2007-2009年全国淋球菌耐药监测实验室药敏试验室间质评结果分析

摘要

Objective To make a nationwide external quality assessment for drug sensitivity testing of Neisseria gonorrhoeae, analyze the problems in and factors associated with the drug sensitivity testing, and to enhance the quality of drug sensitivity testing of N. gonorrhoeae at different monitoring sites. Methods Samples were uniformly delivered to monitoring sites by express mail service. Test results were analyzed in the National Center for STD Control, and the evaluation results were fed back to these monitoring sites. Results A total of 105 quality control samples were delivered from 2007 to 2009, with a response rate of 88.57% (93/105). Thirteen monitoring sites were enrolled in the external quality assessment, including 9 laboratories in 2007, 9 in 2008 and 13 in 2009. The total percentage amounted to 77.42% (24/31) for qualified laboratories during the 3 years, including 6 laboratories in 2007, 7 in 2008 and 11 in 2009. The coincidence rate increased for the detection of penicillinase-producing N. gonorrhoeae (PPNG), N. gonorrhoeae with chromosome-mediated ciprofloxacin resistance, and N. gonorrhoeae with chromosome-mediated spectinomycin resistance, and declined for the detection of N. gonorrhoeae with plasmid-mediated high level tetracycline-resistance (TRNG) and N. gonorrhoeae with chromosome-mediated ceftriaxone resistance. Conclusions The 3-year external quality assessment reveals an improvement in the overall quality of drug sensitivity testing of N. gonorrhoeae at national monitoring sites; the accuracy is improved markedly for the detection of PPNG, N. gonorrhoeae with resistance to spectinomycin and ciprofloxacin, but is needed to increase for the detection of ceftriaxone-resis- tant N. gonorrhoeae and TRNG.%目的了解全国淋球菌耐药监测点药敏试验的检测水平,分析其影响因素及存在的问题,以提高我国淋球菌耐药监测点实验室药敏试验检测的质量.方法采用特快专递的方式,将质评样本集中统一发放到全国各淋球菌耐药监测点,由中国疾病预防控制中心性病控制中心将同报结果与预期结果进行比对分析.并将考评结果集中反馈给各参评单位.结果 2007-2009年间共发放室间质评考核样本35组,每组3份样本,合计105份,总回报率为88.57%(93/105).全国共有13个淋球菌耐药监测点参加了室间质评活动,3年间参评单位数分别为9、9、13,合格单位数分别为6、7、11.质评考核成绩的总合格率为77.42%(24/31).淋球菌的药敏检测结果符合率:提高的有质粒介导的产青霉素酶淋球菌、染色体介导的环丙沙星以及大观霉素耐药淋球菌;降低的有质粒介导的高度耐四环素淋球菌和染色体介导的头孢曲松耐药淋球菌.结论经过3年的室间质评,全国淋球菌耐药监测实验室药敏试验的整体检测质量得到了提高,其中产青霉素酶淋球菌、环丙沙星和大观霉素的药敏检测结果的符合率提升较快,而头孢曲松及质粒介导的高度耐四环素淋球菌的药敏检测质量有待提高.