Guidance

Specialist and reference microbiology: laboratory tests and services

UK Health Security Agency's laboratories provide a comprehensive range of microbiological tests and services.

Important service update

To enable UK Health Security Agency (UKHSA) reference and specialist laboratories to continue to provide critical support to the enhanced COVID-19 incident, some service delivery changes have been made with immediate effect.

The following updates have since been issued:

  • Legionella services (urine antigen testing, PCR, culture and typing) are unaffected (see user manual for details)
  • Streptococcal identification and typing services are offered as routine, with priority to outbreak typing (GBS and GAS)
  • Mycoplasma pneumoniae macrolide resistance testing is not suspended, but samples may be batched and turnaround times may be extended

The situation will be regularly reviewed. For the most current information, contact the relevant department using the contact details provided in the BRD user manual or VRD user manual.

More information about the tests, services and reference units are available from the unit pages.

Tests and services

Services Test type Request form Unit
Acanthamoeba For keratitis/ophthalmic samples only Contact the Diagnostic Parasitology Laboratory at the London School of Hygiene and Tropical Medicine LSHTM
Achromobacter Species identification, molecular typing and antimicrobial resistance H1, H2 AMRHAI
Acinetobacter Species identification, molecular typing and antimicrobial resistance H1, H2 AMRHAI
Actinomycetes (Aerobic) Antimicrobial susceptibility H1, H2 AMRHAI
Actinomycetes (Aerobic) Identification and confirmation M1, H2 AMRHAI
Adenoviruses (enteric) PCR E1 EVU
Adenoviruses (respiratory) PCR E27 RVU
Amoebae (excluding Acanthamoeba keratitis) Detection, identification and confirmation, serodiagnosis Contact National parasitology reference laboratory (NPRL) NPRL
Anaerobes (bacteroides, clostridia, fusobacteria, actinomyces spp., other closely related genera) Identification Contact ARU ARU
Anthrax See Bacillus anthracis    
Antibiotic resistance surveys European antibiotic resistance surveillance scheme (EARSS) and surveillance of resistance H1 AMRHAI
Antibiotic susceptibility testing New antimicrobials, susceptibility testing service, beta-lactamases, endocarditis H1, H2 AMRHAI
Arboviruses (bunyaviridae, flaviviridae, togaviridae) Isolation, serology, PCR P1 RIPL
Aspergillus Identification and confirmation Y1 or Y2 Mycology RL
Astrovirus RT-PCR E1 EVU
Astrovirus Genotyping Contact EVU EVU
Bacillus anthracis Identification and confirmation, PCR, serology, characterisation (phage, penicillin sensitivity) Contact RIPL lab RIPL
Bacillus (other than B.anthracis) Identification L4 GBRU
Bacillus (other than B.anthracis) Molecular typing L4 GBRU
Bacillus (other than B.anthracis) Detection of emetic toxin gene by PCR L4 GBRU
Bacillus (other than B.anthracis) Antimicrobial susceptibility H1, H2 AMRHAI
Bacterial Identification Service (BIDS) - isolates Isolate identification (unknown, atypical, fastidious, emerging bacteria) M1 AMRHAI
Bacterial Identification Service (BIDS) - clinical samples Bacterial detection and species identification for culture-negative, unknown clinical samples from normally sterile sites M1 AMRHAI
Blastomyces dermatidis Serology, identification and confirmation Y1 or Y2 MRL
Bordetella spp. Identification R3 RVPBRU
Bordetella spp. Antimicrobial susceptibility H1, H2 AMRHAI
Bordetella pertussis Serology: anti-PT IgG antibodiesNot suitable for immune status R3 RVPBRU
Bordetella pertussis Oral fluid: anti-PT IgG antibodies. NOT suitable for immune status Form distributed with kit RVPBRU
Bordetella pertussis qPCR R3 RVPBRU
Brucella spp. Serodiagnosis Y3 BRU
Brucella spp. Speciation and characterisation Contact AHVLA laboratory, Weybridge BRU
Burkholderia spp. Species identification, molecular typing and antimicrobial resistance H1, H2 AMRHAI
