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Journal of Clinical Microbiology, November 2007, p. 3626-3630, Vol. 45, No. 11
0095-1137/07/$08.00+0     doi:10.1128/JCM.00784-07
Copyright © 2007, American Society for Microbiology. All Rights Reserved.

Proficiency Analysis of Drug Susceptibility Testing by National-Level Tuberculosis Reference Laboratories from 1995 to 2003

Gill-Han Bai,¹ Sang-Jae Kim,² Chulhun L. Chang,^1,3,4* and Members of National and Regional Tuberculosis Reference Laboratories

Korean Institute of Tuberculosis, Seoul,¹ Department of Laboratory Medicine, School of Medicine,³ Medical Research Institute, Pusan National University, Busan, Korea,⁴ International Union against Tuberculosis and Lung Disease, Paris, France²

Received 12 April 2007/ Returned for modification 31 May 2007/ Accepted 31 August 2007

A proficiency review of antituberculous drug susceptibility testing (DST) was undertaken by the regional tuberculosis reference laboratories of the Western Pacific Region of WHO to evaluate the performance of national reference laboratories (NRLs) and to ensure that the results from the participating laboratories are reliable and similar. A panel of 30 Mycobacterium tuberculosis strains with various patterns of resistance to isoniazid, rifampin, ethambutol, and streptomycin was sent to the NRLs, and their DST results were analyzed by comparing them with the judicial results. The efficiency scores for each drug were 90 to 99% (mean, 95%) for isoniazid, 77 to 100% (mean, 94%) for rifampin, 82 to 97% (mean, 90%) for ethambutol, and 82 to 98% (mean, 89%) for streptomycin. Significant changes over time in the rates of accordance with the judicial results were observed for rifampin (P < 0.0001) and streptomycin (P = 0.0002), whereas no changes were observed for ethambutol (P = 0.0880). The efficiency score for isoniazid was consistently good throughout the nine rounds. As a whole, NRL02 showed the highest score (95%) in accordance rates for all drugs, while NRL03 (86%) and NRL04 (88%) ranked lowest. Continued proficiency testing with subsequent technical assistance improved the DST quality of participating laboratories, demonstrating the importance of the current WHO/IUATLD external quality assurance program for DST proficiency testing.

Published ahead of print on 12 September 2007.

Participating laboratories are listed in Acknowledgments.