Tuberculosis and other Infectious Diseases Testing

Mission

To assist with national and state surveillance, and subsequent epidemiological investigations, of infectious diseases by providing an array of molecular and conventional detection and characterization methods for pathogens of public health significance, such as those that cause tuberculosis (TB), malaria, influenza (Flu), and vaccine preventable diseases (e.g. pertussis/whooping cough, bacterial meningitis, measles, and mumps).

What we do

  • Test clinical specimens and microbiological isolates routinely submitted by hospital and commercial laboratories, health centers, the Rhode Island State Medical Examiner, and medical practitioners throughout the state for the presence of infectious disease-causing pathogens of public health significance.
  • Maintain readiness to provide heightened laboratory support and testing during infectious disease outbreaks.
  • Maintain the capacity to identify emerging and re-emerging pathogens using cutting-edge technologies.
  • Partner with the RIDOH Center for HIV, Hepatitis, STD, and TB Epidemiology to contribute laboratory data used in the active surveillance of tuberculosis within the state and to focus public health intervention efforts.
  • Refer Mycobacterium tuberculosis isolates from patients for molecular genotyping to assist with the epidemiologic tracking of TB across the nation.
  • Share test results with the RIDOH Center for Acute Infectious Diseases and Epidemiology (CAIDE) to assist them with surveillance for the presence and spread of respiratory pathogens, including influenza, as well as other vaccine preventable diseases.
  • Participate in the National Influenza Surveillance Program to assist in informing influenza vaccine development and the early detection of new influenza strains.
  • Confirm and characterize carbapenem-resistant Enterobacteriaceae (CRE) as part of a national surveillance program and to assist Rhode Island health care institutions with infection control efforts.
  • Characterize pathogens causing bacterial meningitis using serotyping and serogrouping methods to anticipate and prevent newly forming outbreaks.
  • Provide expert microscopic slide review to confirm the diagnosis of bloodborne parasites (Plasmodium spp./malaria and Babesia spp./babesiosis).
  • Refer specimens and isolates to the Centers for Disease Control (CDC) for further consultation and specialty testing (e.g. Powassan virus serology, placental tissue for Zika virus detection, invasive pneumococcal serotyping, botulism toxin testing, and M. tuberculosis susceptibility testing, among many others).

Accomplishments

  • In association with a nationwide CDC initiative, state Healthcare-Associated Infections/Antimicrobial Resistance prevention programs, and the Antimicrobial Resistance Laboratory Network, the RISHL stood up a new program to collect, confirm, and characterize carbapenem-resistant Enterobacteriaceae (CRE) and Pseudomonas aeruginosa (CRPA) isolates. These activities help identify isolates that produce a carbapenemase, classify the kind of carbapenemase present, alert the emergence of new antimicrobial resistance mechanisms, inform healthcare institution infection prevention programs, and estimate the burden of CRE and CRPA within the state and nationwide.
  • Ship on average 125 specimens/isolates per year to the Centers for Disease Control, or another CDC designated laboratory, for specialty testing or further characterization.
  • Contributed ˜30 stored Bordetella pertussis isolates from Rhode Island patients to the CDC as part of a nationwide molecular epidemiologic surveillance project.
  • Identified 6 cases of Mumps virus infections in an outbreak amongst college students.
  • Enhanced surveillance for 16 non-influenza respiratory pathogens by adding a multiplex molecular diagnostic panel to the labís test menu and integrated it into the labís routine influenza surveillance algorithm.