Burkholderia pseudomallei Identification and antimicrobial resistance H1, H2 AMRHAI
Candida spp. Identification and confirmation Y1 or Y2 Mycology RL
Campylobacter Antibiotic susceptibility testing for gram negative GI pathogens L4 GBRU
Campylobacter Identification L4 GBRU
Chikungunya virus Serology, PCR P1 RIPL
Chlamydia (respiratory) Only available after discussion and prior agreement with RVPBRU C. pneumoniae, C. psittacci, C. abortus: PCR assay For urgent enquiries, contact RVPBRU RVPBRU
Chlamydia trachomatis C. trachomatis: LGV multiplex PCR B7 CSU
Clostridium difficile 16S/23S PCR ribotyping, antibiotic susceptibility testing and toxin A and B assay on isolates Contact ARU ARU
Clostridium botulinum Detection and identification of C. botulinum from clinical, food or environmental samples by PCR and culture L4 GBRU
Clostridium botulinum Detection of botulinum neurotoxins in clinical specimens or food L4, L7 GBRU
Clostridium perfringens Identification of enterotoxigenic C. perfringens by PCR L4 GBRU
Clostridium perfringens Molecular typing L4 GBRU
Clostridium perfringens Detection of C. perfringens enterotoxin in faeces by ELISA L4 GBRU
Clostridium perfringens C. perfringens Toxin (lethal toxins) typing by PCR L4 GBRU
Clostridium tetani Detection and identification of C. tetani by PCR and culture L4 GBRU
Clostridium tetani Detection of C. tetani neurotoxin in serum (note: serum will be first tested for tetanus antibody levels by RVPBRU) L4 GBRU
Clostridium tetani Tetanus immunity: serum antibodies R3 RVPBRU
Coccidioides immitis Serology, identification and confirmation Y1 or Y2 Mycology RL
Coronavirus Virus detection by PCR (sequencing) E16 RVU
Coronavirus (SARS) Contact laboratory prior to collection of samples E16 RVU
Coronavirus (SARS-CoV-2) Confirmatory testing V30 regional UKHSA
Coronavirus (MERS-CoV) Contact laboratory prior to collection of samples E16 RVU
Corynebacterium Molecular typing and antimicrobial resistance H1, H2 AMRHAI
Corynebacterium diphtheriae C. diphtheriae and other potentially toxigenic corynebacteria: identification and toxin testing by PCR and Elek R3 RVPBRU
Corynebacterium diphtheriae Diphtheria immunity: serum antibodies R3 RVPBRU
Corynebacterium jeikeium C. jeikeium antimicrobial sensitivity H2 AMRHAI
Crimean-Congo haemorrhagic fever Serology, PCR. Please contact lab before sending samples. P1 RIPL
Cronobacter C. sakazakii: confirmation of identification, molecular typing and antimicrobial resistance H1, H2 AMRHAI
Cystic Fibrosis (CF) pathogens Identification and molecular typing H2 AMRHAI
Cystic Fibrosis (CF) pathogens Antimicrobial susceptibility H1, H2 AMRHAI
Cryptococcus spp. Identification and confirmation Y1 or Y2 Mycology RL
Cryptosporidium spp. Detection, identification and confirmation, typing Contact CRU CRU
Dengue virus Serology, PCR P1 RIPL
Dermatophytes Identification, confirmation Y1 or Y2 Mycology RL
Diphtheria (see Corynebacterium diphtheriae)      
Ebola virus Serology, PCR. Please contact lab before sending samples. P1 RIPL
Elizabethkingia.spp Identification, molecular typing and antimicrobial resistance H1, H2 AMRHAI
Enterobacter spp. Molecular typing and antimicrobial resistance H1, H2 AMRHAI
Enterococcus spp. Species identification, molecular typing and antimicrobial resistance H1, H2 AMRHAI
Enterovirus RT-PCR E1 EVU
Enterovirus Virus culture Contact EVU EVU
Enterovirus Typing E1 EVU
Escherichia Antibiotic susceptibility testing for gram negative GI pathogens L4 GBRU
Escherichia E. coli (ACDP HG 2 only): molecular typing and antimicrobial resistance H1, H2 AMRHAI
Escherichia Identification and typing L4 GBRU
Escherichia E. coli O157: serodiagnostic service L5 GBRU
Escherichia Detection and isolation from faeces L5 GBRU
Francisella spp., including tularensis PCR, serology, isolation P1 RIPL
Gram-negative bacteria non fermenter and fastidious organisms Molecular typing and antimicrobial resistance H1, H2 AMRHAI
