Ability of Laboratories To Detect Emerging Antimicrobial Resistance: Proficiency Testing and Quality Control Results from the World Health Organization's External Quality Assurance System for Antimicrobial Susceptibility Testing

摘要: The accuracy of antimicrobial susceptibility data submitted by microbiology laboratories to national and international surveillance systems has been debated for a number years. To assess the World Health Organization users WHONET software, Centers Disease Control Prevention distributed six bacterial isolates representing key antimicrobial-resistance phenotypes approximately 130 laboratories, all but one which were outside United States, testing as part Organization's External Quality Assurance System Antimicrobial Susceptibility Testing. Each laboratory also was asked submit 10 consecutive quality control values several organism-drug combinations. Most able detect methicillin (oxacillin) resistance in Staphylococcus aureus, high-level vancomycin Enterococcus faecium, extended-spectrum cephalosporins Klebsiella pneumoniae. Many particularly those using disk diffusion tests, had difficulty recognizing reduced penicillin an isolate Streptococcus most difficult phenotype epidermidis. proficiency challenge included request biochemical identification gram-negative bacillus, recognized Enterobacter cloacae. Although only small subset have their data, it is clear that many these generate results oxacillin when S. aureus ATCC 25923 pneumoniae 49619 are acceptable range. narrow range proved be submitting data; 27% out Thus, important establish organisms tested locally, pneumococci glycopeptide staphylococci.