郑州市麻疹/风疹网络实验室质量控制结果分析

Analysis of quality control results of measles/rubella network laboratory in Zhengzhou

目的了解河南省郑州市麻疹/风疹网络实验室监测能力及运行状况,探讨实验室监测的工作质量。方法收集各县(市、区)疾病预防控制(简称疾控)中心负责辖区内的麻疹、风疹疑似病例病原学样本及信息,并对样本开展复核检测,分析2021—2022年郑州市麻疹/风疹网络实验室的各项考核指标。结果2021—2022年郑州市市级麻疹/风疹实验室职能考核成绩均为满分(100分),向省级实验室上送麻疹血清427份、复核一致率100.00%。2021年郑州市县级麻疹/风疹实验室质量考核的42家实验室均合格,上送复核血清296份,检测一致295份、一致率99.66%,血清盲样考核符合率100.00%。2022年考核实验室42家,合格34家、合格率80.96%,复核血清131份,检测一致127份、一致率96.95%,血清盲样考核符合率100.00%。两年间的实验室质量不同评价等次,疾控机构差异无统计学意义(Fisher确切概率法,P=0.226),医疗机构差异有统计学意义(Fisher确切概率法,P=0.049)。2022年各实验室质量考核不合格率有所增高(19.04%),问题较多。结论2021年郑州市麻疹/风疹网络实验室运行情况良好,考核全部合格;2022年受新型冠状病毒肺炎疫情影响,实验室考核不合格率有所增高,问题出现较多,2023年各级网络实验室需要加强业务水平和管理能力,提高工作质量,为消除麻疹/风疹奠定良好的实验室基础。

Objectivee To understand the monitoring capacity and operational status of measles and rubella network laboratory in Zhengzhou city of Henan province,and explore the quality of work in laboratory monitoring.Methods The pathogenic samples and information of suspected cases of measles and rubella were collected from the centers for disease control and prevention of every counties(cities,districts)for recheck detection.The assessment indicators were analyzed of measles/rubella network laboratory in Zhengzhou from 2021 to 2022.Results From 2021 to 2022,the two-year functional assessment scores of the municipal measles/rubella laboratory in Zhengzhou city were full marks(100 points),and the consistency rate of 427 measles serum sent to the provincial laboratory was 100.00%.In 2021,there were no unqualified laboratories among 42 county-level measles/rubella laboratories in Zhengzhou city for quality assessment.Out of 296 serum samples sent to upgrade laboratories for reexamination,295 samples were consistent,with the consistency rate of 99.66%.The accordance rate of recheck detection of blind serum samples was 100.00%.Out of 42 laboratories,34 laboratories were qualified,with the qualified rate of 80.96%in 2022.There were 131 serum samples sent to upgrade laboratories for retest,and 127 were consistent,with the consistency rate of 96.95%.The accordance rate was 100.00%in the blind serum samples assessment.There was no statistical difference in the different evaluation levels of laboratory quality evaluation of the disease control institutions between two years(Fisher exact test,P=0.226),but there was statistical difference in the different evaluation levels of laboratory quality evaluation of the medical institutions between two years(Fisher exact test,P-0.049).In 2022,the unqualified rate of laboratory quality assessment increased to 19.04%,and there were many problems.Conclusions The operation of the measles and rubella network laboratory was good in Zhengzhou city in 2021,and all assessments were qualified.In 2022,affected by the COVID-19 pandemic,the unqualified rate of laboratory assessment increased,with many problems.The professional level and management capability of the network laboratories at all levels should be strengthened to improve work quality,and establish solid laboratory foundation for measles and rubella elimination in 2023.