Gram-positive bacteria (except C.diphtheriae) Molecular typing and antimicrobial resistance H1, H2 AMRHAI
Haemophilus Haemophilus ducreyi: PCR B3  
Haemophilus Haemophilus spp. (excluding H. ducreyi): identification R3 RVPBRU
Haemophilus H. influenzae: sero typing and capsular genotyping of H.influenzae R3 RVPBRU
Haemophilus spp. and Aggregatibacter spp. Antimicrobial susceptibility H1, H2 AMRHAI
Haemorrhagic fever viruses (filoviridae, arenaviridae, Bunyaviridae) Serology, PCR. Please contact lab before sending samples. P1 RIPL
Hantavirus Serology, PCR. P1 RIPL
Hendra virus Serology, PCR. Please contact lab before sending samples. P1 RIPL
Helicobacter Antibiotic susceptibility testing for gram negative GI pathogens L4 GBRU
Helicobacter H. pylori identification and antibiotic susceptibility L4,L5 GBRU
Hepatitis A virus (HAV) RNA S1 BBVU
Hepatitis A virus (HAV) Genotyping and phylogenetics S1 BBVU
Hepatitis A virus (HAV) Anti-HAV IgG and IgM S1 CSU
Hepatitis B virus (HBV) HBsAg detection S1 CSU
Hepatitis B virus (HBV) HBsAg quantification S1 CSU
Hepatitis B virus (HBV) HBsAg neutralisation S1 CSU
Hepatitis B virus (HBV) HBeAg S1 CSU
Hepatitis B virus (HBV) Anti-HBc S1 CSU
Hepatitis B virus (HBV) Anti-HBc IgM S1 CSU
Hepatitis B virus (HBV) Anti-HBs S1 CSU
Hepatitis B virus (HBV) Anti-HBe S1 CSU
Hepatitis B virus (HBV) DNA viral load S1 CSU
Hepatitis B virus (HBV) Pre-core and BCP mutation screen S10 BBVU
Hepatitis B virus (HBV) Surface mutation screen S10 BBVU
Hepatitis B virus (HBV) Antiviral resistance S10 BBVU
Hepatitis B virus (HBV) Genotyping and phylogenetics S10 BBVU
Hepatitis C virus (HCV) Antibody confirmation and viral load S1 CSU
Hepatitis C virus (HCV) Antibody confirmation (dried blood spots and oral fluid samples) S1 BBVU
Hepatitis C virus (HCV) Viral load S1 CSU
Hepatitis C virus (HCV) Viral load (sensitivity >15 IU/ml) Please contact lab prior to sample referral S1 CSU
Hepatitis C virus (HCV) Qualitative RNA detection S1 BBVU
Hepatitis C virus (HCV) Genotyping (NS5B sequencing): EDTA plasma S1 CSU
Hepatitis C virus (HCV) Genotyping (NS5B sequencing): dried blood spots S1 BBVU
Hepatitis C virus (HCV) Phylogenetics S1 BBVU
Hepatitis C virus (HCV) HCV DAA genotypic resistance Contact AVU AVU
Hepatitis Delta virus (HDV) Anti-HDV IgG S1 CSU
Hepatitis Delta virus (HDV) Anti-HDV IgM S1 CSU
Hepatitis Delta virus (HDV) RNA S1 BBVU
Hepatitis E virus (HEV) Anti-HEV IgG S1 CSU
Hepatitis E virus (HEV) Anti-HEV IgM S1 CSU
Hepatitis E virus (HEV) RNA S1 BBVU
Hepatitis E virus (HEV) Genotyping, phylogenetics S1 BBVU
Herpes simplex virus (HSV 1 and 2) Phenotypic drug resistance Contact AVU AVU
Herpes simplex virus (HSV 1 and 2) Intrathecal antibody testing E22 IDU
Histoplasma capsulatum Serology, identification and confirmation Y1 or Y2 Mycology RL
Histology slides Examination for the presence of fungi Y1 or Y2 Mycology RL
HIV-1 and HIV-2 HIV 1, HIV-2 antibody screen, confirmation, typing S3 CSU
HIV-1 and HIV-2 HIV 1, HIV-2 antibody screen, confirmation, typing (dried blood spots) S3 CSU
HIV-1 and HIV-2 HIV 1, HIV-2 antibody screen, confirmation, typing, oral fluid (OraSure) S3 CSU
HIV-1 and HIV-2 HIV-1 proviral DNA S3 CSU
HIV-1 and HIV-2 HIV-1 RNA quantification (viral load) S3 CSU
HIV-1 and HIV-2 HIV-1 p24 antigen with neutralisation S3 CSU
HIV-1 and HIV-2 HIV-1 incidence testing (avidity) S3 CSU
HIV-1 and HIV-2 HIV-1 genotypic resistance S9 AVU
HIV-1 and HIV-2 HIV-1 proviral tropism testing S9 AVU
HIV-1 and HIV-2 Detection of minority drug resistance mutants S9 AVU
HIV-1 and HIV-2 HIV-1 sequencing and sequence comparison Contact AVU AVU
Human T-lymphotropic virus type I and Human T-lymphotropic virus type II (HTLV-I and II) HTLV antibody screen, confirmation, typing S5 CSU
Human T-lymphotropic virus type I and Human T-lymphotropic virus type II (HTLV-I and II) HTLV type-specific PCR S5 CSU
Human herpesvirus 6 (HHV-6) PCR and genotyping E18 IDU
Human herpesvirus 7 (HHV-7) PCR E18 IDU
Human herpesvirus 8 (HHV-8) Quantitative DNA PCR S19 CSU
