2007 - Alabama Department of Public Health

ureau of clinical laboratories
The division continues participation in the Tuberculosis
Cooperative Agreement Grant and CDC Tuberculosis
Multi-Drug Resistant Susceptibility Study. Isolates from
all new cases of M. tuberculosis are being sent to the
regional DNA Fingerprint laboratory in Michigan for
genotyping. Genotype cluster information is relayed to
the Division of Tuberculosis Control.
Sanitary Bacterology/Media Division
The Sanitary Bacteriology/Media Division, located
in the Montgomery Laboratory, tests dairy products,
public and private water samples, as well as prepares
the media used by both the county health departments
and within the lab system. The number of both dairy
and water samples tested remained relatively the same
when compared to 2006. Working with the Alabama
Department of Environmental Management, four public
water utility laboratories were inspected for compliance
with state and federal regulations. The Media Section
made a total of 4,295 liters of media which poured 78,051
plates and 102,286 tubes. The breakdown for each
division is shown in Table 3 below.
TABLE 3 Liters Tubes Plates Flasks/Bottles
Metabolic 19
Milk and Water 455 2500 2,678
TB 1,366 8,141 8,052
Mycology 146 24,107 160
Microbiology 1,692 67,538 36,647
Birmingham Lab 603 32,472
Mobile Lab 14 720
Serology Division
In March of 2007 the division began using a new, third
generation human immunodeficiency virus (HIV) test
that detects both HIV 1 and HIV 2 and is much more
sensitive than the first generation test that we had been
using. The positivity rate for the enzyme immunoassay
(EIA) test went up slightly, about 0.35 percent. As a
result the division ran about 10 percent more Western
Blots. There was very little change in the number of
positive Western Blots but the number of indeterminate
specimens increased significantly. No HIV 2 positive
specimens were detected in 2007. Overall test numbers
remained steady with 107,161 specimens being tested for
HIV in 2007.
The division participated in a syphilis methodology
comparison study with Trinity BioTech comparing its
EIA test for syphilis with the Venereal Disease Research
Laboratory (VDRL) test that the division runs on a
routine basis. Due to the increased cost of the EIA it
was decided to continue with VDRL. There were 42,464
specimens for syphilis tested in 2007 with a positivity
rate of 3.2 percent.
The division continued to experience relatively high
positivity rates for Chlamydia trachomatis,13.1 percent,
and Neisseria gonorrhea, 5.2 percent. The Serology
Division tested 37,556 specimens for each condition.
Quality Management Division
The responsibilities of the Quality Management
Division of the Bureau of Clinical Laboratories and the
Alabama County Health Department Laboratory System
encompass all facets of technical and non-technical
functions. The division began the year with a host of
changes and challenges. Changes in leadership and the
addition of new personnel allowed the division to pursue
its mission to ensure that the policies and procedures
set forth by the Clinical Laboratory Improvement
Amendments standards are maintained and ultimately
exceeded.
The division’s functions consist of several components
such as: patient test management; procedure manual
development; quality control assessment of county
clinics; training assessment of new and existing clinical
personnel; administration and monitoring of the Bureau
of Clinical Laboratories and county proficiency testing;
test result and method validation; patient information
and test relationships; personnel assessment of bureau
and county employees; communication assessments;
complaint investigations; assessment of safety issues and
laboratory documentation issues.
The highlight for the division is the debut of the new
county laboratory system policies and procedure manual
that was published and distributed throughout the state.
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