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Journal of Clinical Microbiology, July 1999, p. 2297-2305, Vol. 37, No. 7
0095-1137/99/$04.00+0
Copyright © 1999, American Society for Microbiology. All rights reserved.

Evaluation of Mycology Laboratory Proficiency Testing

Andrew A. Reilly,1,2,* Ira F. Salkin,1,2 Michael R. McGinnis,3 Sally Gromadzki,1 Lester Pasarell,3 Maggi Kemna,1 Nancy Higgins,1 and Max Salfinger1,4

Wadsworth Center, New York State Department of Health,1 and Department of Medicine, Albany Medical College,4 Albany, and School of Public Health, The University at Albany, Rensselaer,2 New York, and Center for Tropical Diseases, Department of Pathology, University of Texas Medical Branch, Galveston, Texas3

Received 16 December 1998/Returned for modification 8 February 1999/Accepted 19 April 1999

Changes over the last decade in overt proficiency testing (OPT) regulations have been ostensibly directed at improving laboratory performance on patient samples. However, the overt (unblinded) format of the tests and regulatory penalties associated with incorrect values allow and encourage laboratorians to take extra precautions with OPT analytes. As a result OPT may measure optimal laboratory performance instead of the intended target of typical performance attained during routine patient testing. This study addresses this issue by evaluating medical mycology OPT and comparing its fungal specimen identification error rates to those obtained in a covert (blinded) proficiency testing (CPT) program. Identifications from 188 laboratories participating in the New York State mycology OPT from 1982 to 1994 were compared with the identifications of the same fungi recovered from patient specimens in 1989 and 1994 as part of the routine procedures of 88 of these laboratories. The consistency in the identification of OPT specimens was sufficient to make accurate predictions of OPT error rates. However, while the error rates in OPT and CPT were similar for Candida albicans, significantly higher error rates were found in CPT for Candida tropicalis, Candida glabrata, and other common pathogenic fungi. These differences may, in part, be due to OPT's use of ideal organism representatives cultured under optimum growth conditions. This difference, as well as the organism-dependent error rate differences, reflects the limitations of OPT as a means of assessing the quality of routine laboratory performance in medical mycology.

* Corresponding author. Mailing address: Wadsworth Center, Rm. C543, New York State Department of Health, P.O. Box 509, Albany, NY 12201-0509. Phone: (518) 473-3493. Fax: (518) 474-2769. E-mail: Andrew.Reilly{at}Wadsworth.Org.

Journal of Clinical Microbiology, July 1999, p. 2297-2305, Vol. 37, No. 7
0095-1137/99/$04.00+0
Copyright © 1999, American Society for Microbiology. All rights reserved.


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