Jessica Gentry Tuberculosis Laboratory Supervisor jgentry@isdh.in.gov QFT at ISDH Laboratory Collecting and Submitting Specimens for QuantiFERON-TB Gold Plus Jessica Gentry Tuberculosis Laboratory Supervisor jgentry@isdh.in.gov

Objectives Specimen collection and hold times Packaging and shipping Reporting and results interpretation Timeline for results LimsNet Cost of testing

Specimen Collection

Collection Methods Available Single Tube—minimum 5 mL 4 Tube—1 mL in each tube

Blood Collection Methods www.quantiferon.com

Blood Collection Methods Blood from lithium heparin tubes will be transferred into QFT tubes when received at ISDH QFT tubes must be shaken 10 times and incubated at 37 °C for 16-24 hours. After incubation, tubes must be centrifuged to harvest plasma.

Hold Time Option #1 www.quantiferon.com

Hold Time Option #2 www.quantiferon.com

Hold Time Option #3 www.quantiferon.com

Which Collection Method is Better? Single Tube It’s one tube! More accurate results 4 tube draw requires specific and detailed pre-analytical processing that can impact the results 4 Tube More flexible hold times Whichever option is used, it is important to strictly follow the sample handling instructions exactly. Improper handling could lead to inaccurate results.

Packaging and Shipping

Specimen Packaging and Shipping All blood specimens must be packaged as a Category B, Biological Substance ISDH provides collection tubes and shipping supplies free for local health departments To order containers: containers@isdh.in.gov 317-921-5875

Ambient Shipping Supplies 3 components: Lithium heparin collection tube Watertight, secondary container Rigid outer container Secure caps Include absorbent material inside secondary container Paperwork and cans should be placed in UPS bag for shipment

Refrigerated Shipping Supplies Blood tubes should be placed in a biohazard bag with absorbent material Bag and ice packs should be placed in cooler box Cooler box is placed in outer box Outer box is labeled with UPS label and Category B label

Reporting and Results Interpretation

QuantiFERON Lab Report Expected time for results: 2-3 business days

Results Interpretation www.quantiferon.com

LimsNet

Ordering QFT in LimsNet The same test name Tuberculosis will be used for both sputum submissions and QFT tests, but several updates will be made to this form Test types: 1) Specimen (AFB Smear and Culture) 2) Mycobacteriology Isolate 3) QuantiFERON-TB When one of these is selected, it will gray out the non- applicable items for each test type Reason for test Specimen information

Billing and Pricing QFT will be a billable test for ISDH: LHDs may provide valid insurance billing information for each patient tested OR LHDs will be billed $20 per test This billing strategy will allow ISDH to recover the cost of the QFT tubes/ELISA test kits

Timeline for Go-Live Date LimsNet changes are being implemented Packaging and shipping materials are being purchased Lab documents still being written/reviewed Training materials for LHDs being created The goal is to be offering this testing to LHDs by early summer

Questions? Jessica Gentry, Tuberculosis Laboratory Supervisor Indiana State Department of Health jgentry@isdh.in.gov Phone: 317-921-5858