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Since 2007, national public health laboratories in the WHO Eastern Mediterranean Region (EMR) have participated in a regional external quality assessment scheme in bacteriology to improve testing proficiency.To assess laboratory performance in bacteriology in the EMR between 2011 and 2019 using the regional external quality assessment scheme.We analysed the accuracy of participant-reported data in bacterial identification, Gram stain microscopy, and antimicrobial susceptibility testing. For each category, we assessed the performance over time, the performance on multiple organisms, and whether a laboratory repeatedly failed to attain satisfactory results.Between 2011 and 2019, 70% of laboratories achieved satisfactory performance for bacterial identification and antimicrobial susceptibility testing, and 85% performed satisfactory Gram stain microscopy. Testing did not improve on multiple organisms and results were consistently low for some pathogens and test categories. Twenty-nine percent of laboratories underperformed throughout the study period.The unchanged performance over time and underperformance of laboratories highlight the need for improvements in the regional external quality assessment scheme. Participating laboratories and WHO need to work more actively to strengthen the problem areas.التقييم الخارجي لجودة أداء المختبرات المتخصصة في علم الجراثيم في إقليم شرق المتوسط، 2011–2019.همايون أصغر، كارين نهابتيان، أماني غنيم، فرانك كونينجز، أمينة الجرداني.منذ عام 2007 ، شاركت مختبرات الصحة العامة الوطنية في إقليم شرق المتوسط في مخطط إقليمي للتقييم الخارجي للجودة في علم الجراثيم لتحسين كفاءة الاختبارات.هدفت هذه الدراسة الى تقييم أداء المختبرات في مجال علم الجراثيم في إقليم شرق المتوسط بين عامَي 2011 و 2019 ، باستخدام النظام الإقليمي للتقييم الخارجي للجودة.حللنا دقة البيانات التي أبلغ بها المشاركون فيما يخص تحديد الجراثيم، والفحص المجهري لصبغة جرام، واختبار الحساسية لمضادات الميكروبات. وبالنسبة إلى كل فئة، قيمنا الأداء مع مرور الزمن، والأداء على كائنات حية متعددة، وما إذا كان المختبر قد فشل مرارًا في تحقيق نتائج مُرضية.بين عامَي 2011 و 2019 ، حقق 70 ٪ من المختبرات أداءً مُرضيًا في التعرف على الجراثيم وتحديدها واختبار الحساسية لمضادات الميكروبات، ونفذ 85 ٪ منها الفحصَ المجهري لصبغة جرام تنفيذًا مُرضيًا. ولم يتحسن مستوى الاختبار على كائنات حية متعددة، وكانت النتائج منخفضة باستمرار فيما يخص بعض مسببات الأمراض وفئات الاختبارات. وكان أداء 29 ٪ من المختبرات دون المستوى خلال فترة الدراسة.إن عدم تغيُُّّر الأداء بمرور الوقت والأداء القاصر للمختبرات يبرزان الحاجة إلى إدخال تحسينات على الخطة الإقليمية للتقييم الخارجي للجودة. لذا، يتعيََّّن على المختبرات المشارِكة و المختبرات المشاركة ومنظمة الصحة العالمية بحاجة إلى العمل بشكل أكثر نشاطا لتقوية مناطق المشاكل.Évaluation externe de la qualité des performances des laboratoires en bactériologie dans la Région de la Méditerranée orientale, 2011-2019.Depuis 2007, les laboratoires de santé publique nationaux de la Région OMS de la Méditerranée orientale ont participé à un système régional d'évaluation externe de la qualité en bactériologie afin d'améliorer la bonne exécution des analyses.Évaluer les performances des laboratoires en bactériologie dans la Région de la Méditerranée orientale entre 2011 et 2019 à l'aide du système régional d'évaluation externe de la qualité.Nous avons analysé l'exactitude des données communiquées par les participants concernant l'identification bactérienne, la microscopie après coloration de Gram et les tests de sensibilité aux antimicrobiens. Pour chaque catégorie, nous avons évalué la performance au fil du temps, la performance sur plusieurs micro-organismes et avons vérifié si un laboratoire n'a pas obtenu des résultats satisfaisants à plusieurs reprises.Entre 2011 et 2019, 70 % des laboratoires ont obtenu des résultats satisfaisants pour l'identification bactérienne et les tests de sensibilité aux antimicrobiens, et 85 % ont effectué une microscopie après coloration de Gram satisfaisante. Les tests ne se sont pas améliorés sur plusieurs micro-organismes et les résultats étaient systématiquement faibles pour certains agents pathogènes et certaines catégories de tests. Vingt-neuf pour cent des laboratoires ont eu des résultats insuffisants tout au long de la période d'étude.Les performances inchangées au cours du temps et les résultats insuffisants des laboratoires soulignent la nécessité d'améliorer le système régional d'évaluation externe de la qualité. Les laboratoires participants et l'OMS doivent collaborer plus activement pour renforcer les domaines qui posent problème.

