SUPRA-NATIONAL REFERENCE LABORATORY NETWORK

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Presentation transcript:

SUPRA-NATIONAL REFERENCE LABORATORY NETWORK DST QA Round 11, 2004 A. Van Deun & F. Portaels

CONDUCT OF ROUND 11 20 strains, 10 in duplicate: total 30 cultures non-MDR series: R-mono 7 strains from Borstel, 6 from Paris SRL pre-testing 7 Antwerp strains MIC, sequencing exclusion doubtful strains mass culture from single colony 0 contamination, 9 growth failures (#3, #9)

LABS AND METHODS, Rd 6 TO 11

JUDICIAL RESULTS OF ROUND 11 INH strains: 10 resistant, 10 susc. cultures: 15 resistant, 15 susc. agreement: 100% 18 strains 98% 2 strains

JUDICIAL RESULTS OF ROUND 11 RIFAMPICIN 10 resistant, 10 susceptible strains 16 resistant, 14 susceptible cultures agreement: 100% 19 strains 57% (judicial susc.) 1 strain (#6)

JUDICIAL RESULTS OF ROUND 11 STREPTOMYCIN 11 resistant, 9 susceptible strains 16 resistant, 14 susceptible cultures agreement: 100% 13 strains 96% 2 strains 91% 1 strain 70% 2 strains (#1, 7) <70% 2 strains (#6, 9)

JUDICIAL RESULTS OF ROUND 11 ETHAMBUTOL strains: 5 resistant, 15 susc. cultures: 7 resistant, 23 susc. agreement: 100% 9 strains 90-99% 7 strains 87% 1 strain 70-80% 3 strains (#8, 11, 12)

RESULTS OF ROUND 11

RESULTS OF ROUND 11

RIFAMPICIN INTERMEDIATE RESISTANT STRAIN: results by method

COMPARISON PHENO / GENOTYPIC (SEQUENCING) Results known for 7 Antwerp strains only Perfect correlation for H and E Poor correlation for S (rpsL, rrs530, rrs912) 0/3 resistant have mutation Perfect correlation for R with exception of the discordant strain leu533pro mutation majority finds susceptible

RIFAMPICIN PROBLEM STRAIN MICs

RIFAMPICIN PROBLEM STRAIN: CLINICALLY #6, judicial HS resistant, 57% R-susceptible patient from Bujumbura, Burundi failure of 2EHRZ / 4H3R3 failure of 2SEHRZ / 1EHRZ / 5E3H3R3