Yıl: 2018 Cilt: 75 Sayı: 1 Sayfa Aralığı: 1 - 12 Metin Dili: İngilizce DOI: 10.5505/TurkHijyen.2018.89166 İndeks Tarihi: 17-07-2020

Laboratory evaluation of susceptibility tests for National Antimicrobial Resistance Surveillance System (NAMRSS) in Turkey

Öz:
Objective: Antimicrobial resistance is a growingproblem worldwide, and to combat with this problemsome measures should be taken. One of them isanalysis of current situation and National AntimicrobialResistance Surveillance System (NAMRSS) wasestablished for this purpose. The quality of the datadepends on the participating laboratories performance,so there was need for an assessment of the laboratoriesin the system. This study was aimed to analyse thestatus of the participating laboratories for antimicrobialsusceptibility testing requirements.Methods: There were 77 participating laboratoriesselected for NAMRSS throughout the country. Twentyfive of them were included in for capacity analysisstudy. A Laboratory Assessment Tool (LAT) was used forthe evaluation of laboratories with ‘checklist’ features,and face-to-face interviews were used. LAT was aprogramme containing 677 questions in 10 modules thatwere developed by World Health Organization (WHO).A set of questions were added to use for antimicrobialsusceptibility tests (AST). Teams were formed froma total of 33 volunteer experts who received trainingprior to laboratory visits in a workshop, and there wereat least two people in each team. They have visitedthe laboratories for implementing the LAT. Data weretransferred to a database and analysed for both generalconditions, and AST capacity.Results: Laboratories were distributedinstitutionally as university hospital (n=17), trainingand research hospital (n = 4), state hospital (n = 2) andmilitary hospital (n = 2). NAMRSS laboratories performedidentification and AST by automated systems as well asdisc diffusion and minimum inhibitory concentration(MIC) tests except for one laboratory. Also, thelaboratories were generally in ‘good standing’ (approx.> 85%) for three of the modules, where the othermodules suggest that there are issues that ‘need someimprovements’ at different degrees. When focused onAST, outside of internal quality control applications, itwas observed that availability for AST culture media andreagents, identification and AST capacity are between84-95%. It was found that total quality was 67%.Conclusion: NAMRSS laboratories seem to be ableto provide reliable results in AST, which is essential forboth surveillance system and evidence based decisionsin effective treatment of patients. On the other hand,improvement in some other issues is necessary.
Anahtar Kelime:

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Öz:
Amaç: Antimikrobiyal direnç dünya çapında büyüyen bir problemdir ve bu problem ile savaşmak için bazı önlemler alınmalıdır. Mevcut durum analizi bunlardan biridir ve Ulusal Antimikrobiyal Direnç Surveyans Sistemi (UAMDSS) bu amaçla kurulmuştur. Verilerin kalitesi katılımcı laboratuvarların performansına bağlıdır, o nedenle sistemdeki laboratuvarların değerlendirilmesine ihtiyaç olmuştur. Bu çalışma, katılımcı laboratuvarların antimikrobiyal duyarlılık testi ihtiyaçları için durumlarını analiz etmeyi amaçlamaktadır. Yöntem: UAMDSS için ülke çapında seçilmiş 77 katılımcı laboratuvar bulunmaktadır. Kapasite analizi çalışmasına bunlardan 25 adedi dahil edilmiştir. Laboratuvarların değerlendirilmesi için ‘kontrol listesi’ özellikleri olan bir Laboratuvar Değerlendirme Aracı (LAT) yüz yüze görüşmelerle kullanılmıştır. LAT, Dünya Sağlık Örgütü (DSÖ) tarafından geliştirilmiş, 10 modülde 677 soru içeren bir programdır. Antimikrobiyal duyarlılık testleri (ADT) için sorular eklenerek kullanılmıştır. Laboratuvar ziyaretleri öncesinde, bir çalıştayda eğitim alan toplam 33 gönüllü uzmandan ekipler oluşturuldu ve her ekipte en az iki kişi bulunmaktaydı. LAT’ı uygulamak için bu ekipler laboratuvarları ziyaret etmiştir. Veriler bir veritabanına aktarılmıştır ve hem genel koşullar, hem de ADT kapasitesi için analiz edilmiştir. Bulgular: Laboratuvarların kurumsal dağılımı üniversite hastanesi (n = 17), eğitim ve araştırma hastanesi (n = 4), devlet hastanesi (n = 2) ve askeri hastane (n = 2) şeklindeydi. UAMDSS laboratuvarları, biri hariç tanımlama ve ADT otomatize sistemlerin yanısıra disk difuzyon ve minimum inhibitör konsantrasyon (MIK) testleri ile yapmaktadır. Ayrıca, laboratuvarlar modüllerden üçü için genellikle “iyi durumda” (yaklaşık >%85) olup diğer modüller, farklı derecelerde “bazı gelişmelere ihtiyaç duyan” sorunlar olduğunu öne sürmektedir. İç kalite kontrol uygulamaları dışındaki ADT’ye odaklandığında, ADT kültür ortamı ve reaktifleri için kullanılabilirlik, tanımlama ve ADT kapasitesinin %84-95 arasında olduğu gözlenmiştir. Toplam kalite gerekliliklerinin sağlanması %67 olarak bulunmuştur. Sonuç: UAMDSS laboratuvarlarının hem sürveyans sistemi, hem de hastaların etkin tedavisinde kanıta dayalı kararlar için gerekli olan ADT’de güvenilir sonuçlar sağlayabildikleri görülmektedir. Öte yandan, bazı diğer konularda iyileştirme gerekmektedir.
Anahtar Kelime:

