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

______________________________________________________________________________________________________