Article Text
Abstract
Objectives A Neisseria gonorrhoeae antimicrobial susceptibility quality control comparison programme was re-established in Latin America and the Caribbean to ensure antimicrobial susceptibility data produced from the region are comparable nationally and internationally.
Methods Three panels, consisting of N. gonorrhoeae isolates comprising reference strains and other characterised isolates were sent to 11 participating laboratories between 2013 and 2015. Antimicrobial susceptibilities for these isolates were determined using agar dilution, Etest or disc diffusion methods. Modal minimum inhibitory concentrations (MICs) for each panel isolate/antibiotic combination were calculated. The guidelines of the Clinical and Laboratory Standards Institute were used for interpretations of antimicrobial susceptibility. The agreement of MICs with the modal MICs was determined for each of the participating laboratories as well as for each of the antibiotics tested.
Results Five of 11 laboratories that participated in at least one panel had an overall average agreement between participants’ MIC results and modal MICs of >90%. For other laboratories, agreements ranged from 60.0% to 82.4%. The proportion of agreement between interpretations for all the antibiotics, except penicillin and tetracycline, was >90%. The percentages of agreement between MIC results and their modes for erythromycin, spectinomycin, cefixime and azithromycin were >90%. Tetracycline, ceftriaxone and ciprofloxacin agreement ranged from 84.5% to 89.1%, while penicillin had 78.8% agreement between MICs and modal MICs.
Conclusions The participating laboratories had acceptable results, similar to other international quality assurance programmes. It is important to ensure continuation of the International Gonococcal Antimicrobial Susceptibility Quality Control Comparison Programme to ensure that participants can identify and correct any problems in antimicrobial susceptibility testing for N. gonorrhoeae as they arise and continue to generate reproducible and reliable data.
- antimicrobial resistance
- gonorrhoea
- Latin America
- surveillance
Statistics from Altmetric.com
Footnotes
Handling editor Catherine A Ison
Contributors PG, METC, PAR, OMSC, ALH, MFM, GB, DP, JEM and MC performed MIC testing and collected and reported data. These authors read and offered comments on draft manuscripts. J-ARD established the QC program in Latin America and the Caribbean, worked with IM to develop the protocols and reporting formats used in this study and shipped isolates to participants. J-ARD was responsible for the final submission of the manuscript. PS and IM analysed submitted data and drafted the first versions of the manuscript. SDT prepared strains for shipment and co-developed the chocolate agar slant method used to transport isolates. AHC communicated with participants regarding technical questions and comments on the manuscript as well as preparing data summaries for analysis by J-ARD and IM. AHC and SDT also provided comments on versions of the manuscript.
Funding This study was partially funded by the University of Saskatchewan (to JRD) and the Saskatchewan Health Research Foundation (grant no. 9127, Research Alliance for the Prevention of Infectious Disease (RAPID).
Competing interests None declared.
Patient consent Not required.
Ethics approval Not required
Provenance and peer review Not commissioned; externally peer reviewed.