27Background: In 2002, the World Health Organization (WHO) launched a regional microbiology external 28 quality assessment (EQA) programme for national public health laboratories in the African region, initially 29 targeting priority epidemic-prone bacterial diseases, and later including other common bacterial pathogens. 30Objectives: The aim of this study was to analyse the efficacy of an EQA programme as a laboratory quality 31 system evaluation tool. 32 Methods:We analysed the proficiency of laboratories' performance of bacterial identification and AST for the 33 period 2011-2016. Overall, 81 laboratories from 45 countries participated. 34The National Institute for Communicable Diseases of South Africa provided technical coordination following 35 an agreement with WHO, and supplied EQA samples of selected bacterial organisms for microscopy (Gram 36 stain), identification, and antimicrobial susceptibility testing (AST). National public health laboratories, as well 37 as laboratories involved in the Invasive Bacterial Diseases Surveillance Network, were enrolled by the WHO 38 Regional Office for Africa to participate in the EQA programme. 39 Results: We analysed participants' results of 41 surveys, which included the following organisms sent as 40 challenges: Streptococcus pneumonia, Haemophilus influenza, Neisseria meningitidis, Salmonella Typhi, 41 Salmonella Enteritidis, Shigella flexneri, Staphylococcus aureus, Streptococcus agalactiae, Streptococcus 42 anginosus, Enterococcus faecium, Serratia marcescens, Acinetobacter baumannii, and Enterobacter cloacae. 43Overall, 76% of participants obtained acceptable scores for identification, but a substantial proportion of AST 44 scores were not in the acceptable range. 45 Conclusion:In the African Region, implementation of diagnostic stewardship in clinical bacteriology is 46 generally suboptimal. This report illustrates that AST is poorly done compared to microscopy and identification. 47It is critically important to make the case for implementation of quality assurance in AST, as it is the 48 cornerstone for antimicrobial resistance surveillance reporting and implementation of the Global Antimicrobial 49 Resistance Surveillance System. 50 100 laboratories for continuous capacity assessment, for example to obtain information on their facilities, capacity, 101 and staff competence. Preparation of the samples included quality control and validation of survey material 102 before dispatch. The programme followed the ISO/IEC 17043 guidelines and all samples were packaged and 103 shipped according to International Air Transport Association Packing Instructions P650. 4 104Concurrently, five referee laboratories tested the isolates and their results determined whether the specimen 105 panels were suitable for distribution to participants. For this analysis, participating laboratories' bacterial 106 identification and AST results for the period 2011-2016 were identified from the programme database.
Background: In 2002, the World Health Organization (WHO) launched a regional microbiology external quality assessment (EQA) programme for national public health laboratories in the African region, initially targeting priority epidemic-prone bacterial diseases, and later including other common bacterial pathogens. Objectives: The aim of this study was to analyse the efficacy of an EQA programme as a laboratory quality system evaluation tool. Methods: We analysed the proficiency of laboratories' performance of bacterial identification and antimicrobial susceptibility testing (AST) for the period 2011-2016. The National Institute for Communicable Diseases of South Africa provided technical coordination following an agreement with WHO, and supplied EQA samples of selected bacterial organisms for microscopy (Gram stain), identification, and antimicrobial susceptibility testing (AST). National public health laboratories, as well as laboratories involved in the Invasive Bacterial Diseases Surveillance Network, were enrolled by the WHO Regional Office for Africa to participate in the EQA programme. We analysed participants' results of 41 surveys, which included the following organisms sent as challenges: Streptococcus pneumonia, Haemophilus influenzae, Neisseria meningitidis, Salmonella Typhi, Salmonella Enteritidis, Shigella flexneri, Staphylococcus aureus, Streptococcus agalactiae, Streptococcus anginosus, Enterococcus faecium, Serratia marcescens, Acinetobacter baumannii, and Enterobacter cloacae. Results: Eighty-one laboratories from 45 countries participated. Overall, 76% of participants obtained acceptable scores for identification, but a substantial proportion of AST scores were not in the acceptable range. Of 663 assessed AST responses, only 42% had acceptable scores. Conclusion: In the African Region, implementation of diagnostic stewardship in clinical bacteriology is generally suboptimal. This report illustrates that AST is poorly done compared to microscopy and identification. It is critically important to make the case for implementation of quality assurance in AST, as it is the cornerstone of antimicrobial resistance surveillance reporting and implementation of the Global Antimicrobial Resistance Surveillance System.
The microbial ecology of a commercial bread production line was assessed by plate counts and characterization of microbial populations of raw materials, dough, equipment surfaces, air inside the bakery and baked bread. Aerobic plate counts for raw materials were higher than mould counts. Dough samples had high aerobic plate counts, but low mould counts. Mould counts on pre-baking equipment surfaces were lower than those on post-baking equipment surfaces, while aerobic plate counts on equipment surfaces varied. Counts of bacteria and moulds on bread increased during storage at 30 degrees C and moulds predominated over bacteria on air settle plates. Of the 316 bacterial isolates, 50% were Bacillus and 31.6% Micrococcus. Of the 97 mould isolates, 37.1% were Penicillium, 18.6% Aspergillus and 13.4% Cladosporium. Bacillus, Aspergillus and Penicillium were isolated predominantly from baked bread.
The CEPH consortium map of chromosome 15q is presented. The map contains 41 loci defined by genotypes generated from CEPH family DNAs with 45 different probe and restriction enzyme combinations contributed by 10 laboratories. A total of 29 loci have been placed on the map with likelihood support of at least 1000:1. The map extends from 15q13 to 15q25-qter. Multipoint linkage analyses provided estimates that the male, female, and sex-averaged maps extend for 127, 190, and 158 cM, respectively. The largest interval is 21 cM and is between D15S37 and D15S74. The on-average locus spacing is 5.6 cM and the mean genetic distance between the 21 uniquely placed loci is 8 cM.
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