ABSTRACT
Candida auris is an emerging multidrug-resistant yeast that causes serious invasive infections and outbreaks with high mortality. Controlling C. auris is a challenge in which laboratories, clinicians and public health agencies are needed to identify and treat infections and prevent transmission. This review describes the general aspects of the biology, diagnosis and treatment of C. auris infection, as well as the main recommendations recently published by expert groups. We also present our experience of the C. auris outbreak at the Consorcio Hospital General Universitario de Valencia from September 2017 to August 2019. A total of 203 patients were colonised and/or infected by C. auris. Thirty invasive infections (29 blood cultures and one case of meningitis) were diagnosed. In all, 32% cases of candidemia were caused by C. auris in 2018. All strains were resistant to fluconazole.
Subject(s)
Candidiasis, Invasive/epidemiology , Cross Infection , Antifungal Agents/therapeutic use , Candida/drug effects , Cross Infection/drug therapy , Disease Outbreaks , Drug Resistance, Fungal , Humans , Spain/epidemiologyABSTRACT
This article provides an analysis of the results obtained in 2017 by the participants inscribed in the External Quality Control Programme of the Spanish Society of Infectious Diseases and Clinical Microbiology (SEIMC), which includes controls for bacteriology, serology, mycology, parasitology, mycobacteria, virology, molecular microbiology, and genotypic bacterial resistance. The results obtained in 2017 confirm the excellent skill and good technical standards found in previous editions. However, the programme again showed that erroneous results can be obtained in any laboratory and even in clinically relevant determinations. Once again, the results of this program highlight the need to implement both internal and external controls, as in the SEIMC programme.
Subject(s)
Infectious Disease Medicine/standards , Laboratories/standards , Microbiology/standards , Quality Control , Bacteriology , Humans , Mycology , SpainABSTRACT
This article provides an analysis of the results obtained in 2018 by the participants inscribed in the External Quality Control Programme of the Spanish Society of Infectious Diseases and Clinical Microbiology (SEIMC), which includes controls for bacteriology, serology, mycology, parasitology, mycobacteria, virology, molecular microbiology, and genotypic bacterial resistance. The results obtained in 2018 confirm the excellent skill and good technical standards found in the vast majority of Spanish clinical microbiology laboratories, as shown in previous editions. However, the programme again shows that erroneous results can be obtained in any laboratory and even in clinically relevant determinations. Once again, the results of this programme highlight the need to implement both internal and external controls, as in the SEIMC programme.
Subject(s)
Infectious Disease Medicine/standards , Laboratories/standards , Microbiology/standards , Quality Control , Bacteriology , Humans , Mycology , SpainABSTRACT
BACKGROUND: Human immunodeficiency virus type 1 (HIV-1) and hepatitis B (HBV) and C virus (HCV) viral load determinations are among the most relevant markers for the follow-up of patients infected with these viruses. External quality control tools are crucial to ensure the accuracy of the results obtained by microbiology laboratories. This article summarised the results obtained from the 2017 SEIMC External Quality Control Programme for HIV-1, HCV, and HBV viral loads and HCV genotyping. METHODS AND RESULTS: In the HIV-1 programme, a total of five standards were sent. One standard consisted of seronegative human plasma, while the remaining four contained plasma from three different viremic patients, in the range of 2-5 log10 copies/mL; two of these standards were identical, with the aim of determining repeatability. A significant proportion of the laboratories (35% on average) obtained values outside the accepted range (mean±0.25 log10 copies/mL), depending on the standard and on the method used for quantification. Repeatability was good, with up to 94% of laboratories reporting results within the limits (D<0.5 log10 copies/mL). The HBV and HCV programme consisted of two standards with different viral load contents. Most of the participants, 82% in the case of HCV and 87% in that of HBV, obtained all the results within the accepted range (mean±1.96 SD log10 UI/mL). CONCLUSIONS: Data from this analysis reinforce the utility of proficiency programmes to ensure the quality of the results obtained by a particular laboratory. Due to the marked interlaboratory variability observed, it is advisable to use the same method and laboratory for patient follow-up.
Subject(s)
HIV Infections , Hepatitis B , Hepatitis C , Quality Control , Viral Load , HIV Infections/diagnosis , HIV-1 , Hepacivirus , Hepatitis B/diagnosis , Hepatitis B virus , Hepatitis C/diagnosis , Humans , Infectious Disease Medicine/standardsABSTRACT
BACKGROUND: Human immunodeficiency virus type 1 (HIV-1) and hepatitis B (HBV) and C virus (HCV) viral load determinations are among the most relevant markers for the follow-up of patients infected with these viruses. External quality control tools are crucial to ensure the accuracy of the results obtained by microbiology laboratories. This article summarised the results obtained from the 2018 SEIMC External Quality Control Programme for HIV-1, HCV, and HBV viral loads and HCV genotyping. METHODS AND RESULTS: In the HIV-1 program, a total of five standards were sent. One standard consisted of seronegative human plasma, while the remaining four contained plasma from three different viremic patients, in the range of 2-5 log10 copies/mL; two of these standards were identical, with the aim of determining repeatability. A significant proportion of the laboratories (28% on average) obtained values outside the accepted range (mean±0.25 log10 copies/mL), depending on the standard and on the method used for quantification. Repeatability was good, with most laboratories reporting results within the limits (D<0.5 log10 copies/mL). The HBV and HCV programme consisted of two standards with different viral load contents. Most of the participants, 87% in the case of HCV and 88% in the HBV, obtained all the results within the accepted range (mean±1.96 SD log10 UI/mL). CONCLUSIONS: Data from this analysis reinforce the utility of proficiency programmes to ensure the quality of the results obtained by a particular laboratory. Due to the marked interlaboratory variability, it is advisable to use the same method and the same laboratory for patient follow-up.