Influenza viruses must be amplified in cell culture for detailed antigenic analysis and for phenotypic assays assessing susceptibility to antiviral drugs or for other assays. Following on from the first external quality assessment (EQA) for isolation and identification of influenza viruses using cell culture techniques in 2016, a follow up EQA was performed in 2019 for National Influenza Centres (NICs) in the World Health Organization (WHO) South East Asia and Western Pacific Regions. Nineteen WHO NICs performed influenza virus isolation and identification techniques on an EQA panel comprising 16 samples, containing influenza A or B viruses and negative control samples. One sample was used exclusively to assess capacity to measure a hemagglutination titer and the other 15 samples were used for virus isolation and subsequent identification. Virus isolation from EQA samples was generally detected by assessment of cytopathic effect and/or hemagglutination assay while virus identification was determined by real time RT-PCR, hemagglutination inhibition and/or immunofluorescence assays. For virus isolation from EQA samples, 6/19 participating laboratories obtained 15/15 correct results in the first EQA (2016) compared to 11/19 in the follow up (2019). For virus identification in isolates derived from EQA samples, 6/19 laboratories obtained 15/15 correct results in 2016 compared to 13/19 in 2019. Overall, NIC laboratories in the Asia Pacific Region showed a significant improvement between 2016 and 2019 in terms of the correct results reported for isolation from EQA samples and identification of virus in isolates derived from EQA samples (p=0.01 and p=0.02, respectively).

AimsThe aim of the current study was to assess the proteolytic activities of collectin-bound MASP-1 and MASP-2 in the blood of patients with ischaemic stroke, as well as the association of their six genetic polymorphisms (rs3203210, rs28945070, rs28945073 inMASP1gene and rs2273343, rs12711521, rs147270785 inMASP2gene) with this pathology.MethodsIn total, 250 patients and 300 healthy subjects were involved in this study. MBL-associated serine protease (MASP)-1 and MASP-2 activities were measured using in-house developed immunofluorescent and enzyme-linked immunosorbent assays, respectively. Sequence specific primer PCR was used to study the association ofMASP1andMASP2genetic polymorphisms with ischaemic stroke.ResultsThe results obtained demonstrate that the activities of collectin-bound MASP-1 and MASP-2 in patients with ischaemic stroke are significantly higher than those in healthy subjects (pMASP1gene and the rs147270785 polymorphism in theMASP2gene are associated with ischaemic stroke (pConclusionsIn conclusion we suggest that the complement lectin pathway serine proteases, MASP-1 and MASP-2, can be associated with ischaemic stroke development risk and may participate in pathological events leading to post-ischaemic brain damage. Moreover rs3203210 and rs147270785 single nucleotide polymorphisms in theMASP1andMASP2genes, respectively, are strongly associated with ischaemic stroke, and the minor rs3203210*C and rs147270785*A alleles of these polymorphisms may be considered as protective factors for ischameic stroke, at least in the Armenian population.