11/8/23 TRF Requested Updates
SUBMITTER INFORMATION (no changes)
PATIENT INFORMATION (no changes)
SPECIMEN INFORMATION (need changes)
Modifications:
Move “Sediment-AFB Negative” from “Other” to “Sediment”
a. if “Sediment-AFB Negative” selected:
i. show selection “*Material approved by CDPH”: Yes/No
AND
ii. display message:
Under “Other” add additional options:
a. Processed tissue
b. Mixed culture
c. Non-viable culture
d. Other (add comment field, if selected)
Rename “Other” to “Other (e.g. tissue, mixed culture)”
TEST REQUESTED
Sequencing-Based DST (performed by default)
Please see detailed testing algorithm on test information webpage.
Phenotypic DST (pDST)
pDST is recommended to be performed in conjunction with sequencing-based DST, unless pDST has already been performed or will be conducted elsewhere. Please choose a pDST test below (leave blank if not needed):
Additional test option:
First-line pDST (RIF, INH, PZA[KV1] , EMB)
Additional test option:
Second-line pDST (MOX, AMK, CAP, ETA, KAN, RFB)
Additional test option:
First-line pDST [KV2] for 4-month RPT-MOX regimen (RIF, INH, PZA, MOX)[KV3]
WGS Genotyping
WGS Genotyping is performed by default on culture submissions or isolates obtained from submitted sediments and data will be submitted to the CDC for analysis/National Surveillance.
*Please confirm that you would like TB DST Reference Center to perform WGS Genotyping:
Yes, please perform default testing
No, submitter will be responsible for submitting necessary isolate and/or data elsewhere
Has sequencing-based DST been performed by CDPH or CDC on a sample from this patient previously?
Yes No
SUBMITTING LABORATORY’S RESULTS
*Has MTBC been identified in the submitted specimen?
Yes No
*Has any Rifampin resistance (RIF-R) been detected previously in the submitted specimen by molecular or growth-based testing?
Not Tested Not Detected Indeterminate Detected [KV8]
*Has first-line DST been previously performed?
Yes No
Please select any that apply:
Drug resistant TB has been previously detected in this patient
Patient is not responding to treatment or was previously treated for TB
Mixed culture
Non-viable culture
Phenotypic DST failed due to low growth
Comments on Submitting Laboratory’s Results
SHIPPING (no changes)
GENERAL COMMENTS
Provide any additional information pertaining to the test requisition here
______________________________________________________________________________________________________