Belge Türü: Makale Makale Türü: Araştırma Makalesi Erişim Türü: Erişime Açık
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APA AKBAŞ E, ÇÖPLÜ N, Şimşek H, ESEN B, SEZGİN B (2018). Laboratory evaluation of susceptibility tests for National Antimicrobial Resistance Surveillance System (NAMRSS) in Turkey. , 1 - 12. 10.5505/TurkHijyen.2018.89166
Chicago AKBAŞ Efsun,ÇÖPLÜ Nilay,Şimşek Hüsniye,ESEN BERRİN,SEZGİN Berna Laboratory evaluation of susceptibility tests for National Antimicrobial Resistance Surveillance System (NAMRSS) in Turkey. (2018): 1 - 12. 10.5505/TurkHijyen.2018.89166
MLA AKBAŞ Efsun,ÇÖPLÜ Nilay,Şimşek Hüsniye,ESEN BERRİN,SEZGİN Berna Laboratory evaluation of susceptibility tests for National Antimicrobial Resistance Surveillance System (NAMRSS) in Turkey. , 2018, ss.1 - 12. 10.5505/TurkHijyen.2018.89166
AMA AKBAŞ E,ÇÖPLÜ N,Şimşek H,ESEN B,SEZGİN B Laboratory evaluation of susceptibility tests for National Antimicrobial Resistance Surveillance System (NAMRSS) in Turkey. . 2018; 1 - 12. 10.5505/TurkHijyen.2018.89166
Vancouver AKBAŞ E,ÇÖPLÜ N,Şimşek H,ESEN B,SEZGİN B Laboratory evaluation of susceptibility tests for National Antimicrobial Resistance Surveillance System (NAMRSS) in Turkey. . 2018; 1 - 12. 10.5505/TurkHijyen.2018.89166
IEEE AKBAŞ E,ÇÖPLÜ N,Şimşek H,ESEN B,SEZGİN B "Laboratory evaluation of susceptibility tests for National Antimicrobial Resistance Surveillance System (NAMRSS) in Turkey." , ss.1 - 12, 2018. 10.5505/TurkHijyen.2018.89166
ISNAD AKBAŞ, Efsun vd. "Laboratory evaluation of susceptibility tests for National Antimicrobial Resistance Surveillance System (NAMRSS) in Turkey". (2018), 1-12. https://doi.org/10.5505/TurkHijyen.2018.89166
APA AKBAŞ E, ÇÖPLÜ N, Şimşek H, ESEN B, SEZGİN B (2018). Laboratory evaluation of susceptibility tests for National Antimicrobial Resistance Surveillance System (NAMRSS) in Turkey. Türk Hijyen ve Deneysel Biyoloji Dergisi, 75(1), 1 - 12. 10.5505/TurkHijyen.2018.89166
Chicago AKBAŞ Efsun,ÇÖPLÜ Nilay,Şimşek Hüsniye,ESEN BERRİN,SEZGİN Berna Laboratory evaluation of susceptibility tests for National Antimicrobial Resistance Surveillance System (NAMRSS) in Turkey. Türk Hijyen ve Deneysel Biyoloji Dergisi 75, no.1 (2018): 1 - 12. 10.5505/TurkHijyen.2018.89166
MLA AKBAŞ Efsun,ÇÖPLÜ Nilay,Şimşek Hüsniye,ESEN BERRİN,SEZGİN Berna Laboratory evaluation of susceptibility tests for National Antimicrobial Resistance Surveillance System (NAMRSS) in Turkey. Türk Hijyen ve Deneysel Biyoloji Dergisi, vol.75, no.1, 2018, ss.1 - 12. 10.5505/TurkHijyen.2018.89166
AMA AKBAŞ E,ÇÖPLÜ N,Şimşek H,ESEN B,SEZGİN B Laboratory evaluation of susceptibility tests for National Antimicrobial Resistance Surveillance System (NAMRSS) in Turkey. Türk Hijyen ve Deneysel Biyoloji Dergisi. 2018; 75(1): 1 - 12. 10.5505/TurkHijyen.2018.89166
Vancouver AKBAŞ E,ÇÖPLÜ N,Şimşek H,ESEN B,SEZGİN B Laboratory evaluation of susceptibility tests for National Antimicrobial Resistance Surveillance System (NAMRSS) in Turkey. Türk Hijyen ve Deneysel Biyoloji Dergisi. 2018; 75(1): 1 - 12. 10.5505/TurkHijyen.2018.89166
IEEE AKBAŞ E,ÇÖPLÜ N,Şimşek H,ESEN B,SEZGİN B "Laboratory evaluation of susceptibility tests for National Antimicrobial Resistance Surveillance System (NAMRSS) in Turkey." Türk Hijyen ve Deneysel Biyoloji Dergisi, 75, ss.1 - 12, 2018. 10.5505/TurkHijyen.2018.89166
ISNAD AKBAŞ, Efsun vd. "Laboratory evaluation of susceptibility tests for National Antimicrobial Resistance Surveillance System (NAMRSS) in Turkey". Türk Hijyen ve Deneysel Biyoloji Dergisi 75/1 (2018), 1-12. https://doi.org/10.5505/TurkHijyen.2018.89166