National Tuberculosis Institute

The laboratory at NTI has a distinction of being designated as one of the six National Reference Laboratories (NRL) under the National Tuberculosis Elimination Program (NTEP) by the Central TB Division, Ministry of Health and Family Welfare, Government of India.  The laboratory was assessed and certified as an NABL Accredited laboratory in 2021 for clinical diagnostic services offered for diagnosis and follow up of TB.

Functions:

• To enhance and strengthen skills of laboratory workers in the TB laboratory network across the country in timely and accurate diagnosis of TB & its drug resistance under NTEP.
• To provide quality assured clinical diagnostic services for tuberculosis to Karnataka districts under NTEP and referral services all over the country using state-of-the-art technologies.
• To function as National reference laboratory for monitoring and review of laboratory performance of TB laboratory network for quality assurance and continuous quality improvement in TB diagnostic services.
• To facilitate evaluation of innovative tools and technologies for improved and rapid detection of TB and drug resistance.
• To provide technical support to NTEP in development of technical guidance documents.

ACTIVITIES:

1. Laboratory Division provides clinical diagnostic referral services under NTEP for diagnosis of TB & NTM infection in clinical specimens received from Karnataka and other states.

2. Human Resource Capacity and Skill building:

• National level Trainings with hands on experience to the microbiologists and laboratory technologists from TB lab network across the country under NTEP for strengthening their skills and capacity building in various approved laboratory techniques to provide accurate and timely detection of TB and drug resistance.
• As a WHO collaborating centre, laboratory conducts trainings or workshops activities for national and international participants time to time.

3. External Quality Assurance Activities:

• Functions as NRL to supervise and monitor the performance of state level laboratories in the TB laboratory network through on-site evaluation and annual proficiency testing to strengthen Quality Assurance in TB diagnostic services and effective implementation of NTEP.
• The laboratory runs annual EQA program for rapid NAAT for all the NAAT sites across the country to strengthen lab proficiency in delivering highly accurate NAAT results.

4. Innovations and Research:

• Participates in evaluation of innovative and newer tools or technologies for facilitating their use in rapid determination of TB & Drug resistance
• Conducts validation of new diagnostic material under NTEP for its quality assurance whenever required such as for indigenous Gene Xpert cartridges.
• Participates in surveillance or prevalence studies under NTEP.

5. Technical Support to Central TB Division (CTD) by providing technical expertise in formulating guidelines on use of various diagnostic tools for TB under NTEP.

Diagnostic Services offered at Laboratory Division:

• Fluorescent or Zeihl Neelsen AFB Microscopy,
• Gene Xpert or Truenat testing for MTB and rifampicin resistance detection,
• Liquid culture (MGIT 960) and solid culture (Lowenstein Jenson) for mycobacterial growth,
• Line probe assay for MTB and first & second line drugs resistance,
• Liquid culture drug susceptibility testing for first, second line and newer anti-tubercular drugs,
• Line probe assay for non-tuberculous mycobacteria species identification.

List of Equipments:

The laboratory has state of the art diagnostic testing facilities and equipped with BSL-2 and BSL-3 laboratories. An array of specialized laboratory equipments are available including Gene Xpert (4 & 16 module), truenat machine, BACTEC MGIT 960 automated system, GT Blot-48, Twincubator and thermocycler for rapid diagnosis of tuberculosis and DST. Other equipments include refrigerated sealed centrifuges, microcentrifuges, Biosafety Class II A2 cabinets, fluorescent microscopes, light microscopes, inspissators, single and double water distilling units, - 20̊ C & - 80̊ C deep freezers, horizontal autoclaves, walk in incubator and walk in cold room. The advanced instrument for nucleic acid detection such as Next generation sequencer- MiSeq Illumina is installed by CTD for drug resistance surveillance and monitoring of most prevalent mutations associated with anti-tubercular drug resistance in the country.

The laboratory team consists of microbiologists, biotechnologist, biomedical engineer and laboratory technologists working together to provide clinical diagnostic services for a wide range of approved tests in diagnostic algorithm under the NTEP and facilitating training and research activities.

External Quality Assessment Scheme:

Laboratory regularly participates in annual external quality assessment programme (proficiency testing) of WHO-GLI Supranational Reference Laboratory Network (Antwerp, Belgium) and has been certified for first, second line and newer drugs sensitivity testing by phenotypic and genotypic methods.