WHO Global Salm-Surv external quality assurance system for serotyping of Salmonella isolates from 2000 to 2007

TY - JOUR

T1 - WHO Global Salm-Surv external quality assurance system for serotyping of Salmonella isolates from 2000 to 2007

AU - Hendriksen, Rene S

AU - Mikoleit, Matthew

AU - Carlson, Valeria P

AU - Karlsmose, Susanne

AU - Vieira, Antonio R

AU - Jensen, Arne B

AU - Seyfarth, Anne Mette

AU - DeLong, Stephanie M

AU - Weill, François-Xavier

AU - Lo Fo Wong, Danilo Marino Armando

AU - Angulo, Frederick J

AU - Wegener, Henrik C

AU - Aarestrup, Frank M

PY - 2009/9

Y1 - 2009/9

N2 - An international external quality assurance system (EQAS) for the serotyping of Salmonella species was initiated in 2000 by WHO Global Salm-Surv to enhance the capacity of national reference laboratories to obtain reliable data for surveillance purposes worldwide. Seven EQAS iterations were conducted between 2000 and 2007. In each iteration, participating laboratories submitted serotyping results for eight Salmonella isolates. A total of 249 laboratories in 96 countries participated in at least one EQAS iteration. A total of 756 reports were received from the participating laboratories during the seven EQAS iterations. Cumulatively, 76% of participating laboratories submitted data for all eight strains, and 82% of strains were correctly serotyped. In each iteration, 84% to 96% of the laboratories correctly serotyped the Salmonella enterica serovar Enteritidis isolate that was included as an internal quality control strain. Regional differences in performance were observed, with laboratories in Central Asia and the Middle East performing less well overall than those in other regions. Errors that resulted in incorrect serovar identification were typically caused by difficulties in the detection of the phase two flagellar antigen or in differentiation within antigen complexes; some of these errors are likely related to the quality of the antisera available. The results from the WHO Global Salm-Surv EQAS, the largest of its kind in the world, show that most laboratories worldwide are capable of correctly serotyping Salmonella species. However, this study also indicates a continuing need for improvement. Future training efforts should be aimed at enhancing the ability to detect the phase two flagellar antigen and at disseminating information on where to purchase high-quality antisera.

AB - An international external quality assurance system (EQAS) for the serotyping of Salmonella species was initiated in 2000 by WHO Global Salm-Surv to enhance the capacity of national reference laboratories to obtain reliable data for surveillance purposes worldwide. Seven EQAS iterations were conducted between 2000 and 2007. In each iteration, participating laboratories submitted serotyping results for eight Salmonella isolates. A total of 249 laboratories in 96 countries participated in at least one EQAS iteration. A total of 756 reports were received from the participating laboratories during the seven EQAS iterations. Cumulatively, 76% of participating laboratories submitted data for all eight strains, and 82% of strains were correctly serotyped. In each iteration, 84% to 96% of the laboratories correctly serotyped the Salmonella enterica serovar Enteritidis isolate that was included as an internal quality control strain. Regional differences in performance were observed, with laboratories in Central Asia and the Middle East performing less well overall than those in other regions. Errors that resulted in incorrect serovar identification were typically caused by difficulties in the detection of the phase two flagellar antigen or in differentiation within antigen complexes; some of these errors are likely related to the quality of the antisera available. The results from the WHO Global Salm-Surv EQAS, the largest of its kind in the world, show that most laboratories worldwide are capable of correctly serotyping Salmonella species. However, this study also indicates a continuing need for improvement. Future training efforts should be aimed at enhancing the ability to detect the phase two flagellar antigen and at disseminating information on where to purchase high-quality antisera.

KW - Bacteriological Techniques

KW - Diagnostic Errors

KW - Health Services Research

KW - Humans

KW - Quality Assurance, Health Care

KW - Reference Standards

KW - Salmonella

KW - Salmonella Infections

KW - Serotyping

KW - World Health Organization

KW - Journal Article

KW - Multicenter Study

U2 - 10.1128/JCM.02437-08

DO - 10.1128/JCM.02437-08

M3 - Journal article

C2 - 19571024

SN - 0095-1137

VL - 47

SP - 2729

EP - 2736

JO - Journal of Clinical Microbiology

JF - Journal of Clinical Microbiology

IS - 9

ER -