A national audit of the laboratory diagnosis of tuberculosis and other mycobacterial diseases within the United Kingdom

被引:21
作者
Drobniewski, FA [1 ]
Watt, B
Smith, EG
Magee, JG
Williams, R
Holder, J
Ostrowski, J
机构
[1] Univ London Kings Coll, Sch Med, Dulwich Hosp,Dulwich Publ Hlth Lab, PHLS Mycobacterium Reference Unit, London SE22 8QF, England
[2] Univ London Kings Coll, Sch Med, Dulwich Hosp, Dept Microbiol, London SE22 8QF, England
[3] City Hosp, Scottish Mycobacteria Reference Lab, Edinburgh EH20 5SB, Midlothian, Scotland
[4] Birmingham Heartlands Hosp, Birmingham Publ Hlth Lab, Reg Ctr Mycobacteriol, Birmingham B9 5ST, W Midlands, England
[5] Newcastle Gen Hosp, Newcastle Publ Hlth Lab, Reg Ctr Mycobacteriol, Newcastle Upon Tyne NE4 6BE, Tyne & Wear, England
[6] Univ Wales Hosp, Cardiff Publ Hlth Lab, Reg Ctr Mycobacteriol, Cardiff CF4 4XW, S Glam, Wales
关键词
audit; Mycobacterium tuberculosis; molecular diagnosis; rifampicin resistance;
D O I
10.1136/jcp.52.5.334
中图分类号
R36 [病理学];
学科分类号
100104 ;
摘要
In order to audit United Kingdom laboratory diagnostic and reference services including novel molecular methods for tuberculosis, a questionnaire was sent to laboratories submitting specimens to the PHLS Mycobacterium Reference Unit (MRU) and regional centres and to the Scottish Mycobacteria Reference Laboratory (SMRL) in 1996-7. Nationally, 67.2% of laboratories responded. Most UK laboratories were fully or conditionally CPA accredited and take part in the NEQAS proficiency scheme. On average only 3.3% of primary samples submitted for mycobacterial diagnosis in 1995 produced a mycobacterial culture from approximately half as many patients (that is, a mean of 1488 specimens producing 49 isolates from 23 patients). Potentially over 380 000 specimens are processed for mycobacteria in the Uf( each year. The majority of laboratories use 4% NaOH +/- NALC for specimen decontamination. Culture on solid media was used by most laboratories and 62.9% also use Liquid media. Most laboratories incubated cultures for eight weeks. Few laboratories use molecular diagnostic methods. Laboratories were most likely to use molecular methods for diagnosing tuberculous meningitis and for specimens from immunocompromised patients, although usage was strongly influenced by cost. within England and Wales 43.9% (47/107) and 56% (61/109) of laboratories wanted a rapid service for rifampicin resistance detection in M tuberculosis from immunocompetent and immunocompromised patients, respectively. In regard to a tuberculous meningitis service, 80.5% (43/ 112) and 84.3% (102/121) of laboratories wanted this service for immunocompetent and immunocompromised patients, respectively. The quality of reference services was rated as "very good"/"good" by 85.6% of respondents nationally. Rapid molecular amplification diagnostic services were established at the PHLS MRU for rifampicin drug resistance detection nationally and for tuberculous meningitis at the MRU.
引用
收藏
页码:334 / 337
页数:4
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