Denniston M M, Bird B R, Kelley K A
Division of Laboratory Systems, Public Health Practice Program Office, Centers for Disease Control and Prevention, Atlanta, Georgia 30345, USA.
J Clin Microbiol. 1997 Feb;35(2):422-6. doi: 10.1128/jcm.35.2.422-426.1997.
Based on the recommendations of a 1992 conference on tuberculosis, the Centers for Disease Control and Prevention (CDC) established programs for upgrading mycobacteriology laboratories by providing them with monies and focused training. In 1991, state public health laboratories were surveyed to determine the methods they were using for primary Mycobacterium tuberculosis testing and their turnaround times for reporting testing results. A similar survey of nonstate laboratories participating in the National Laboratory Training Network-sponsored, M. tuberculosis-focused training programs was conducted from May 1992 to June 1993. In 1994, follow-up surveys of both the state- and nonstate-laboratory cohorts were conducted with the questionnaire from the initial survey plus additional questions that asked about interventions and changes occurring in the laboratory since the original survey. Although both cohorts showed increases in the percentages of laboratories meeting the recommended turnaround times for reporting M. tuberculosis testing results and using the recommended rapid methods for testing, generally, the increases made by the state laboratories were greater. By June 1994, all state laboratories were using a rapid method for M. tuberculosis isolate identification compared with 88% of the nonstate laboratories. The percentage of laboratories identifying isolates within the recommended 21 days also increased more in the group of state laboratories than in the group of nonstate laboratories (state laboratories, 22 to 73%; nonstate laboratories, 55 to 59%). Responses from the follow-up survey showed large differences in the percentages of laboratories that received CDC funding (state laboratories, 100%; nonstate laboratories, 6%) and participated in M. tuberculosis training (state laboratories, 98%; nonstate laboratories, 45%). These results indicate that adequate funding and focused training are critical in maintaining state-of-the-art mycobacteriology laboratories.
根据1992年结核病会议的建议，美国疾病控制与预防中心（CDC）制定了相关计划，通过提供资金和专项培训来升级分枝杆菌学实验室。1991年，对州公共卫生实验室进行了调查，以确定它们用于初次结核分枝杆菌检测的方法以及报告检测结果的周转时间。1992年5月至1993年6月，对参与由国家实验室培训网络赞助的、以结核分枝杆菌为重点的培训项目的非州实验室进行了类似调查。1994年，对州实验室和非州实验室两组进行了随访调查，问卷采用初始调查的问卷，并增加了一些问题，询问自原始调查以来实验室发生的干预措施和变化。尽管两组实验室在达到报告结核分枝杆菌检测结果的推荐周转时间的实验室百分比以及使用推荐的快速检测方法方面均有所增加，但总体而言，州实验室的增幅更大。到1994年6月，所有州实验室都在使用快速方法进行结核分枝杆菌分离株鉴定，相比之下，非州实验室的这一比例为88%。在推荐的21天内鉴定出分离株的实验室百分比在州实验室组中的增加幅度也大于非州实验室组（州实验室，从22%增至73%；非州实验室，从55%增至59%）。随访调查的结果显示，获得CDC资金的实验室百分比（州实验室，100%；非州实验室，6%）以及参与结核分枝杆菌培训的实验室百分比（州实验室，98%；非州实验室，45%）存在很大差异。这些结果表明，充足的资金和专项培训对于维持一流的分枝杆菌学实验室至关重要。
