识别方法作为影响外部质量评估计划参与的临床微生物学实验室绩效的一个因素:一个横截面的,回顾性分析分析
Jennifer Wu1, Md Saiful Alam2, Veronica Restelli1
1Canadian Microbiology Proficiency Testing Program (CMPT), Department of Pathology and Laboratory Medicine, The University of British Columbia, Vancouver, British Columbia, Canada.
Journal of medical microbiology
|October 29, 2024
概括
与传统方法相比,矩阵辅助激光脱离离子化飞行时间质谱法 (MALDI-TOF MS) 在熟练测试中显著提高了临床细菌学实验室的性能. 鉴定无氧生物仍然是实验室面临的挑战.
科学领域:
- 临床微生物学 临床微生物学
- 实验室诊断 实验室诊断 实验室诊断
- 质量保证 质量保证 质量保证
背景情况:
- 外部质量评估 (EQA) 和能力测试 (PT) 对于临床实验室根据ISO 15189:2022认证至关重要.
- 能力测试评估实验室的性能与参考方法和同行进行比较,识别整个测试过程中的潜在错误.
- 分析阶段,特别是测试方法是通过PT检测错误的关键领域.
研究的目的:
- 为了比较矩阵辅助激光吸附离子化飞行时间质谱法 (MALDI-TOF MS) 与传统的表型生物化学测试对临床细菌学实验室性能的影响.
- 在使用不同识别方法的技能测试计划中评估实验室性能.
主要方法:
- 一项为期6年的横截面研究 (2017-2022),涉及112个PT挑战,采用22种样本类型和61种细菌物种.
- 分析了5883个分级测试事件,比较了MALDI-TOF MS和表型生物化学测试.
- 使用多重后勤回归,样本类型和有氧分类作为混变量.
主要成果:
- 使用MALDI-TOF MS的实验室比单独使用表型方法的实验室表现出明显更好的微生物表征 (OR = 5.68).
- 这种改善MALDI-TOFMS的性能在不同样本类型和有氧分类中是一致的.
- 厌氧生物的鉴定与较差的实验室性能 (OR = 0.24) 有显著的关联,这表明对细菌的持续挑战.
结论:
- MALDI-TOF MS在临床细菌学熟练测试中提供了显著的优势,提高了实验室的准确性和能力.
- 尽管取得了进展,但对无氧和苛刻生物的鉴定仍然是临床微生物学改进的关键领域.
- 能力测试提供商在评估实验室性能和推动质量改进举措方面发挥着至关重要的作用.
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