Human metapneumovirus Virus detection by PCR andsequencing Contact RVU RVU
Hydatid disease or Echinococcosis Serology Contact NPRL NPRL
Identification of bacterial isolates with no national reference facility (unknowns, atypical, fastidious, emerging MALDI-TOF-MS, 16s ribosomal sequence analysis M1 AMRHAI
Infection prevention and control testing Contact AMRHAI AMRHAI
Influenza Virus detection by multiplex PCR E3 RVU
Influenza Strain typing HAI E3 RVU
Influenza Antibody response HAI E2 RVU
Influenza Phenotypic drug resistance Contact RVU RVU
Influenza Genotypic drug resistance by pyrosequencing and SNP PCR Contact RVU RVU
Influenza Genotypic drug resistance by gene sequencing Contact RVU RVU
Influenza (avian) Confirmation of regional laboratory H9 virus detection Contact RVU RVU
Influenza (avian) Antibody response Contact RVU RVU
JC virus (see Polyomavirus) PCR E13 IDU
Klebsiella spp. Molecular typing and antimicrobial resistance H1, H2 AMRHAI
Lassa virus Serology, PCR. Please contact lab before sending samples. P1 RIPL
Legionella L.pneumophila: in-house urinary antigen EIA assay (confirmation of sending lab testing results only) R1 RVPBRU
Legionella L pneumophila PCR (from urinary antigen positive patients only) R1 RVPBRU
Legionella Identification and epidemiological typing of clinical or outbreak associated isolates R1 RVPBRU
Leuconostoc spp. Antimicrobial susceptibility H1, H2 AMRHAI
Leptospira spp Isolation and confirmation, identification, serology Leptospirosis: request form NLS
Listeria spp. Identification, serotyping and molecular typing of L.monocytogenes L4 GBRU
Listeria spp. Species identification of Listeria L4 GBRU
Listeria spp. Antimicrobial susceptibility H1, H2 AMRHAI
Lyme disease Serology, PCR P2 RIPL
Malaria Blood film diagnosis, antigen detection, PCR, drug resistance markers Malaria report form Malaria RL
Marburg virus Serology, PCR. Please contact lab before sending samples. P1 RIPL
Measles IgG and IgM serology for recent infection E8 IDU
Measles IgG antibody status E8 IDU
Measles Intrathecal antibody testing E22 IDU
Measles PCR E8 IDU
Measles Plaque reduction neutralisation assay E8 IDU
Middle East respiratory syndrome coronavirus (MERS-CoV) Contact laboratory prior to collection of specimens E16 RVU
Molluscum contagiosum Electron microscopy E17 HPU
Moulds Identification and confirmation, susceptibility testing Y1 or Y2 Mycology RL
Methicillin-resistant staphylococcus aureus (MRSA) (see Staphylococcus)      
Mumps IgG and IgM serology for recent infection E8 IDU
Mumps IgG antibody status E8 IDU
Mumps PCR E8 IDU
Mycobacterium spp. Identification, genotyping, drug susceptibility, molecular diagnosis (eg PCR for rapid species identification and detection of resistance genes), molecular epidemiological studies, QuantiFERON®-TB Gold test N1, N4 NMRS-South
Mycoplasma M.hominis and Ureaplasma spp.: PCR and/or culture R1 RVPBRU
Mycoplasma Mycoplasma and ureaplasma: biochemical characterisation and molecular methods R1 RVPBRU
Mycoplasma M. pneumoniae: PCR R1 RVPBRU
Mycoplasma M. genitalium: molecular detection of the adhesion MgPa gene B2 AMRHAI
Mycoplasma Other species: culture, PCR and sequencing when relevant R1 RVPBRU
Neisseria spp. N.gonorrhoeae: confirmation of identification by phenotypic and molecular methods B2 AMRHAI
Neisseria spp. Susceptibility testing for third-generation cephalosporin and azithromycin antibiotics B2 AMRHAI
Neisseria spp. Programme: Gonococcal resistance to antimicrobials surveillance programme (GRASP) Contact AMRHAI before sending samples AMRHAI
Neisseria meningitidis Culture identification, molecular epidemiological studies, PCR, serology Meningococcal reference unit request form MRU
Nipah and Hendra viruses PCR, isolation P1 RIPL
Nocardia spp. Antimicrobial susceptibility H1, H2 AMRHAI
Noroviruses RT-PCR E6 EVU
Noroviruses Genotyping E6 EVU
Opportunistic Pathogens Molecular typing and antimicrobial resistance H1, H2 AMRHAI
Orf Electron microscopy E17 HPU
