National Public Health Laboratory Drug Susceptibility Testing Reference Center for Mycobacterium tuberculosis

The California Department of Public Health’s Microbial Diseases Laboratory serves as the National PHL Drug Susceptibility (DST) Reference Center for MTB. The Reference Center provides quality-assured drug susceptibility testing for eligible US public health laboratories with low volumes of testing and serves as an extension of CDC’s Division of TB Elimination Laboratory Branch providing services that are harmonized with and complementary to those available at CDC. 

Enrollemnt Cirteria

Enrollment is restricted to public health laboratories performing TB DST on fewer than 50 isolates per year.Participation in the reference center is voluntary. CDC’s testing services remain available to all US TB Programs.Jurisdictions that are not eligible to enroll may still submit specimens and/or isolates to CDC for the Molecular Detection of Drug Resistance (MDDR) or second-line DST.

Testing Srvices ​

The National PHL DST Reference Center for MTBC will provide the following services at no cost to eligible submitting PHLs: First-Line DST using MGIT with a panel of rifampin, isoniazid, pyrazinamide and ethambutol Second-Line DST using MGIT with a panel of ethionomide, capreomycin, amikacin and moxifloxacin Molecular detection of drug resistance will be performed by pyrosequencing on specimen sediments and isolates from patients that meet pre-determined criteria for suspicion of drug resistance.

Resources for Submitting Laboratories

TB DST Reference Center User’s Guide
Submission and Shipping Instructions
Pre-submission Approval Form for pyrosequencing
Requisition Form
Flowchart of referral and testing algorithms

Additional Information

Dear Colleague Letter
Informational Webinar presentation


Please direct questions to Kelly Wroblewski at