Diagnostics of fungal infections in the Nordic countries: we still need to improve!

Abstract number: 1733_663

Arendrup M.C., Chryssanthou E., Gaustad P., Sandven P., Koskela M., Fernandez on behalf of the Nordic Reference Group for Methods in Medical Mycology V.

Objectives: A Nordic External Quality Assessment programme in medical mycology was established in 2005. In order to monitor not ``best practice'' but the level of routine diagnostics, the specimens were designed to resemble clinical samples and laboratories were asked to handle the samples like routine samples.

Methods: Five simulated clinical samples were distributed to 59 participating Nordic laboratories of clinical microbiology. The specimens contained the following microorganisms: (1) Candida glabrata and C. albicans in a ratio of 1:20; (2) Cryptococcus neoformans; (3) Aspergillus fumigatus, C. albicans and Enterobacter cloacae; (4) C. tropicalis, Klebsiella pneumoniae and Enterococcus faecium, (5) None.

Results: Sixty-six percent of the laboratories failed to detect the C. glabrata isolate in sample 1. Thirty-four percent of the laboratories reporting susceptibility results incorrectly reported the Cryptococcus neoformans isolate as fluconazole susceptible. Twenty-four percent of the laboratories failed to detect Aspergillus fumigatus in specimen 3 although the accompanying clinical information notified that it was a BAL sample from a neutropenic patient in an ICU.

Conclusion: This distribution of simulated clinical samples illustrates that the traditional quality assessment programmes may give a false sense of well performance, that mycological diagnosis is difficult, and that there is a need of further improvement and attention.

Session Details

Date: 31/03/2007
Time: 00:00-00:00
Session name: European Society of Clinical Microbiology and Infectious Diseases
Location: ICC, Munich, Germany
Presentation type:
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