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诊断实验室质量管理的步骤、实施及重要性,特别强调2019冠状病毒病

Steps, implementation and importance of quality management in diagnostic laboratories with special emphasis on coronavirus disease-2019.

作者信息

Pawar Shailesh D, Kode Sadhana S, Keng Sachin S, Tare Deeksha S, Abraham Priya

机构信息

Poliovirus Group, ICMR-National Institute of Virology, Pune, Maharashtra, India.

The Director, ICMR-National Institute of Virology, Pune, Maharashtra, India.

出版信息

Indian J Med Microbiol. 2020 Jul-Dec;38(3 & 4):243-251. doi: 10.4103/ijmm.IJMM_20_353.

Abstract

A well-established and functional quality management system is an integral part of any diagnostic laboratory. It assures the reliability and standards of the laboratory function. A pandemic situation such as that caused by the influenza H1N1 2009 virus or the recent severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) increases the demands on the public health system, and the need to build, upgrade and expand the number of diagnostic laboratories. The Coronavirus disease-19 (COVID-19) pandemic caused by the SARS-CoV-2 unleashed a public health emergency of an unprecedented scale. The need has been highlighted for the accreditation of tests relating to COVID-19 by the National Accreditation Board for Testing and Calibration Laboratories (NABL) or any agencies approved by the World Health Organization (WHO) or Indian Council of Medical Research. The implementation of quality system in diagnostic laboratories would ensure accurate, reliable and efficient test results at par with the international standards. The functional aspects of a laboratory such as a well-defined organogram, standard operating procedures, good laboratory practices, quality controls, human resources, equipment management, reagents, inventory of records, proper communication need to be addressed to assure quality. Biosafety considerations should include the guidelines laid out by the WHO, the Institutional Biosafety Committee and the Department of Biotechnology, Government of India for carrying out diagnostic work in the laboratory. Currently, there are 1922 laboratories, operational for COVID-19 diagnosis in India. Considering the urgency of testing, the NABL has expedited the process of accreditation and issued accreditation to 818 laboratories. The adherence to the practicable aspects of quality described in this article would help in establishing quality in COVID-19 testing laboratories.

摘要

一个完善且运行良好的质量管理体系是任何诊断实验室不可或缺的一部分。它确保了实验室功能的可靠性和标准。诸如2009年甲型H1N1流感病毒或近期的严重急性呼吸综合征冠状病毒2(SARS-CoV-2)引发的大流行情况,增加了对公共卫生系统的需求,以及建设、升级和扩大诊断实验室数量的必要性。由SARS-CoV-2引起的冠状病毒病19(COVID-19)大流行引发了一场前所未有的大规模公共卫生紧急事件。国家测试和校准实验室认可委员会(NABL)或世界卫生组织(WHO)或印度医学研究理事会批准的任何机构对与COVID-19相关检测进行认可的必要性已得到凸显。诊断实验室实施质量体系将确保获得与国际标准相当的准确、可靠和高效的检测结果。为确保质量,需要解决实验室的功能方面问题,如明确的组织架构图、标准操作规程、良好实验室规范、质量控制、人力资源、设备管理、试剂、记录清单、适当沟通等。生物安全考量应包括WHO、机构生物安全委员会以及印度政府生物技术部制定的在实验室开展诊断工作的指南。目前,印度有1922个实验室可用于COVID-19诊断。考虑到检测的紧迫性,NABL加快了认可流程,并已向818个实验室颁发了认可。遵循本文所述质量的实际可行方面将有助于在COVID-19检测实验室中建立质量。

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