Bacteriology

The Bacteriology section isolates, identifies and characterizes pathogens, and performs confirmatory testing of suspect agents of bioterrorism. The Hygienic Laboratory is the only laboratory in Iowa that performs many specialized public health tests, including enteric serology, rabies and Pulsed Field Gel Electrophoresis for participation in PulseNet. This program uses lab methods to extract DNA from enteric pathogens and create a "fingerprint" pattern of the organisms. This pattern is then used to link the incidence of illness to larger outbreaks.

During fiscal year 2013:

• Iowa and Missouri successfully demonstrated that sharing services between the states to conduct tuberculosis nucleic acid amplification testing (NAAT) can decrease costs for the public health laboratory without adversely affecting patient care.

  Bacteriology also determined how many NAATs are required on a smear-negative patient to detect the presence of Mycobacterium tuberculosis complex within 24 hours of receipt of the specimen from patients who were ultimately culture positive in a low prevalence state. The study demonstrated that a maximum of two specimens allowed for early detection of TB. This is one less specimen than guidelines previously recommended, which resulted in savings for the TB program. Both these projects were funded by the Association of Public Health Laboratories and CDC.

• The Hygienic Laboratory implemented the CDC recommendation to return to culture for Neisseria gonorrhea to detect antibiotic resistant strains in patients who are either failing injectable therapy or receiving oral antibiotics. All aspects of the testing were validated, from selection of collection swab, media suitability and transport conditions to the identification method and IT (information technology) considerations. Testing became available within two months of the recommendations being released.