients with potentially drug-resistant TB are referred to a CLIA-compliant laboratory for additional testing.
The National TB Genotyping Service established universal genotyping for all Mtb isolates in 2004. This service has supported U.S. public health efforts to identify potential outbreaks of TB. The NTMSC will now include advanced molecular detection technologies to characterize isolates from newly diagnosed patients. All Mtb isolates will undergo both conventional genotyping and WGS for a three-year transition period, after which WGS will replace conventional genotyping. The new capacity to perform universal whole genome sequencing does not replace the diagnostic and reference testing available through CDC’s Molecular Detection of Drug Resistance Service or the National DST Reference Center located at the California Microbial Diseases Laboratory.
Additional details and educational opportunities will be provided to partners over the next several months. Visit the CDC Division of Tuberculosis Elimination’s website for more information.
Thank you for your continued work toward the goal of TB elimination.