title: Results of use of WHO Global Salm-Surv external quality assurance system for antimicrobial susceptibility testing of Salmonella isolates from 2000 to 2007.
abstract: An international External Quality Assurance System (EQAS) for antimicrobial susceptibility testing of Salmonella was initiated in 2000 by the World Health Organization (WHO) Global Salm-Surv in order to enhance the capacities of national reference laboratories to obtain reliable data for surveillance purposes worldwide. Seven EQAS iterations have been conducted from 2000 to 2007. In each iteration, participating laboratories submitted susceptibility results from 10 to 15 antimicrobial agents for eight Salmonella isolates and an Escherichia coli reference strain (ATCC 25922). A total of 287 laboratories in 102 countries participated in at least one EQAS iteration. A large number of laboratories reported results for the E. coli ATCC 25922 reference strain which were outside the quality control ranges. Critical deviations for susceptibility testing of the Salmonella isolates varied from 4% in 2000 to 3% in 2007. Consistent difficulties were observed in susceptibility testing of amoxicillin-clavulanic acid, cefotaxime, ceftazidime, streptomycin, sulfonamides, and tetracycline. Regional variations in performance were observed, with laboratories in central Asia, Africa, and the Middle East not performing as well as those in other regions. Results from the WHO Global Salm-Surv EQAS show that most laboratories worldwide are capable of correctly performing antimicrobial susceptibility testing of Salmonella isolates, but they also indicate that further improvement for some laboratories is needed. In particular, further training and dissemination of information on quality control, appropriate interpretive criteria (breakpoints), and harmonization of the methodology worldwide through WHO Global Salm-Surv and other programs will contribute to the generation of comparable and reliable antimicrobial susceptibility data.
authors.affiliation: WHO Collaborating Centre for Antimicrobial Resistance in Foodborne Pathogens and Community Reference Laboratory for Antimicrobial Resistance, National Food Institute, Copenhagen, Denmark. rshe@food.dtu.dk
authors.forename: Rene S
authors.initials: RS
authors.lastname: Hendriksen
authors.forename: Anne Mette
authors.initials: AM
authors.lastname: Seyfarth
authors.forename: Arne B
authors.initials: AB
authors.lastname: Jensen
authors.forename: Jean
authors.initials: J
authors.lastname: Whichard
authors.forename: Susanne
authors.initials: S
authors.lastname: Karlsmose
authors.forename: Kevin
authors.initials: K
authors.lastname: Joyce
authors.forename: Matthew
authors.initials: M
authors.lastname: Mikoleit
authors.forename: Stephanie M
authors.initials: SM
authors.lastname: Delong
authors.forename: François-Xavier
authors.initials: FX
authors.lastname: Weill
authors.forename: Awa
authors.initials: A
authors.lastname: Aidara-Kane
authors.forename: Danilo M A
authors.initials: DM
authors.lastname: Lo Fo Wong
authors.forename: Frederick J
authors.initials: FJ
authors.lastname: Angulo
authors.forename: Henrik C
authors.initials: HC
authors.lastname: Wegener
authors.forename: Frank M
authors.initials: FM
authors.lastname: Aarestrup
mesh_terms: D000900:Anti-Bacterial Agents / Q000494:pharmacology*; D003951:Diagnostic Errors; D004926:Escherichia coli / Q000187:drug effects; D017408:Guidelines as Topic; D006801:Humans; D008826:Microbial Sensitivity Tests / Q000592:standards*; D011786:Quality Control; D012015:Reference Standards; D015203:Reproducibility of Results; D012475:Salmonella / Q000187:drug effects*; D014944:World Health Organization
chemical_list: D000900:Anti-Bacterial Agents