Pandoraea spp. Molecular typing and antimicrobial resistance H1, H2 AMRHAI
Parainfluenza virus Virus detection by PCR (sequencing) Contact RVU RVU
Parasites, intestinal protozoa and helminths, blood and tissue protozoa and helminths   Contact NPRL NPRL
Parvovirus B19 Serology (IgG and IgM) E9 IDU
Parvovirus B19 PCR E9 IDU
Penicillium marneffei   Y1 or Y2 Mycology RL
Plasmodium spp.   Malaria report form Malaria RL
Polioviruses RT-PCR, genotyping, virus culture E1 EVU
Polioviruses Intratypic neutralisation E1 EVU
Polyomavirus JC PCR E13 IDU
Pseudomonas spp. Molecular typing and antimicrobial susceptibility H1, H2 AMRHAI
PVL (see staphylococcus)      
Q fever (Coxiella burnetii)   P1 RIPL
Rabies exposure Contact rabies clerk on 020 8327 6204    
Rabies diagnosis Contact rabies clerk on 020 8327 6204    
Ralstonia spp. Molecular typing and antimicrobial resistance H1, H2 AMRHAI
Respiratory syncytial virus (RSV) Virus detection by multiplex PCR Contact RVU RVU
Resistance mechanisms Molecular detection and confirmation H1, H2 AMRHAI
Rickettsiae (typhus and spotted fever groups, scrub typhus group)   P1 RIPL
Rhinovirus Virus detection by PCR Contact RVU RVU
Rotavirus RT-PCR E1 EVU
Rotavirus VP6 and NSP4 genotyping E1 EVU
Rubella IgG and IgM serology for recent infection E8 IDU
Rubella IgG antibody status E8 IDU
Rubella PCR E8 IDU
Salmonella Antibiotic susceptibility testing for gram negative GI pathogens L4 GBRU
Salmonella Identification and typing L4 GBRU
Sapovirus RT-PCR E1 EVU
Severe acute respiratory syndrome (SARS) See coronavirus. Contact laboratory prior to collection of specimens E16 RVU
Serratia Molecular typing and antimicrobial resistance H1, H2 AMRHAI
Shigella Antibiotic susceptibility testing for gram negative GI pathogens L4 GBRU
Shigella Identification and typing L4 GBRU
Staphylococcus S.aureus: molecular typing H3, H4 AMRHAI
Staphylococcus Staphylococcus coagulase negative: species identification and molecular typing H3, H4 AMRHAI
Staphylococcus Antimicrobial susceptibility testing H3, H4 AMRHAI
Staphylococcus Resistance gene detection H3, H4 AMRHAI
Staphylococcus Toxin gene detection (including PVL) H3, H4 AMRHAI
Staphylococcus Detection of staphylococcal enterotoxins A, B, C, D or E in foods or beverages. Contact laboratory GBRU
Stenotrophomonas S.maltophilia: molecular typing and antimicrobial resistance H1, H2 AMRHAI
Streptococcus Streptococcus spp. and related genera or Gram positive cocci: identification H3, H4 AMRHAI
Streptococcus S.pyogenes (Lancefield Group A) typing H3, H4 AMRHAI
Streptococcus S.agalactiae (Lancefield Group B) typing H3, H4 AMRHAI
Streptococcus Lancefield Group C and G typing H3, H4 AMRHAI
Streptococcus S. pneumoniae: serological typing R3 RVPBRU
Streptococcus Antimicrobial susceptibility H3, H4 AMRHAI
Tetanus Tetanus immunity: serum antibodies R3 RVPBRU
Toxoplasma gondii Isolation, identification, culture collection, serology (for active infection) molecular diagnostics by PCR Contact toxoplasma reference laboratory, Swansea TRL
Treponema T. pallidum (syphilis): serological (please refer to Bristol UKHSA South West)    
Treponema T.pallidum: PCR B3  
Unknown haemadsorbing agents Virus detection by PCR Contact RVU RVU
Ureaplasma Refer to mycoplasma R1 RVPBRU
Varicella-zoster virus (VZV) IgG serology E11 IDU
Varicella-zoster virus (VZV) Intrathecal antibody testing E22 IDU
Vibrio (including Plesiomonas shigelloides) Antibiotic susceptibility testing for gram negative GI pathogens L4 GBRU
Vibrio (including Plesiomonas shigelloides) Identification and typing L4 GBRU
Viral haemorrhagic fever (filoviridae, arenaviridae, Bunyaviridae) Serology, PCR, isolation. Please contact lab before sending samples. P1 RIPL
VTEC O157 (See Escherichia coli)      
West Nile virus Serology, PCR P1 RIPL
Yeasts Serodiagnosis Y1 or Y2 Mycology RL
Yellow fever virus Serology, PCR P1 RIPL
Yersinia Antibiotic susceptibility testing for gram negative GI pathogens L4 GBRU
Yersinia Identification L4 GBRU

