Engler Kathryn H, Kozlov Roman S, Copping Steven J, Diphtheria Members Of The European Laboratory Working Group On, Efstratiou Androulla
Respiratory and Systemic Infection Laboratory and †Quality Assurance Laboratory, PHLS Central Public Health Laboratory, 61 Colindale Avenue, London NW9 5HT and *Institute of Antimicrobial Chemotherapy, Smolensk State Medical Academy, Smolensk, Russia.
J Med Microbiol. 2001 Nov;50(11):1006-1012. doi: 10.1099/0022-1317-50-11-1006.
An international external quality assessment (EQA) scheme has been established so as to evaluate the proficiency of specialist, national diphtheria reference laboratories in the laboratory diagnosis of diphtheria. Six simulated clinical specimens were freeze-dried and distributed to 23 participants in 20 countries. Participants were asked to isolate, identify and perform toxigenicity testing on any corynebacteria present and to complete a simple questionnaire describing the procedures and reagents used. Only three laboratories obtained correct biochemical and toxigenicity results for all six specimens. The majority of laboratories performed better with toxigenicity testing than with the biochemical identification. Of concern were the results from three laboratories that failed to isolate any corynebacteria from four or more of the specimens. In one centre this was shown to be due to lack of availability of 'in-date' media and, in the other two, was presumed to be due to lack of experience in primary laboratory diagnostics for this organism. It is essential that countries, globally, maintain awareness and laboratory capabilities in this specialised area of microbiology. EQA is an invaluable process, which enables laboratories to monitor, evaluate and improve their own performance in such areas.
已建立一项国际外部质量评估（EQA）计划，以评估各国专业白喉参考实验室对白喉进行实验室诊断的能力。六个模拟临床标本经冷冻干燥后分发给20个国家的23个参与者。要求参与者对存在的任何棒状杆菌进行分离、鉴定和产毒检测，并填写一份简单的问卷，描述所使用的程序和试剂。只有三个实验室对所有六个标本都获得了正确的生化和产毒检测结果。大多数实验室在产毒检测方面的表现优于生化鉴定。令人担忧的是，有三个实验室未能从四个或更多标本中分离出任何棒状杆菌。在一个中心，这被证明是由于缺乏“有效期内”的培养基，而在另外两个中心，推测是由于缺乏对该生物体进行初级实验室诊断的经验。全球各国必须保持对微生物学这一专业领域的认识和实验室能力。EQA是一个非常宝贵的过程，它使实验室能够监测、评估和改进自己在这些领域的表现。
