Mycology and Mycobacteriology Testing in Vermont

The Vermont Department of Health Laboratory offers a few different options for Mycology and Mycobacteriology testing; you will find detailed information about each below.

For collection/packaging instructions for any of the tests listed below visit our Forms & Ordering Information page.

TB and Fungi-TB

The Vermont Department of Health Laboratory cultures and identifies Mycobacterium tuberculosis, the causative agent of tuberculosis (TB) and other pathogenic Mycobacterium species from all specimen types.

There is no fee for mycobacteriology test services.

Isolates that cannot be identified at the Laboratory may be forwarded to National Jewish Health for identification.

Rapid, direct detection of M. tuberculosis in respiratory specimens is available on demand for patients who have not started TB treatment. All first time smear positive and provider requested respiratory specimens are tested.

  • The GeneXpert MTB/RIF Assay detects M. tuberculosis and resistance to the important TB treatment drug rifampin in sputum specimens.
  • The Amplified M. tuberculosis Direct (MTD) test detects M. tuberculosis in bronchoscopy specimens.

If rifampin resistance is detected by GeneXpert, the specimen is referred to CDC for gene sequencing.

Rapid molecular detection of drug resistance is available at a designated CDC laboratory for all M. tuberculosis isolates suspected to have drug resistance.

 

Guidelines for using nucleic acid amplification tests to aid TB diagnosis and airborne infection isolation decisions:

 

Consensus statement on the use of Cepheid Xpert MTB/RIF®assay in making decisions to discontinue airborne infection isolation in healthcare settings

TB and Fungi-Fungi

The Vermont Department of Health Laboratory accepts all specimen types submitted for culture of both mycobacteria and fungi. Yeasts are identified via biochemical testing with API ID32C. Fungal isolates are referred to reference laboratories for identification.

Quantiferon Testing

Tuberculosis (TB) is caused by a bacterium called Mycobacterium tuberculosis. Not everyone infected with TB bacteria becomes sick. As a result, two TB-related conditions can exist: latent TB infection (LTBI) and active TB infection.

Culture of the bacteria, molecular assays, and blood tests can be performed to determine if a person has been exposed to TB. The blood test utilized at the Vermont Department of Health Laboratory is called the QuantiFERON-TB Gold (QFT®). 

The QFT an interferon-gamma (IFN-y ) release assay, commonly known as an IGRA, and is a current alternative to the  tuberculin skin test (TST or Mantoux). Unlike the TST, QFT is a controlled laboratory test that requires only one patient visit and is unaffected by previous vaccination with Bacille-Calmette Guerin (BCG). 

A positive QFT is a strong indicator of exposure to TB, but it cannot differentiate between active infection with TB and latent tuberculosis infection (i.e. a person who has no signs or symptoms of disease). 

Positive QFT results are used in conjunction with risk assessments, radiography, and other medical and diagnostic evaluations by the patient’s doctor.