Packaging guidance for infectious disease samples

UKHSA follows the Guidance on regulations for the transport of infectious substances 2013-2014, published by WHO.

Terms and conditions of business

Read the UKHSA terms and conditions of business for all sales and provision of services.

Published 18 July 2014
Last updated 22 March 2024 + show all updates
  1. Removed link to B3 form for T. pallidum serology. Added the link to B3 form for T.pallidum: PCR.

  2. Change B7 to B2 for Neisseria spp. and M. genitalium. Removed CSU as this service is now provided by STI. Removed Neisseria spp. Molecular confirmation of GC NAAT result as this service is no longer provided.

  3. Removed rubella virus culture test.

  4. Removed services that are no longer offered.

  5. Removal of some services and amended form links.

  6. Updated Tests and services table.

  7. Added V30 SARS-CoV-2 sample request form.

  8. Added notification of service delivery changes made to PHE reference and specialist laboratories to provide critical support to the COVID-19 incident.

  9. Updated list with Diagnostic test form (S19).

  10. Updated request form and unit links for some Hep B, Hep C and HIV tests.

  11. Updated list to include Acanthamoeba.

  12. Updated some contact details.

  13. Updated link to National parasitology reference laboratory (NPRL).

  14. Made a number of small additions to the table.

  15. Updated with latest gastrointestinal bacteria reference unit (GBRU) tests and services.

  16. Added packaging guidance and links to HPA archive.

  17. First published.