National and International Activities

The Microbiology division of PHL participates in international, national and regional programs for public health surveillance and response, including:

• PulseNet - National Molecular Subtyping Network for Foodborne Disease Surveillance
• World Health Organization (WHO) Collaborating Laboratory for Influenza Surveillance
• NREVSS - National Respiratory and Enteric Virus Surveillance System
• NARMS - National Antimicrobial Resistance Monitoring System
• FoodCORE - CDC Foodborne Centers for Outbreak Response Enhancement
• CaliciNet - National Molecular Subtyping Network for Foodborne Disease Surveillance
• LRN - CDC Laboratory Response Laboratory

Food Microbiology Laboratory

The Food Microbiology Laboratory protects the safety, health, and welfare of the citizens of South Carolina by ensuring that food is safe and wholesome. The laboratory works with the Bureau of Environmental Health and the Division of Acute Disease Epidemiology (DADE) to determine the source of causative agents in foodborne illness outbreaks.

The Food Microbiology Laboratory was awarded a grant from the Food and Drug Administration (FDA) to obtain ISO/IEC 17025:2005 accreditation and achieved this accreditation in March of 2016. As part of this grant, the Food Laboratory routinely tests frozen dairy treats for foodborne pathogens and, in 2015, the laboratory isolated and identified Listeria monocytogenes in Blue Bell Ice Cream which led to a recall of products. The Laboratory has also been awarded a grant to work with the Food and Drug Administration (FDA) Center for Veterinary Medicine (CVM) to perform routine testing of retail meat samples as part of a National Antimicrobial Resistance Monitoring System (NARMS) Cooperative Agreement Program to Enhance and Strengthen Antibiotic Resistance Surveillance in Retail Food Specimens.

Service Offered

Foodborne pathogens surveillance:

• Laboratory tests for Staphylococcus aureus, Bacillus cereus, Clostridium perfringes, Salmonella,Campylobater, Listeria, E. coli O157:H7 and non-O157 STEC, Aerobic Plate Counts, E. coli/Coliform Plate Counts, and Enumeration of E. coli and coliform bacteria.

Identification of select agent from food samples:

• Laboratory tests for Shigella and Vibrio and for the rapid detection and isolation of select biological agents.

Tuberculosis Laboratory

The South Carolina Tuberculosis (TB) Laboratory works closely with the Division of TB control to provide diagnostic testing services for isolation and identification of Mycobacterium tuberculosis complex (MTBC) and Mycobacterium avium complex (MAC). The laboratory works jointly with local public health departments, hospitals, and clinicians to perform contact investigations to ensure rapid results are received and timely and effective treatment is given to minimize the spread of TB.

Service Offered

• Identification of Mycobacterium tuberculosis complex (MTBC) and Mycobacterium avium complex (MAC).
• Same day detection of MTBC and rifampin resistance directly on specimens by the GeneXpert.
• Referrals for sensitivities
• Referrals for genotyping

Clinical Microbiology Laboratory

Clinical Microbiology Laboratory is responsible for testing organisms of public health importance and works closely with the Division of Acute Disease Epidemiology (DADE), Association of Public Health Laboratories (APHL), and Centers for Disease Control (CDC). Testing includes conventional biochemical testing, antigen testing, PCR, serotyping, serogrouping, and shiga-toxin testing to confirm and identify human pathogens of a public health importance.

Service Offered
Enteric cultures and isolates to include:

• For DADE Epidemiology only (in outbreak situations)
• Aeromonas species, Plesiomonas shigelloides, Yersinia enterocolitica
• Suspected cause of outbreak - toxins Bacillus cereus, Clostridium perfringens, and Staphylococcus aureus
• Requirement for all isolates or PCR+ specimens to be shipped to the PHL. Further identification, serotyping, PCR if available are performed on the following:
• Shiga-toxin producing Escherichia coli, Shigella species, Salmonella species, Vibriospecies.
• Cryptosporidium and Giardia lamdia are tested for DADE during suspected outbreaks.
• BioFire FilmArray GI panel which contains 21 targets to include Enteric Bacteria pathogens, Parasites and Viruses. This testing is performed per DADE Epidemiology request.

