National Reference TB Laboratory (NRL TB)

NRL TB was established in 2005 as a part of the Microbiological Department, NCIPD. The laboratory is ISO 17 025 certified and also certified for its regular participation in the TB External Quality Assurance Scheme of e.V., Dusseldorf, Germany.

Routine diagnosis of TB: using conventional and molecular methods – from sample accepting through smear microscopy and culture to strain isolation, species identification and drug susceptibility testing. The performed microbiological analysis are: smear microscopy – Ziehl-Neelsen; culture – solid medium: Löwenstein-Jensen and liquid medium, BACTEC MGIT 960 System; DST FLD – liquid medium, BACTEC MGIT 960 System; DST SLD – liquid medium, BACTEC MGIT 960 System; LPA – Geno Type, BRUKER: MTBDRplus, MTBDRsl, CM, AS, MTBC.

Confirmation of resistant tuberculosis strains and species identification of Nontuberculous Mycobacteria strains (NTM) from all over the country.

Annual organisation and implementation of External Quality Assessment (EQA) for tuberculosis diagnostics across the national laboratory network, covering smear microscopy, mycobacterial culture, drug susceptibility testing (DST) and Nucleic Acid Amplification Testing (NAAT) for tuberculosis bacteria.

Yearly 5 days training for biologists, doctors and lab technicians on microbiological diagnosis of TB and NTM.

1. National Tuberculosis Prevention Programme for the Period 2026–2030, adopted by Decision No. 303 of 17 April 2026 of the Council of Ministers of the Republic of Bulgaria.
2. European Reference Laboratory for Tuberculosis-Net (ERLTB-Net) CDC/GRANT/2022/010
3. Molecular-structural correlations with antimicrobial resistance in Mycobacterium bulgaricum and related mycobacteria - КП-06-М91/2 от 03.12.2025 г.
4. Integal analysis of pathogenomic characteristics and transmission of Mycobacterium tuberculosis strains in Bulgaria and the Balkans, with a focus on paediatric patients. - КП-06-Н93/5 от 09.12.2025 г.
5. Research, Innovation and Digitalisation for Smart Transformation” BG16RFPR002-1.014-007.

1. Atanasova Y, Baykova A, Bachiyska E, Yordanova S. Nontuberculous Mycobacteria - current risk in Bulgaria. Problems of infectious and parasitic diseases. Vol 51, 2, 2023, 19-24: DOI: https://doi.org/10.58395/gnmhxb78
2. Bachiyska EV, Atanasova YA, Baykova AI, Yordanova SP (2022) Mycobacterium intracellulare among TB suspected patients in Bulgaria – microbiological aspects. Folia Medica 64(4): 661-666. https://doi.org/10.3897/folmed.64.e76901
3. Yordanova S, Bachiyska E, Tagliani E, Baykova A, Atanasova Y, Spitaleri A, Cirillo DM (2022) Whole genome sequencing of Bulgarian rifampicin resistant Mycobacterium tuberculosis strains. Folia Medica 64(4): 633-640. https://doi.org/10.3897/folmed.64.e70554
4. Guglielmetti L, Günther G, Leu C, et al. Rifapentine access in Europe: growing concerns over key tuberculosis treatment component. Eur Respir J 2022; 59: 2200388 [DOI: 10.1183/13993003.00388-2022].
5. Gunar Günther, Lorenzo Guglielmetti, Claude Leu, Christoph Lange, Frank van Leth, TB net, Availability and costs of medicines for the treatment of tuberculosis in Europe, Clinical Microbiology and Infection, https://doi.org/10.1016/j.cmi.2022.07.026
6. Cost and availability of drugs and treatment regimens and availability of drug resistance testing for tuberculosis in Europe. medRxiv 2022.02.15.22271006; doi: https://doi.org/10.1101/2022.02.15.22271006.
7. Vladimir Milanov, Nikolay Yanev, Natalia Gabrovska, Denitsa Dimitrova, Elizabeta Bachiyska, Vania Youroukov, Current approaches to control of isoniazid-resistant tuberculosis, Probl Inf Dis, Vol 50, 2022, 1, 25-31
8. S. Yordanova, A. Baykova, Y. Atanasova, Y. Todorova, E. Bachiyska. Isoniazid-monoresistant tuberculosis in Bulgaria. Probl. Inf. Parasit. Dis.,Vol. 48, 2020, 1,p. 21-24.