Subject(s)
HIV Infections , Hepatitis B , Hepatitis C , Quality Control , Viral Load , HIV Infections/diagnosis , HIV-1 , Hepacivirus , Hepatitis B/diagnosis , Hepatitis B virus , Hepatitis C/diagnosis , Humans , Infectious Disease Medicine/standardsABSTRACT
Human immunodeficiency virus type 1 (HIV-1) and hepatitis B (HBV) and C virus (HCV) viral load determinations are among the most important markers for the follow-up of patients infected with these viruses. External quality control tools are crucial to ensure the accuracy of the results obtained by microbiology laboratories. This article summarized the results obtained in the 2010 External Quality Control Program of the Spanish Society of Infectious Diseases and Clinical Microbiology for HIV-1, HCV, and HBV viral loads and HCV genotyping. In the HIV-1 program, a total of five standards were sent. One standard consisted of seronegative human plasma, while the remaining four contained plasma from three different viremic patients, in the range of 3-5 log(10) copies/mL; two of these standards were identical, with the aim of determining repeatability. A significant proportion of the laboratories (22.6% on average) obtained values out of the accepted range (mean ± 0.2 log(10)copies/mL), depending on the standard and on the method used for quantification. Repeatability was very good, with up to 95% of laboratories reporting results within the limits (Δ<0.5 log(10)copies/mL). The HBV and HCV program consisted of two standards with different viral load contents. Most of the participants, 86.1% in the case of HCV and 87.1% in HBV, obtained all the results within the accepted range (mean ± 1.96 SD log(10)UI/mL). Post-analytical errors due to mistranscription of the results were detected in these controls. Data from this analysis reinforce the utility of proficiency programs to ensure the quality of the results obtained by a particular laboratory, as well as the importance of the post-analytical phase in overall quality. Due to interlaboratory variability, use of the same method and the same laboratory for patient follow-up is advisable.
Subject(s)
DNA, Viral/blood , HIV Infections/virology , Hepatitis B/virology , Hepatitis C/virology , Infectious Disease Medicine/standards , Laboratories/standards , Laboratory Proficiency Testing , Microbiology/standards , RNA, Viral/blood , Societies, Scientific/standards , Viral Load , Viremia/virology , Virology/standards , HIV-1/genetics , HIV-1/isolation & purification , Hepacivirus/genetics , Hepacivirus/isolation & purification , Hepatitis B virus/genetics , Hepatitis B virus/isolation & purification , Humans , Plasma , Polymerase Chain Reaction/methods , Polymerase Chain Reaction/standards , Polymorphism, Restriction Fragment Length , Quality Assurance, Health Care , Reproducibility of Results , SpainABSTRACT
The External Quality Control Program of the Spanish Society of Infectious Diseases and Clinical Microbiology (SEIMC) include controls for bacteriology, serology, mycology, parasitology, mycobacteria and virology. This article present the most relevant conclusions and lessons from the 2008 controls. As a whole, the results obtained in 2008 confirm the excellent skill and good technical standards of the microbiology laboratories in Spain found in previous editions. However, a few deviations can be obtained in any laboratory, even in clinically relevant determinations. Once again, the results of this program highlighted the need to implement both internal an external controls in order to assure the maximal quality of the microbiological tests.
Subject(s)
Clinical Laboratory Techniques/standards , Infectious Disease Medicine/organization & administration , Laboratories/standards , Microbiology/organization & administration , Quality Control , Diagnostic Errors/prevention & control , Diagnostic Errors/statistics & numerical data , Humans , Infections/diagnosis , Infections/microbiology , Infections/parasitology , Infections/virology , Infectious Disease Medicine/standards , Laboratories/statistics & numerical data , Microbiology/standards , Program Evaluation , Quality Assurance, Health Care , SpainABSTRACT
BACKGROUND: Human immunodeficiency virus type 1 (HIV-1) and hepatitis C virus (HCV) viral load determinations are among the most relevant markers for the follow up of patients infected with these viruses. External quality control tools are crucial to ensure the accuracy of results obtained by microbiology laboratories. This article summarized the results obtained from the 2008 SEIMC External Quality Control Program for HIV-1 and HCV viral loads. METHODS AND RESULTS: In the HIV-1 program, a total of five standards were sent. One standard consisted in seronegative human plasma, while the remaining four contained plasma from 3 different viremic patients, in the range of 2-5 log(10) copies/mL; two of these standards were identical aiming to determine repeatability. The specificity was complete for all commercial methods, and no false positive results were reported by the participants. A significant proportion of the laboratories (24% on average) obtained values out of the accepted range (mean +/- 0.2 log(10) copies/mL), depending on the standard and on the method used for quantification. Repeatability was very good, with up to 95% of laboratories reporting results within the limits (D < 0.5 log(10) copias/mL). The HCV program consisted of two standards with different viral load contents. Most of the participants (88,7%) obtained results within the accepted range (mean +/- 1.96 SD log(10) UI/mL). Post-analytical errors due to mistranscription of the results were detected for HCV, but not for the HIV-1 program. CONCLUSIONS: Data from this analysis reinforce the utility of proficiency programmes to ensure the quality of the results obtained by a particular laboratory, as well as the importance of the post-analytical phase on the overall quality. Due to the remarkable interlaboratory variability, it is advisable to use the same method and the same laboratory for patient follow up.