Other organisms which are a concern for public health and are tested include the following:

• Bordetella pertussis - ability to culture, identify
• Corynebacterium diphtheria - isolate submission required, confirm ID.
• CRE (Carbapenem-resistant Enterobacteriaceae) isolate submission required, confirm ID, AST
• CRPA (Carbapenem-resistant Psuedomonas aeruginosa) isolate submission required, confirm ID, AST
• Group A Streptococcus - outbreaks
• Hemophilus influenza - isolate submission required from invasive disease, confirm ID, serotype
• Legionella pneumophilia - Urine antigen testing
• Listeria monocytogenes - isolate submission required, confirm ID
• MRSA - outbreaks
• Neisseria gonorrhea - ability to culture, identify
• Neisseria meningitidis - isolate submission required, confirm ID, serogroup

Diagnostic Serology Laboratory

The Diagnostic Serology Section is dedicated to providing the most accurate and high quality laboratory analyses for sexually transmitted diseases and hepatitis to the citizens of South Carolina. This is achieved by using tests that assure cost effectiveness and minimum turnaround time. Results generated by the Diagnostic Serology Laboratory make it possible for Health Services personnel across the state to detect populations at risk for disease, track case contacts, educate the public to the dangers of the disease and reduce the number of new cases. This commitment helps accomplish the vision of providing healthy people with a healthy community in which to live and work.

Service Offered
HIV-1 Screening and Confirmation

• HIV-1/HIV-2 Ag/Ab screening test performed followed by confirmatory testing.

Hepatitis Testing

• Hepatitis A-Outbreaks
• Hepatitis B-Diagnostic profiles and immune status
• Hepatitis C-HCV Ab screening test followed by confirmatory testing.

Viral Load Testing

• HIV-1-Therapeutic monitoring of HIV infection
• HCV-Confirmatory test for Hepatitis C

Chlamydia and Neisseria Gonorrhoeae Testing

• CT/GC testing for detection performed from a single sample and multiple sites.

Syphilis Screening

• Rapid Plasma Reagin (RPR) screening test.
• Treponema pallidum particle agglutination (TPPA)-Aid in determining stage of infection.

Virology and Rabies Laboratory

The Virology and Rabies Laboratory's mission is to provide rapid identification of viruses causing disease and to provide surveillance and monitoring data for the prevention of future outbreaks.

This laboratory is the only provider in South Carolina for rabies testing on animals suspected of carrying the rabies virus. A standardized protocol for rabies detection from the CDC is strictly followed to ensure the safety of the citizens of South Carolina. Another large component of this laboratory is the Influenza surveillance that is performed year-round to monitor the virus for changes in antigenic characteristics and anti-viral resistance throughout the year. The laboratory works closely with CDC to monitor for novel Influenza strains. Additionally, the laboratory performs outbreak response testing for Measles and Mumps as well as screening for TB contact investigations and arboviral surveillance in humans, mosquitoes, and birds.

Service Offered
Respiratory virus testing:

Molecular methods including RT-PCR and multiplex PCR to detect and identify various respiratory pathogens for surveillance and outbreak identification purposes. Viral pathogens include Influenza A and B through subtyping, Parainfluenza 1, 2, and 3, Adenovirus, Respiratory Syncytial virus (RSV), human Metapneumovirus (hMPV), Rhino/Enterovirus, and Coronavirus.

TB Screening:

Interferon-gamma release assays (IGRA) for screening purposes to aid in tuberculosis (TB) contact investigations.

Arbovirus surveillance:

Arboviral surveillance includes both RT-PCR and serological assays for a variety of mostly zoonotic viruses transmitted by mosquitoes. They cause clinical syndromes of varying severity in humans. Viruses include Zika, Dengue, Chikungunya, West Nile, Eastern Equine Encephalitis (EEE), St. Louis Encephalitis (SLE), and California-group.

Preventable diseases surveillance:

Laboratory support for preventable disease surveillance for testing Measles, Mumps, Varicella, and Rubella.

Rabies testing:

The Direct Fluorescent Antibody (DFA) test for rabies virus is primarily directed against the nucleoprotein (antigen) of the virus. The Public Health Laboratory is the only laboratory in the state to perform rabies virus testing on animal heads. All suspected human rabies cases are tested at CDC.

Emergency Response & Special Pathogens Laboratory

The South Carolina Public Health Laboratory is part of the CDC Laboratory Response Network (LRN) and performs specific CDC assays to identify agents of bioterrorism. In addition, the South Carolina Public Health Lab provides targeted training, emergency response drills, and proficiency exercises for the South Carolina Sentinel Network.

The hospitals across the state are members of the South Carolina Sentinel Network. Network participants receive training and participate in exercises to enhance their ability to quickly detect the organisms.

Service Offered

The South Carolina Public Health Laboratory provides 24/7 bioterrorism testing capability for emergency situations. Suspected specimens are submitted through physicians, hospital laboratories, and the Federal Bureau of Investigations. If additional information is needed, please call 803-896-0800 Monday through Friday during normal business hours (8:00AM- 4:30PM).