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Quality assurance for antimicrobial susceptibility testing of Neisseria gonorrhoeae in Latin American and Caribbean countries, 2013–2015
  1. Pam Sawatzky1,
  2. Irene Martin1,
  3. Patricia Galarza2,
  4. Marıa Elena Trigoso Carvallo3,
  5. Pamela Araya Rodriguez2,4,
  6. Olga Marina Sanabria Cruz5,
  7. Alina Llop Hernandez6,
  8. Mario Fabian Martinez7,
  9. Graciela Borthagaray8,
  10. Daisy Payares9,
  11. José E Moreno10,
  12. Marina Chiappe11,
  13. Aura Helena Corredor12,
  14. Sidharath Dev Thakur12,
  15. Jo-Anne R Dillon12
  1. 1Streptococcus and STI Unit, National Microbiology Laboratory, Public Health Agency of Canada, Winnipeg, Manitoba, Canada
  2. 2Servicio de Enfermedades deTransmisión Sexual, Centro Nacional de Referencia en ITS, INEI-ANLIS ‘Dr. Carlos G. Malbrán’, Buenos Aires, Argentina
  3. 3Programa de ITS/VIH/SIDA, Laboratorio del Centro Departamental de Vigilancia, Informacion y Referencia, La Paz, Bolivia
  4. 4Bacteriology section,Infectious Diseases Sub-Department, Biomedical Department, Instituto de Salud Publica de Chile, Santiago, Chile
  5. 5Grupo de Microbiología, Instituto National de Salud, Bogota, Colombia
  6. 6Laboratorio Nacional de Referencia de Microbiología, Instituto de Medicina Tropical ‘Pedro Kouri’ (IPK), La Habana, Cuba
  7. 7Seccion Antimicrobianos, Laboratorio Central De Salud Pública, Asunción, Paraguay
  8. 8Laboratorio de Microbiologia, Departamento deBiociencias, Facultad de Quimica, Universidad de la Republica, Montevideo, Uruguay
  9. 9Departamento de Bacteriologia, Instituto Nacional de Higine ‘Rafael Rangel’, Caracas, Venezuela
  10. 10Laboratorio Central de Referencia en Salud Publica, Instituto Conmemeorahvo Gorgas de Estudios de la Salud, Panamá, República de Panamá
  11. 11Facultad de Salud Pública y Administración, Universidad Peruana Cayetano Heredia, Lima, Peru
  12. 12Department of Microbiology and Immunology, University of Saskatchewan, Saskatoon, Saskatchewan, Canada
  1. Correspondence to Dr Jo-Anne R Dillon, Department of Microbiology and Immunology, University of Saskatchewan, Saskatoon, Saskatchewan, Canada; j.dillon{at}usask.ca

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

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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.

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