title: Proficiency of drug susceptibility testing for Mycobacterium tuberculosis in Taiwan, 2007-2011.
abstract: METHODS
  Authorised clinical mycobacteriology laboratories in Taiwan.
  
  
  OBJECTIVE
  To evaluate the impact of external quality assessment (EQA) on the quality of drug susceptibility testing (DST) in 2007-2011.
  
  
  METHODS
  Panels consisting of 20-30 Mycobacterium tuberculosis  strains were used. Efficiency of 95% in detecting resistance to both isoniazid (INH) and rifampicin (RMP), and of 90% to ethambutol (EMB) and streptomycin (SM) was used to define a competent laboratory.
  
  
  RESULTS
  The proportion of laboratories that fulfilled the competency criteria for all  first-line drugs was 16.7% in 2007, increasing to 85.7% in 2008, 86.1% in 2009, 82.4% in 2010, and to 96.8% in 2011 (P < 0.01). The mean efficiency in detecting resistance to INH and RMP reached >99% during 2008-2011 (P = 0.90 for INH and P = 0.82 for RMP),  and for EMB it increased from 82.0% in 2007 to 92.2% in 2008 and 99.5% in 2011 (P < 0.01), while that for resistance to SM increased from 82.0% in 2007 to 98.1% in 2008 and 99.5% in 2011 (P < 0.01). Preparations of inoculum for DST and detection of EMB resistance were the  main reasons for non-competence.
  
  
  CONCLUSIONS
  The EQA programme was effective in improving the competency of clinical laboratories in performing DST for tuberculosis.
authors.affiliation: Reference Laboratory of Mycobacteriology, Research and Diagnostic Center, Centers for Disease Control, Department of Health, Taiwan.
authors.forename: M-H
authors.initials: MH
authors.lastname: Wu
authors.forename: C-Y
authors.initials: CY
authors.lastname: Chiang
authors.forename: Y-M
authors.initials: YM
authors.lastname: Deng
authors.forename: T-F
authors.initials: TF
authors.lastname: Wang
authors.forename: R
authors.initials: R
authors.lastname: Jou
mesh_terms: D001431:Bacteriological Techniques / Q000592:standards; D019411:Clinical Laboratory Techniques / Q000592:standards*; D006801:Humans; D008826:Microbial Sensitivity Tests; D009169:Mycobacterium tuberculosis / Q000187:drug effects*; D011361:Professional Competence; D013624:Taiwan; D013997:Time Factors