International external quality assurance for laboratory diagnosis of diphtheria (2024)

Neal, S. E. (2009). International external quality assurance for laboratory diagnosis of diphtheria. Journal of Clinical Microbiology, 47(12), 4037-4042. https://doi.org/10.1128/JCM.00473-09

Neal, S. E. ; Efstratiou, Androulla. / International external quality assurance for laboratory diagnosis of diphtheria. In: Journal of Clinical Microbiology. 2009 ; Vol. 47, No. 12. pp. 4037-4042.

@article{1647c2d19a754d7bb7fec5488714f448,

title = "International external quality assurance for laboratory diagnosis of diphtheria",

abstract = "The diphtheria surveillance network (DIPNET) encompassing National Diphtheria Reference Centers from 25 European countries is a Dedicated Surveillance Network recognized by the European Commission. A key DIPNET objective is the quality assessment of microbiological procedures for diphtheria across the European Union and beyond. A detailed questionnaire on the level of reference laboratory services and an external quality assessment (EQA) panel comprising six simulated throat specimens were sent to 34 centers. Twentythree centers are designated National Diphtheria Reference Centers, with the laboratory in the United Kingdom being the only WHO Collaborating Centre. A variety of screening and identification tests were used, including the cysteinase test (20/34 centers), pyrazinamidase test (17/34 centers), and commercial kits (25/34 centers). The classic Elek test for toxigenicity testing is mostly used (28/34 centers), with variations in serum sources and antitoxin concentrations. Many laboratories reported problems obtaining Elek reagents or media. Only six centers produced acceptable results for all six specimens. Overall, 21% of identification and 13% of toxigenicity reports were unacceptable. Many centers could not isolate the target organism, and most found difficulties with the specimens that contained Corynebacterium striatum as a commensal contaminant. Nineteen centers generated either false-positive or negative toxigenic results, which may have caused inappropriate medical management. The discrepancies in this diphtheria diagnostics EQA alarmingly reflect the urgent need to improve laboratory performance in diphtheria diagnostics in Europe, standardize feasible and robust microbiological methods, and build awareness among public health authorities. Therefore, DIPNET recommends that regular workshops and EQA distributions for diphtheria diagnostics should be supported and maintained.",

author = "Neal, {S. E.} and Androulla Efstratiou",

note = "Copyright: Copyright 2010 Elsevier B.V., All rights reserved.",

year = "2009",

month = dec,

doi = "10.1128/JCM.00473-09",

language = "English",

volume = "47",

pages = "4037--4042",

journal = "Journal of Clinical Microbiology",

issn = "0095-1137",

publisher = "American Society for Microbiology",

number = "12",

}

Neal, SE 2009, 'International external quality assurance for laboratory diagnosis of diphtheria', Journal of Clinical Microbiology, vol. 47, no. 12, pp. 4037-4042. https://doi.org/10.1128/JCM.00473-09

International external quality assurance for laboratory diagnosis of diphtheria. / Neal, S. E.; Efstratiou, Androulla.
In: Journal of Clinical Microbiology, Vol. 47, No. 12, 12.2009, p. 4037-4042.

Research output: Contribution to journal › Article › peer-review

TY - JOUR

T1 - International external quality assurance for laboratory diagnosis of diphtheria

AU - Neal, S. E.

AU - Efstratiou, Androulla

N1 - Copyright:Copyright 2010 Elsevier B.V., All rights reserved.

PY - 2009/12

Y1 - 2009/12

N2 - The diphtheria surveillance network (DIPNET) encompassing National Diphtheria Reference Centers from 25 European countries is a Dedicated Surveillance Network recognized by the European Commission. A key DIPNET objective is the quality assessment of microbiological procedures for diphtheria across the European Union and beyond. A detailed questionnaire on the level of reference laboratory services and an external quality assessment (EQA) panel comprising six simulated throat specimens were sent to 34 centers. Twentythree centers are designated National Diphtheria Reference Centers, with the laboratory in the United Kingdom being the only WHO Collaborating Centre. A variety of screening and identification tests were used, including the cysteinase test (20/34 centers), pyrazinamidase test (17/34 centers), and commercial kits (25/34 centers). The classic Elek test for toxigenicity testing is mostly used (28/34 centers), with variations in serum sources and antitoxin concentrations. Many laboratories reported problems obtaining Elek reagents or media. Only six centers produced acceptable results for all six specimens. Overall, 21% of identification and 13% of toxigenicity reports were unacceptable. Many centers could not isolate the target organism, and most found difficulties with the specimens that contained Corynebacterium striatum as a commensal contaminant. Nineteen centers generated either false-positive or negative toxigenic results, which may have caused inappropriate medical management. The discrepancies in this diphtheria diagnostics EQA alarmingly reflect the urgent need to improve laboratory performance in diphtheria diagnostics in Europe, standardize feasible and robust microbiological methods, and build awareness among public health authorities. Therefore, DIPNET recommends that regular workshops and EQA distributions for diphtheria diagnostics should be supported and maintained.

AB - The diphtheria surveillance network (DIPNET) encompassing National Diphtheria Reference Centers from 25 European countries is a Dedicated Surveillance Network recognized by the European Commission. A key DIPNET objective is the quality assessment of microbiological procedures for diphtheria across the European Union and beyond. A detailed questionnaire on the level of reference laboratory services and an external quality assessment (EQA) panel comprising six simulated throat specimens were sent to 34 centers. Twentythree centers are designated National Diphtheria Reference Centers, with the laboratory in the United Kingdom being the only WHO Collaborating Centre. A variety of screening and identification tests were used, including the cysteinase test (20/34 centers), pyrazinamidase test (17/34 centers), and commercial kits (25/34 centers). The classic Elek test for toxigenicity testing is mostly used (28/34 centers), with variations in serum sources and antitoxin concentrations. Many laboratories reported problems obtaining Elek reagents or media. Only six centers produced acceptable results for all six specimens. Overall, 21% of identification and 13% of toxigenicity reports were unacceptable. Many centers could not isolate the target organism, and most found difficulties with the specimens that contained Corynebacterium striatum as a commensal contaminant. Nineteen centers generated either false-positive or negative toxigenic results, which may have caused inappropriate medical management. The discrepancies in this diphtheria diagnostics EQA alarmingly reflect the urgent need to improve laboratory performance in diphtheria diagnostics in Europe, standardize feasible and robust microbiological methods, and build awareness among public health authorities. Therefore, DIPNET recommends that regular workshops and EQA distributions for diphtheria diagnostics should be supported and maintained.

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U2 - 10.1128/JCM.00473-09

DO - 10.1128/JCM.00473-09

M3 - Article

C2 - 19828749

AN - SCOPUS:71549123380

SN - 0095-1137

VL - 47

SP - 4037

EP - 4042

JO - Journal of Clinical Microbiology

JF - Journal of Clinical Microbiology

IS - 12

ER -

Neal SE, Efstratiou A. International external quality assurance for laboratory diagnosis of diphtheria. Journal of Clinical Microbiology. 2009 Dec;47(12):4037-4042. doi: 10.1128/JCM.00473-09