J Lab Med Qual Assur.  2015 Dec;37(4):153-178. 10.15263/jlmqa.2015.37.4.153.

Annual Report on External Quality Assessment Scheme for Clinical Microbiology in Korea (2014)

• Ko YJ
• Kim MN
• Kim EC
• Shin JH
• Lee NY
• Kim S
• Jeong SH
• Kim JS
• Kim CK
• Bae HG
• Yoon NS
• Joo SI
• Hwang YY
• Kim K
• Jang IH
• Heo J
• Clinical Microbiology Subcommittee, Korean Association of External Quality Assessment Service

• KMID: 2200274
• DOI: http://doi.org/10.15263/jlmqa.2015.37.4.153

Abstract

Annual proficiency surveys were performed in March, June and September 2014 by clinical microbiology division of The Korean Association of Quality Assurance for Clinical Laboratory. Parasitology part has been newly incorporated in this survey. For each trial, three sets which were composed of different combinations of five bacteria and yeast were distributed for gram stain, culture, identification, and antimicrobial susceptibility tests of general bacteriology and five fixed sputum smear on slides were distributed for acid fast bacilli stain. Two advanced bacteriology survey materials for culture and identification of anaerobic bacteria and mold were distributed to the voluntary participants in every trial and five mycobacterial culture and identification specimens, five anti-tuberculosis susceptibility testing specimens, and two Mycobacterium tuberculosis strains for rapid detection of rifampin and isoniazid resistance were distributed to the voluntary participants in March and June trials. Five virtual microscopic slides for stool parasite examination were open for the registered participants in June trial. A total of 340 laboratories were enrolled and 330 (97.0%), 331 (97.4%), and 331 (97.4%) returned the results on trial I, II, and III, respectively. For bacterial identification, the percent acceptable identification of Burkholderia cepacia, Klebsiella pneumoniae, Streptococcus pyogenes, Staphylococcus aureus, Pseudomonas aeruginosa, Streptococcus pneumoniae, Streptococcus agalactiae, Plesiomonas shigelloides, and Enterococcus faecalis were greater than 95%. Group C and group D Salmonella species challenged as the different sets of M1422 resulted in the acceptable rate lower than 95% because nine participants reported the identification of different sets. Surveillance cultures for methicillin-resistant S. aureus and vancomycin-resistant enterococci were correctly determined by 89.6% and 69.0% of the respondents, respectively. Correct identification to species level of Candida albicans, Candida auris, Candida glabrata, and Candida parapsilosis were 86.1%, 1.6%, 48.1%, and 83.8%. Vancomycin disk diffusion test in S. aureus, missing oxacillin screen or penicillin susceptibility test in S. pneumoniae and lack of reliable methods of quinolone resistance detection in Salmonella species caused unacceptable results in antimicrobial susceptibility testing. Advanced bacteriology trials revealed low performance in species identification of mold. Mycobacterial culture, identification and susceptibility test performance was kept in excellence. The performance of identification of stool parasites was acceptable >90% for detection of helminth eggs and amebic cysts but 28.6% false positive responses resulted from negative specimens. In conclusion, species-level identification of fungi of both candida species and mold were challenging to clinical microbiology laboratories. Vancomycin disk diffusion method for S. aureus and lack of proper penicillin susceptibility test for S. pneumoniae were still common cause of inaccurate results. Virtual microscopic survey has been successfully introduced in parasitology.

Keyword

Proficiency survey; Parasitology; Bacteriology; Clinical microbiology; Mycobacterial culture; Susceptibility testing

MeSH Terms

Bacteria
Bacteria, Anaerobic
Bacteriology
Burkholderia cepacia
Candida
Candida albicans
Candida glabrata
Surveys and Questionnaires
Diffusion
Eggs
Enterococcus faecalis
Fungi
Helminths
Isoniazid
Klebsiella pneumoniae
Korea*
Methicillin Resistance
Mycobacterium tuberculosis
Ovum
Oxacillin
Parasites
Parasitology
Penicillins
Plesiomonas
Pneumonia
Pseudomonas aeruginosa
Rifampin
Salmonella
Sputum
Staphylococcus aureus
Streptococcus agalactiae
Streptococcus pneumoniae
Streptococcus pyogenes
Vancomycin
Yeasts
Isoniazid
Oxacillin
Penicillins
Rifampin
Vancomycin