Clinical Bacteriology - Frequently Asked Questions

A: A Texas Notifiable Conditions list is available at Notifiable Conditions | Texas DSHS. The reporting contact(s) for the county of the patient’s residence must be notified of confirmed and suspected cases of a notifiable condition within the required reporting timeframe. Not all notifiable conditions require an isolate be submitted to the DSHS Laboratory for testing.

Reports must be submitted to local or regional DSHS epidemiologists in the DSHS’ Infectious Diseases Control Unit (IDCU), not to the Laboratory.

A: No. Please do not submit reports to the Laboratory. The disease reporting contact (epidemiologist) of the patient’s county of residence must be notified instead.

Call, fax, or mail a completed Infectious Disease Report Form (EPI-1 or EPI-2) to the health department contact listed for that county. Report forms faxed or emailed to the Laboratory may not be forwarded to the correct party.

If your facility is set up for Electronic Lab Reporting (ELR) with DSHS, reports will be automatically submitted to NEDSS and DSHS epidemiologists. Faxing or mailing report forms is not required.

Facilities that have ELR are still required to call 1-800-705-8868 to notify DSHS epidemiologists of immediately reportable conditions.

• Notifiable Conditions Reporting Epidemiology contacts by county available online here: http://www.dshs.state.tx.us/idcu/investigation/conditions/contacts/
• EPI-1 and EPI-2 Reporting Forms available online here: https://www.dshs.texas.gov/notifiable-conditions/reporting-forms
• Information about signing up for ELR is available here. FAQs about electronic reporting are available here.

A: No. Electronic National Electronic Diseases Surveillance System (NEDSS) reports are autogenerated, notifying DSHS epidemiologists of positive results for infectious diseases.

A: Required specimens are:

• Bacillus anthracis isolates
• Bacillus cereus isolates that may contain anthrax toxin genes from patients with severe disease or death
• Clostridium botulinum isolates 
• Brucella species isolates 
• Candida auris isolates
• Corynebacterium diphtheriae isolates
• Haemophilus influenzae isolates from normally sterile sites in children under the age of five years old
• Listeria monocytogenes isolates (Listeriosis)
• Neisseria meningitidis isolates from normally sterile sites or purpuric lesions
• Yersinia pestis isolates 
• Salmonella species isolates (or clinical specimen if positive by culture-independent diagnostic testing)
• Shiga toxin-producing Escherichia coli (all E. coli O157:H7 isolates, and any E. coli isolates or specimens in which Shiga toxin activity has been demonstrated)
• Mycobacterium tuberculosis complex, isolates of all complex members
• Staphylococcus aureus with a vancomycin MIC greater than 2 ug/ml (VISA and VRSA)
• Streptococcus pneumoniae isolates from normally sterile sites in children younger than 5 years old
• Francisella tularensis isolates
• Vibrio species isolates (or clinical specimen if positive by culture-independent diagnostic testing)

Questions about appropriate specimen handling may be directed to the Clinical Bacteriology Team by calling (512) 458-7582 or 1-888-963-7111 ext. 7582 (toll-free).

Additional guidelines on specimen shipping and mailing specimens to the Laboratory are found on DSHS Laboratory’s webpages at Texas Department of State Health Services, Guidelines for Specimen Shipping and Mailing.

A: In Section 2 of the G-2B Form

•  If specimen is associated with an outbreak, check “Outbreak” (you will usually be instructed by an epi to do so) 
• Otherwise, check “Surveillance”

In Section 4.1 of the 2024 G-2B Form

Check the box next to the organism type

• Ship refrigerated or frozen specimens in insulated containers with enough refrigerant (gel ice packs or dry ice) to keep them cold for up to 48 hours.
• Avoid shipping on Fridays or before holidays. Specimens that arrive at the Laboratory at weekends or on holidays will not be processed for intake or be tested.
• Use multiple freezer packs. One cold pack is not enough to keep specimens cold in the elevated summer temperatures.
• Maximize insulation and cushion specimens by minimizing empty space inside the insulated container by packing remaining space with absorbent material.
• Submit specimens as soon as possible after collection. Do not hold onto specimens to bulk-ship them.
  For example, swabs for gonorrhea susceptibility testing (GC AST) must be shipped to the laboratory ASAP after collection. They MUST be tested within 24 hours of collection, otherwise the results are unreliable.

A: Submit the specimen to the DSHS Laboratory and we will attempt to isolate the organism. Specimens should be transported as soon as possible for the best possibility of recovery of the organism. Attach your laboratory results to the submission form. Acceptable specimens are stool in Cary Blair transport or the GN or MAC Broth used for your testing. Specimen that are in a lysis solution such as Prime Store Molecular Transport medium are not acceptable, as viable organisms are required for our studies

A: No. Specific collection and transport rules for food samples must be strictly adhered to for test results to be deemed valid and reliable. If you are feeling unwell, contact your primary care provider. If after consulting your primary care provider, you believe your illness may be caused by something you ate at a food establishment, contact your local health department to make a report.

A: Please submit specimens to the DSHS Laboratory to be routed to the CDC. Do not ship directly to the CDC unless you have received pre-approval from the CDC. You may call the Clinical Bacteriology Team at (512) 458-7582 or 1-888-963-7111 ext. 7582 (toll-free) for handling instructions before shipping.

There are rare, urgent cases where timing is so crucial that a specimen should be sent directly to the CDC, however the local state public health laboratory (DSHS) must always be notified in such cases. Doing so ensures that the result report can be provided to the original submitter as soon as possible. The CDC no longer issues reports directly to submitters; only to state public health laboratories. These reports will then be forwarded to the appropriate submitter upon receipt.