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SUPRA-NATIONAL REFERENCE LABORATORY NETWORK

SUPRA-NATIONAL REFERENCE LABORATORY NETWORK. DST QA Round 11, 2004 A. Van Deun & F. Portaels. CONDUCT OF ROUND 11. 20 strains, 10 in duplicate: total 30 cultures non-MDR series: R-mono 7 strains from Borstel, 6 from Paris SRL pre-testing 7 Antwerp strains MIC, sequencing

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SUPRA-NATIONAL REFERENCE LABORATORY NETWORK

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  1. SUPRA-NATIONAL REFERENCE LABORATORY NETWORK DST QA Round 11, 2004 A. Van Deun & F. Portaels

  2. CONDUCT OF ROUND 11 • 20 strains, 10 in duplicate: total 30 cultures • non-MDR series: R-mono • 7 strains from Borstel, 6 from Paris SRL • pre-testing 7 Antwerp strains • MIC, sequencing • exclusion doubtful strains • mass culture from single colony • 0 contamination, 9 growth failures (#3, #9)

  3. LABS AND METHODS, Rd 6 TO 11

  4. JUDICIAL RESULTS OF ROUND 11 • INH • strains: 10 resistant, 10 susc. • cultures: 15 resistant, 15 susc. • agreement: 100% 18 strains 98% 2 strains

  5. JUDICIAL RESULTS OF ROUND 11 • RIFAMPICIN • 10 resistant, 10 susceptible strains • 16 resistant, 14 susceptible cultures • agreement: 100% 19 strains 57% (judicial susc.) 1 strain (#6)

  6. JUDICIAL RESULTS OF ROUND 11 • STREPTOMYCIN • 11 resistant, 9 susceptible strains • 16 resistant, 14 susceptible cultures • agreement: 100% 13 strains 96% 2 strains 91% 1 strain 70% 2 strains (#1, 7) <70% 2 strains (#6, 9)

  7. JUDICIAL RESULTS OF ROUND 11 • ETHAMBUTOL • strains: 5 resistant, 15 susc. • cultures: 7 resistant, 23 susc. • agreement: 100% 9 strains 90-99% 7 strains 87% 1 strain 70-80% 3 strains (#8, 11, 12)

  8. RESULTS OF ROUND 11

  9. RESULTS OF ROUND 11

  10. RIFAMPICIN INTERMEDIATE RESISTANT STRAIN:results by method

  11. COMPARISON PHENO / GENOTYPIC (SEQUENCING) • Results known for 7 Antwerp strains only • Perfect correlation for H and E • Poor correlation for S (rpsL, rrs530, rrs912) • 0/3 resistant have mutation • Perfect correlation for R with exception of the discordant strain • leu533pro mutation • majority finds susceptible

  12. RIFAMPICIN PROBLEM STRAIN MICs

  13. RIFAMPICIN PROBLEM STRAIN: CLINICALLY • #6, judicial HS resistant, 57% R-susceptible • patient from Bujumbura, Burundi • failure of 2EHRZ / 4H3R3 • failure of 2SEHRZ / 1EHRZ / 5E3H3R3

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