Proficiency of drug susceptibility testing of Mycobacterium tuberculosis against pyrazinamide: the Swedish experience
Proficiency of drug susceptibility testing of Mycobacterium tuberculosis against pyrazinamide: the Swedish experience
复制标题
DOI：
10.5588/ijtld.13.0195
复制
发表时间：
2013-11-01
影响因子：
4
通讯作者：
Werngren, J.
中科院分区：
文献类型：
--
作者：
Hoffner, S.;Angeby, K.;Werngren, J.
背景：吡嗪酰胺（PZA）是治疗结核病（包括耐多药结核病）的关键药物。结核分枝杆菌对PZA的药物敏感性测试（DST）不包括在世界卫生组织的年度能力测试中。有越来越多的需要建立质量控制PZA DST.OBJECTIVE：为了评估PZA DST的性能，并引入一个质量保证体系的测试在Sweden.METHOD：面板与PZA敏感和耐药菌株在三轮的能力测试中使用的所有五个瑞典临床结核病实验室和我们的参考实验室。所有实验室均使用MGIT 960系统。测定最低抑菌浓度（MIC），并对pncA基因进行测序，以进一步鉴定52株pncA菌株。结果：表型PZA DST和pncA序列数据之间具有良好的一致性，MIC测定证实了高水平的耐药性。然而，在其他药物，正确的熟练测试结果，观察到，特异性问题发生PZA DST在一些laborators.CONCLUSIONS：在瑞典，使用面板测试，差异被视为在正确识别PZA敏感性的结核病实验室的熟练程度。在第三轮中注意到改进的结果;因此，PZA被列入年度能力测试。
BACKGROUND: Pyrazinamide (PZA) is a key drug in the treatment of tuberculosis (TB), including multidrug-resistant TB. Drug susceptibility testing (DST) of Mycobacterium tuberculosis against PZA is not included in the World Health Organization's yearly proficiency testing. There is an increasing need to establish quality control of PZA DST.OBJECTIVE: To evaluate the performance of PZA DST and to introduce a quality assurance system for the test in Sweden.METHOD: Panels with PZA-susceptible and -resistant isolates were used in three rounds of proficiency testing in all five Swedish clinical TB laboratories and our reference laboratory. All laboratories used the MGIT 960 system. Minimum inhibitory concentrations (MICs) were determined and the pncA gene was sequenced to further characterise the 52 panel strains.RESULTS: Good agreement was seen between the phenotypic PZA DST and pncA sequence data, and MIC determination confirmed high levels of resistance. However, in contrast to other drugs, for which correct proficiency test results were observed, specificity problems occurred for PZA DST in some laboratories.CONCLUSIONS: In Sweden, using panel testing, differences were seen in the proficiency of TB laboratories in correctly identifying PZA susceptibility. Improved results were noted in the third round; PZA has therefore been included in yearly proficiency testing.