P006
Diagnostic capacity and Biosafety practices for Tuberculosis: Assessment of the Portuguese National Laboratory Network
R Cordeiro(1,2) P Gonçalves(3) S Silva(3) I Rodrigues(3) A Pelerito(1,2) I L Carvalho(1,2) M S NĂșncio(1,2) A S Silva(3) R Macedo(3)
1:Emergency Response and Biopreparedness Unit, Department of Infectious Diseases, National Institute of Health Doutor Ricardo Jorge, Portugal; 2:Institute of Environmental Health, Faculty of Medicine, University of Lisbon, Portugal; 3:National Reference Laboratory for Mycobacteria, Department of Infectious Diseases, National Institute of Health Doutor Ricardo Jorge, Portugal
To assess tuberculosis (TB) diagnostic capacity and biosafety practices across the 41 laboratories of the Portuguese TB laboratory network, the National Institute of Health Doutor Ricardo Jorge conducted a survey covering laboratory practices, infrastructures, training, emergency procedures, waste management, occupational health, and diagnostic methodologies. The response rate was 90% (37/41), covering six of the seven Portuguese health regions.
Nearly half (49%) of the laboratories focus exclusively on TB diagnosis. About 32% operate under BSL-3 conditions, though one BSL-1 laboratory reported performing solid-media culture. Most laboratories (70%) have biosafety manuals, yet 16% do not use respiratory protection when handling aerosol-generating infectious materials, despite all reporting the use of class II biological safety cabinets. Additionally, 8% report lacking adequately trained staff, and 57% do not have occupational health programmes implemented.
Microscopy is performed by 97%, and 81% use nucleic acid amplification for Mycobacterium tuberculosis complex detection. All but one laboratory performs microbial culture, with 92% using both solid and liquid media. First-line drug susceptibility testing (DST) is carried out by 86% of laboratories, while only 34% extend testing to second-line antibiotics, with just three performing phenotypic second-line DST. Over half (51%) also test for non-tuberculosis mycobacteria. All laboratories can refer specimens within the network if unable to provide a given service.
The findings reveal strong diagnostic coverage and inter-laboratory articulation at national level, but also highlight considerable gaps in biosafety, training, and occupational health. Continued collaboration and improvement efforts are crucial to improve TB control and ensure quality and laboratory safety.