Laboratory for Mycobacteria

Short history of the Laboratory

The original Laboratory for Tuberculosis was renamed the Laboratory for Mycobacteria in 1999, as we managed to reduce the incidence of TB to a level comparable to the best countries in the world On the other hand, other mycobacteria have become increasingly clinically important in recent decades. The decline in the active form of TB is associated with a decrease in the number of such laboratories in Slovenia. The Laboratory for Mycobacteria of the University Clinic Golnik has been the national reference laboratory for mycobacteria for the second decade in a row. It has been included in the European Network of National Reference Laboratories for Mycobacteria (ERL TB Net) for many years. Today, in addition to microscopic examination of infections by fluorescent methods and cultivation on various liquid and solid media, modern molecular biological tests are used to prove or exclude active TB. These tests allow us to demonstrate TB bacilli directly in infants, segregation of mycobacterial species and molecular biological genotyping and assist classical sensitivity testing methods in detecting mechanisms of mycobacterial resistance (gene mutations). Despite the development of molecular biological methods, cultivation remains the gold standard for demonstrating the active form of TB. Recently, state-of-the-art methods, such as the determination of whole genome sequencing or WGS, have been gradually introduced into diagnostics that for the time being only complement the classical laboratory diagnostics of active TB. Tuberculosis can also occur in patients in a latent form. We prove it with the IGRA tests. Over the past two decades, a huge leap forward has been made towards TB diagnostics with new IGRA tests. The current drawback of these tests is that they do not allow for a distinction between latent and active forms of the disease. Therefore, today, development is focused on the search for new biological markers (biomarkers) and the most optimistic experts predict that we will soon have available rapid tests that will differentiate between the two forms of TB. If that came true, it would be a really great revolution.

Employees

The Laboratory employs a total of 8 people:

• 1 Head of Laboratory, Specialist in Medical Microbiology, Doctor of Science;
• 1 R&D Associate, PhD;
• 5 Analysts in the National Laboratory;
• 1 Laboratory Technician.

Working hours

The Laboratory is open on weekdays (Monday through Friday) from 7am to 4pm.

Quality assurance

We devote a great deal of energy to ensuring the quality of our tests at the highest level. We have been constantly updating and improving our quality system since 1996 and have numerous internal and external controls in place on each part of our quality system. The MBL Laboratory Information System, in conjunction with the BIRPIS Hospital Information System, enables the electronic ordering of examinations for all domestic and some external clients as well as the e-mailing of results to the said clients. This way, we shortened the time required from issuing to getting the doctor's results and increased the quality of work. We are involved in various quality assurance schemes from abroad (INSTAND, ERL TB Net, WHO/SRLN Borstel) and regularly receive certificates of quality for our tests. We also have practical multi-day work controls performed by the Supranational Reference Laboratory of the Borstel Research Centre (Forschungszentrum Borstel, Germany). In the professional work and planning of laboratory processes, we follow the recommendations and guidelines of the European Centre for Disease Prevention and Control (ECDC) from Stockholm and the World Health Organisation for TB (WHO TB) as well as Slovenian regulations, such as: Rules on requirements to be met by laboratories performing laboratory medicine tests (Official Gazette of the Republic of Slovenia No. 64/2004 and 1/16).

Other Activities

The Golnik Laboratory for Mycobacteria is an active member of the European Network of National Reference Laboratories (ERL TB Net) and the National TB Programme of Slovenia. Together with the National TB Registry and TB Division at our clinic, we cooperate in the diagnosis of active and latent TB and mycobacteriosis, collect laboratory diagnostic data at the national level, send various data to international institutions (ECDC, WHO, ERLTB Net), perform other tasks of the National Reference Laboratory (testing and introducing new methods, training staff from other laboratories, both domestic and from many Balkan countries) and are active in taking measures to reduce TB in the country. By introducing molecular biological genotyping (in 2000) into routine epidemiological monitoring of TB bacillus transmission among Slovenian patients, which is part of the National TB Prevention Programme in Slovenia, we are able to control the TB epidemic in the country. The Head of the Laboratory also works in the council for treating TB and other mycobacteriosis in the country. We actively participate in domestic and foreign congresses, in international projects, in adopting domestic and European guidelines and in research work in our field.