External Quality Assessment of Bacterial Identification and Antimicrobial Susceptibility Testing in African National Public Health Laboratories, 2011-2016.

Autor:	Perovic O; National Institute for Communicable Diseases, Division of National Health Laboratory Service, Johannesburg 2131, South Africa.; Department of Clinical Microbiology, University of Witwatersrand, Johannesburg 2193, South Africa., Yahaya AA; World Health Organization, Regional Office for Africa, Brazzaville 06, Congo., Viljoen C; Department of Clinical Microbiology, University of Witwatersrand, Johannesburg 2193, South Africa., Ndihokubwayo JB; World Health Organization, Regional Office for Africa, Brazzaville 06, Congo., Smith M; National Institute for Communicable Diseases, Division of National Health Laboratory Service, Johannesburg 2131, South Africa., Coulibaly SO; World Health Organization, Regional Office for Africa, Brazzaville 06, Congo., De Gouveia L; National Institute for Communicable Diseases, Division of National Health Laboratory Service, Johannesburg 2131, South Africa., Oxenford CJ; World Health Organization, 69007 Lyon, France., Cognat S; World Health Organization, 69007 Lyon, France., Ismail H; National Institute for Communicable Diseases, Division of National Health Laboratory Service, Johannesburg 2131, South Africa., Frean J; National Institute for Communicable Diseases, Division of National Health Laboratory Service, Johannesburg 2131, South Africa.; WITS Research Institute for Malaria, University of Witwatersrand, Johannesburg 2193, South Africa.
Jazyk:	angličtina
Zdroj:	Tropical medicine and infectious disease [Trop Med Infect Dis] 2019 Dec 13; Vol. 4 (4). Date of Electronic Publication: 2019 Dec 13.
DOI:	10.3390/tropicalmed4040144
Abstrakt:	Background : In 2002, the World Health Organization (WHO) launched a regional microbiology external quality assessment (EQA) programme for national public health laboratories in the African region, initially targeting priority epidemic-prone bacterial diseases, and later including other common bacterial pathogens. Objectives : The aim of this study was to analyse the efficacy of an EQA programme as a laboratory quality system evaluation tool. Methods : We analysed the proficiency of laboratories' performance of bacterial identification and antimicrobial susceptibility testing (AST) for the period 2011-2016. The National Institute for Communicable Diseases of South Africa provided technical coordination following an agreement with WHO, and supplied EQA samples of selected bacterial organisms for microscopy (Gram stain), identification, and antimicrobial susceptibility testing (AST). National public health laboratories, as well as laboratories involved in the Invasive Bacterial Diseases Surveillance Network, were enrolled by the WHO Regional Office for Africa to participate in the EQA programme. We analysed participants' results of 41 surveys, which included the following organisms sent as challenges: Streptococcus pneumonia, Haemophilus influenzae , Neisseria meningitid i s, Salmonella Typhi , Salmonella Enteritidis , Shigella flexneri, Staphylococcus aureus, Streptococcus agalactiae, Streptococcus anginosus, Enterococcus faecium, Serratia marcescens, Acinetobacter baumannii, and Enterobacter cloacae . Results: Eighty-one laboratories from 45 countries participated. Overall, 76% of participants obtained acceptable scores for identification, but a substantial proportion of AST scores were not in the acceptable range. Of 663 assessed AST responses, only 42% had acceptable scores. Conclusion: In the African Region, implementation of diagnostic stewardship in clinical bacteriology is generally suboptimal. This report illustrates that AST is poorly done compared to microscopy and identification. It is critically important to make the case for implementation of quality assurance in AST, as it is the cornerstone of antimicrobial resistance surveillance reporting and implementation of the Global Antimicrobial Resistance Surveillance System. Competing Interests: The authors declare that they have no financial or personal relationships that may have inappropriately influenced them in writing this article.
Databáze:	MEDLINE
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