Brisbane, Australia SRL

Description

The Queensland Mycobacterium Reference Laboratory (QMRL) is the State diagnostic and reference laboratory for tuberculosis (TB), non-tuberculous mycobacteria (NTM) and Nocardia. QMRL is the only diagnostic laboratory for mycobacteria in the Queensland public sector. It also   receives isolates from private pathology providers for speciation and drug susceptibility testing. The laboratory has PC3 level biosafety and is accredited by the National Association of Testing Authorities, Australia (NATA). QMRL participates in comprehensive external quality assurance and pursues operational and clinical research internally and with external collaborators domestically and internationally. Originally established in the 1950’s, QMRL became an SRL in 1994. The lab is Australia’s only designated World Health Organization  (WHO) Collaborating Centre for Tuberculosis Bacteriology.

Structure and organization

QMRL is located on the Campus of the Royal Brisbane and Womens Hospital and forms part of the Microbiology Department, Central Laboratory, Pathology Queensland. Pathology Queensland provides a wide range of pathology services to all public hospitals in Queensland. Executive line management for Pathology Queensland is located within the Health Support Queensland Division of the Department of Health. QMRL is supervised by a Director (medical microbiologist and infectious diseases physician) and a Chief Scientist (medical PhD scientist). 

Services provided by the SRL

QMRL provides acid fast microscopy (ZN and FM), mycobacterium cultures (liquid and solid), speciation by commercial and in-house molecular methods, drug susceptibility testing for TB and NTM (rapid growers and slow growers including M. intracellulare/avium), TB genotyping by VNTR-MIRU, Whole Genome Sequencing (WGS)   research only, resistance gene sequencing, PCR diagnosis for M leprae, M ulcerans(direct) and  M.abscessus (from isolates), slit smear examination for M lepare, Nocardia speciation and DST. Other services include quality assurance activities (EQA) for external country TB laboratories, overseas private sector partner, reference testing for TB drug susceptibility testing (DST), reference centre for multicentre commercial pharmaceutical trial, and participation in research. QMRL also provides adjudication for National QAP provided by the Royal College of Pathologists of Australasia.

TB diagnostic methods

The QMRL provides the following TB specific tests: 

• acid fast smear microscopy (ZN and FM), 

• mycobacterium cultures (liquid/Bactec MGIT 960 and solid LJ pyruvate), 

• direct detection (IS6110 PCR, gene Xpert MTB/RIF) 

• speciation by commercial and in-house molecular methods (MPT64, CM line probe, region of deletion analysis (RDA), 16s/HSP65 sequencing), 

• DST to first and second line drugs (MGIT proportion), micro broth dilution 

• molecular resistance detection by direct and indirect methods ( Hain MTBDRplus, Hain MTBDRsl, GeneXpert, resistance gene sequencing (rpoB, inhA promotors, katG, emb, pncA, gyrA, rrs, tylA, eis), 

• genotyping by 24 loci MIRU plus VNTR 

• whole genome sequencing (research only).

QMRL has SRL partnerships with the National TB Programmes of Papua New Guinea, Kenya, Vanuatu, Fiji and Nauru. QMRL helped plan and provided reference culture/DST services for the first Subnational DRS PNG, has provided reference services for National DRS, Kenya and will provide consultation and reference services for a National DRS, Sri Lanka 2017.

Current links and partnerships outside of SRLN

In addition to SRL partnering with PNG, targeted services of primary TB isolation, molecular resistance detection, culture and DST is provided to the South Fly TB Program (Daru) and Medecins Sans Frontieres (MSF) funded program. Reference testing is also provided on ad hoc request to Malaysia, Brunei and Sri Lanka. QMRL is a member of the Australian and New Zealand Mycobacterial Special Interest Group (Australian Society for Microbiology). The lab is also a reference centre for a large multicentre commercial trial.