Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2007 Nov;45(11):3626-30.
doi: 10.1128/JCM.00784-07. Epub 2007 Sep 12.

Proficiency analysis of drug susceptibility testing by national-level tuberculosis reference laboratories from 1995 to 2003

Gill-Han Bai  1 , Sang-Jae Kim, Chulhun L Chang; National and Regional Tuberculosis Reference Laboratories
Affiliations

Proficiency analysis of drug susceptibility testing by national-level tuberculosis reference laboratories from 1995 to 2003

Gill-Han Bai et al. J Clin Microbiol. 2007 Nov.

Abstract

A proficiency review of antituberculous drug susceptibility testing (DST) was undertaken by the regional tuberculosis reference laboratories of the Western Pacific Region of WHO to evaluate the performance of national reference laboratories (NRLs) and to ensure that the results from the participating laboratories are reliable and similar. A panel of 30 Mycobacterium tuberculosis strains with various patterns of resistance to isoniazid, rifampin, ethambutol, and streptomycin was sent to the NRLs, and their DST results were analyzed by comparing them with the judicial results. The efficiency scores for each drug were 90 to 99% (mean, 95%) for isoniazid, 77 to 100% (mean, 94%) for rifampin, 82 to 97% (mean, 90%) for ethambutol, and 82 to 98% (mean, 89%) for streptomycin. Significant changes over time in the rates of accordance with the judicial results were observed for rifampin (P < 0.0001) and streptomycin (P = 0.0002), whereas no changes were observed for ethambutol (P = 0.0880). The efficiency score for isoniazid was consistently good throughout the nine rounds. As a whole, NRL02 showed the highest score (95%) in accordance rates for all drugs, while NRL03 (86%) and NRL04 (88%) ranked lowest. Continued proficiency testing with subsequent technical assistance improved the DST quality of participating laboratories, demonstrating the importance of the current WHO/IUATLD external quality assurance program for DST proficiency testing.

PubMed Disclaimer

Figures

FIG. 1.
FIG. 1.
Performance of six participating laboratories in the Regional Reference Laboratory network DST proficiency testing. The P value is a Cochran-Mantel-Haenszel chi-square statistic. RD, rate of detection of resistant strains (sensitivity); SD, rate of detection of susceptible strains (specificity); RP, reproducibility; AR, accuracy ratio (ratio of accordant results to total test results), or efficiency.
FIG. 2.
FIG. 2.
Laboratory scores for DST performance. Dotted lines, mean efficiency; solid lines, mean − 1 SD.
See this image and copyright information in PMC

References

    1. Canetti, G., W. Fox, A. Khomenko, et al. 1969. Advances in techniques of testing mycobacterial drug susceptibility testing, and the use of sensitivity tests in tuberculosis control programmes. Bull. W. H. O. 41:21-43. - PMC - PubMed
    1. Canetti, G., S. Froman, J. Grosset, et al. 1963. Mycobacteria: laboratory methods for testing drug sensitivity and resistance. Bull. W. H. O. 29:565-578. - PMC - PubMed
    1. Fleiss, J. L. 1981. Statistical methods for rates and proportions. Wiley-Interscience, New York, NY.
    1. Kim, S. J. 2005. Drug-susceptibility testing in tuberculosis: methods and reliability of results. Eur. Respir. J. 25:564-569. - PubMed
    1. Laszlo, A., M. Rahman, M. Espinal, and M. Raviglione. 2002. Quality assurance programme for drug susceptibility testing of Mycobacterium tuberculosis in the WHO/IUATLD Supranational Reference Laboratory Network: five rounds of proficiency testing, 1994-1998. Int. J. Tuberc. Lung Dis. 6:748-756. - PubMed

MeSH terms

Substances