Scottish Mycobacteria Reference Laboratory
The Scottish Mycobacteria Reference Laboratory (SMRL) is the Scottish Reference Laboratory for Mycobacteriology, particularly for the identification, drug susceptibility testing and strain typing of Mycobacterium tuberculosis complex (MTBC) and non-tuberculous mycobacteria (NTM). The laboratory receives approximately 1600 mycobacterial cultures a year, mainly from Scottish NHS laboratories.
The laboratory is based within the Directorate of Laboratory Medicine, Royal Infirmary of Edinburgh. It is part of the Scottish Microbiology Reference Laboratories, Edinburgh and is fully integrated with the Combined Laboratories NHS Lothian. SMRL is commissioned and funded through a service level agreement between National Services Scotland (NSS), Public Health Scotland and NHS Lothian. Some services have been developed which are available at a charge to the user.
Levels of Service
1. National Services Scotland funded Remit
SMRL receives cultures of presumed mycobacteria from all NHS laboratories in Scotland. These cultures are tested to determine:
- Presence of mycobacteria.
- Full mycobacterial species identification.
- Susceptibility to standard anti-mycobacterial drugs.
- Susceptibility to second line anti-mycobacterial drugs where appropriate.
- Genomic comparison of M. tuberculosis complex strains
- Use of molecular tests on smear positive respiratory samples to rapidly identify the presence of mycobacteria and screen for rifampicin drug resistance in M.tuberculosis complex.
2. Services available by charging users:
- Rapid liquid culture of samples from normally sterile sites (e.g. blood, CSF, bone marrow, tissue samples, aspirates and bronchoalveolar lavage samples).
- Molecular tests on smear-negative samples and smear positive non-respiratory samples.
- Molecular tests to screen for isoniazid, fluoroquinolones, amikacin, capreomycin, kanamycin and ethionamide drug resistance in isolates of M. tuberculosis complex.
- Culture of smear-negative samples.
- Identification of slow growing mycobacterial species from environmental water and air samples e.g. from heater-cooler units and environments where these units are in operation.
3. Services available by contract between requesting service and NHS Lothian:
- Processing of routine samples including blood cultures from patients for mycobacteria investigation.
Costs for private tests are available on request.
SMRL is currently accredited to UKAS ISO 15189:2012 (9546) and the scope of accreditation can be viewed here.
Environmental water sampling, NTM susceptibility testing, direct molecular detection of non-pulmonary samples is currently out with our scope of accreditation.
Telephone, Fax and E-mail Enquiries
TB Laboratory tel : 0131 242 6022/3
TB Office tel : 0131 242 6016
For non-urgent matters contact us via email: Loth.Smrl@nhslothian.scot.nhs.uk
Fax machines are not considered a safe method of transmitting sensitive information; therefore fax provision in NHS Lothian is not available.
Core hours are from Monday to Friday, 9am to 5 pm. The lab is closed weekends, Christmas and New Year holidays.
At other times users can discuss urgent AFB microscopy via the Consultant/Specialist Registrar On-Call for Clinical Bacteriology (contact via the RIE switchboard on 0131 536 1000). There is currently no out-of-hours AFB screening or Reference Laboratory service.