​​​​​​​​​​​The National PHL Drug Susceptibility Testing (DST) Reference Center for Mycobacterium tuberculosis (MTBC) provides quality-assured drug susceptibility testing for eligible US public health laboratories with low volumes of testing. The Reference Center 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. California Department of Public Health’s Microbial Diseases Laboratory serves as the Reference Center.

Enrollment Criteria

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 Services ​

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 and ethambutol

  • DST for 4-month rifapentine-moxifloxacin regimen using MGIT with a panel of rifampin, isoniazid and moxifloxacin

  • ​​Pyrazinamide DST using MGIT when a mutation with uncertain significance is detected via molecular methods​​ and PZA resistance cannot be ruled out

  • Second-Line DST using MGIT with a panel of ethionamide, capreomycin, amikacin, moxifloxacin, kanamycin and rifabutin

  • Molecular detection of drug resistance performed by whole genome sequencing on submitted isolates and by targeted next generation sequencing on specimen sediments, mixed and non-viable cultures

  • Whole genome sequencing data will be shared with the CDC for the purpose of national molecular surveillance

Resources for Submitting Laboratories


Please direct questions to Sarah Buss (sarah.buss​@aphl.org​)