JAC Advance Access published online on November 18, 2002
Journal of Antimicrobial Chemotherapy, doi:10.1093/jac/dkf231
© 2002 by The British Society for Antimicrobial Chemotherapy
| ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Original Paper
1 National Institute of
Public Health and the Environment, Bilthoven, The Netherlands
* Corresponding author. E-mail: stef.bronzwaer{at}cec.eu.int.
Received 12 February 2002
; revised 2 May 2002
; accepted 5 September 2002
The goal of this exercise was to organize external
quality assurance (QA) of antibiotic susceptibility testing for
laboratories participating in EARSS and to assess the comparability
of susceptibility test results across countries, and guidelines.
In September 2000, UK NEQAS distributed a set of three Streptococcus
pneumoniae strains, two Staphylococcus aureus strains and
one Streptococcus haemolyticus strain. Laboratories
reported the guideline followed, the interpretation of the susceptibility
test result and the MIC, if tested. In this study we considered results ‘concordant' if
the reported interpretation of the participating laboratory agreed
with the designated interpretation of reference laboratories. Overall,
433 (92%) of 471 laboratories from 23 countries reported
back. Of the 8685 tests that were assessed, 8322 (96%)
were interpreted correctly by the participants. Concordance for
detection of penicillin non-susceptibility in the three S.
pneumoniae strains was 96%, 90% and 87%,
respectively. Laboratories performed extremely well in detecting
oxacillin resistance in the homogeneously methicillin-resistant
S. aureus (MRSA) strain, but the
concordance rate dropped from 100% to 77% in the
heterogeneously resistant MRSA strain. Concordance for detection
of teicoplanin resistance in the S. haemolyticus strain
was 82%. We stratified concordance rates first for country
and then for guideline used, but observed only minor
differences among countries and guidelines. Quantitative methods
yielding an MIC were more concordant than non-MIC methods for penicillin resistance
in the S. pneumoniae strains (94% versus
79%). The NCCLS guideline was the most frequently followed,
by 61% of laboratories from 19 countries. This exercise
shows that, overall, countries participating in EARSS are capable
of delivering susceptibility data of good quality. The comparability
of susceptibility data for penicillin resistance in S.
pneumoniae and for homogeneous methicillin resistance in S. aureus is satisfactory among European countries
and across guidelines. However, we emphasize the importance of determining
an MIC for suspected penicillin non-susceptible S. pneumoniae and
for suspected glycopeptide non-susceptible S.
aureus. Laboratories, particularly in some countries, may need
to improve their capability to detect oxacillin resistance in heterogeneously
resistant MRSA. For continuous external quality assessment we recommend
that laboratories participate in national and international schemes with
frequent distribution of control strains.
Comparability
of antimicrobial susceptibility test results from
22 European countries and Israel: an external quality assurance
exercise of the European Antimicrobial Resistance Surveillance System
(EARSS) in collaboration with the United Kingdom National External
Quality Assurance Scheme (UK NEQAS)
2 Institut
Pasteur, Paris, France
3 PHLS, UK-NEQAS, London, UK
4 Università di Verona,
Verona, Italy
5 Institute
de Vieille Sanitaire, Saint-Maurice, France
6 Groningen University Hospital,
Groningen, The Netherlands
CiteULike 
Connotea 
Del.icio.us What's this?
This article has been cited by other articles:
|
|
 |
|
  M. A. Borg, M. de Kraker, E. Scicluna, N. van de Sande-Bruinsma, E. Tiemersma, J. Monen, H. Grundmann, and on behalf of the ARMed Project members and collabo Prevalence of methicillin-resistant Staphylococcus aureus (MRSA) in invasive isolates from southern and eastern Mediterranean countries J. Antimicrob. Chemother., December 1, 2007; 60(6): 1310 - 1315. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 J. Oteo, E. Lazaro, F. J. de Abajo, F. Baquero, J. Campos, and Spanish Members of the European Antimicrobial Resi Trends in Antimicrobial Resistance in 1,968 Invasive Streptococcus pneumoniae Strains Isolated in Spanish Hospitals (2001 to 2003): Decreasing Penicillin Resistance in Children's Isolates J. Clin. Microbiol., December 1, 2004; 42(12): 5571 - 5577. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
N. Bruinsma, K. G. Kristinsson, S. Bronzwaer, P. Schrijnemakers, J. Degener, E. Tiemersma, W. Hryniewicz, J. Monen, H. Grundmann, and on behalf of EARSS participants Trends of penicillin and erythromycin resistance among invasive Streptococcus pneumoniae in Europe J. Antimicrob. Chemother., December 1, 2004; 54(6): 1045 - 1050. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
G. Kahlmeter and D. F. J. Brown Resistance surveillance studies--comparability of results and quality assurance of methods J. Antimicrob. Chemother., December 1, 2002; 50(6): 775 - 777. [Full Text] [PDF]
|
|