Balke Beate, Schmoldt Sabine, Häussler Susanne, Suerbaum Sebastian, Heesemann Jürgen, Hogardt Michael
Institut für Medizinische Mikrobiologie und Krankenhaushygiene, Medizinische Hochschule Hannover, Carl-Neuberg-Strasse 1, 30625 Hanover, Germany.
J Cyst Fibros. 2008 Jan;7(1):7-14. doi: 10.1016/j.jcf.2007.02.007. Epub 2007 Jul 19.
The goal of this pilot study was to design an external quality assessment (EQA) scheme for German cystic fibrosis (CF) clinical microbiology laboratories. Therefore, a multicentre study of 18 German CF laboratories was performed to evaluate their proficiency in analyzing CF respiratory secretions.
Simulated clinical specimens containing a set of four frequent CF pathogens, namely two Pseudomonas aeruginosa strains differing in morphotype (mucoid versus non-mucoid) and resistotype, one Staphylococcus aureus strain and one Burkholderia multivorans strain, were distributed to each laboratory. Isolation, identification and antimicrobial susceptibility testing (AST) of any bacterial pathogen present and completion of a questionnaire about applied microbiological protocols were requested.
Three of four strains were isolated and identified correctly by almost all laboratories. B. multivorans was once misidentified as Burkholderia cenocepacia. Fourteen laboratories failed to detect the second multidrug resistant P. aeruginosa isolate. AST errors occurred most often for P. aeruginosa 2 followed by B. multivorans, P. aeruginosa 1 and S. aureus. Evaluation of the questionnaires revealed major differences in cultivation and identification techniques applied by the participating laboratories.
A periodical EQA programme for German CF laboratories and standardized microbiological procedures seem to be necessary to advance diagnostic microbiology employed on CF respiratory tract specimens and may help to improve anti-infective treatment and infection control practices for CF patients.
本试点研究的目的是为德国囊性纤维化（CF）临床微生物实验室设计一项外部质量评估（EQA）计划。因此，对18个德国CF实验室进行了一项多中心研究，以评估它们分析CF呼吸道分泌物的能力。
向每个实验室分发模拟临床标本，其中包含一组四种常见的CF病原体，即两种形态型（黏液型与非黏液型）和耐药型不同的铜绿假单胞菌菌株、一株金黄色葡萄球菌菌株和一株多食伯克霍尔德菌菌株。要求对存在的任何细菌病原体进行分离、鉴定和抗菌药物敏感性测试（AST），并完成一份关于所应用微生物学方案的问卷。
几乎所有实验室都正确分离和鉴定出了四种菌株中的三种。多食伯克霍尔德菌曾被误鉴定为洋葱伯克霍尔德菌。14个实验室未能检测出第二种耐多药铜绿假单胞菌分离株。AST错误最常发生在铜绿假单胞菌2上，其次是多食伯克霍尔德菌、铜绿假单胞菌1和金黄色葡萄球菌。对问卷的评估显示，参与实验室在培养和鉴定技术方面存在重大差异。
为德国CF实验室开展定期的EQA计划和标准化的微生物学程序似乎是推进CF呼吸道标本诊断微生物学所必需的，可能有助于改善CF患者的抗感染治疗和感染控制措施。
