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Quality Control for Molecular Diagnostics 2012 EQA PROGRAMME CATALOGUE Version number CAT2012/02 V I RA L BACTERIAL SPECIALIST FUNGAL PARASITIC www.qcmd.org Contents Viral Varicella-Zoster virus2 Enterovirus2 Parechovirus3 Herpes simplex virus 1 & 2 3 JC virus and BK virus4 HIV-1 (DNA) programme A & B 4 B19 Virus5 Human Herpes Virus 65 Human Cytomegalovirus6 Epstein-Barr virus6 West Nile Virus7 Dengue Virus7 Cytomegalovirus Dried Blood Spots8 Human Papillomavirus8 Adenovirus9 Influenza A & B virus 9 Human Metapneumovirus 10 Respiratory Syncytial Virus10 Parainfluenza virus 11 Coronavirus11 Rhinovirus 12 Norovirus12 EQA Regulatory Range13 HIV-1 RNA regulatory programme 14 Hepatitis B virus regulatory programme 14 Hepatitis C virus regulatory programme 15 HIV-1 (RNA) Programme A & B 15 Hepatitis B virus programme A & B 16 Hepatitis C virus programme A & B 16 Bacterial Chlamydia trachomatis programme A & B 17 Chlamydophila pneumoniae and Mycoplasma pneumoniae 17 Legionella pneumophila18 Methicillin Resistant S. aureus18 Clostridium difficile 19 Neisseria gonorrhoeae19 M. tuberculosis Complex20 Bordetella pertussis20 Borrelia burgdorferi (Lyme’s Disease)21 Specialist HCV Genotyping22 HBV Genotyping22 Methicillin Resistant S. aureus Typing 23 HIV-1 Drug Resistance23 HIV-1 Drug Resistance (Integrase)24 Influenza Haemagglutinin Typing 24 Fungal Aspergillus25 Pneumocystis jirovecii pneumonia (PCP) 25 Parasitic Toxoplasma gondii26 New EQA pilot studies for 2012 Hepatitis A virus27 Hepatitis E virus28 Gastroenteritis programmes29 Viral Gastroenteritis29 Bacterial Gastroenteritis30 Parasitic Gastroenteritis30 Candida albicans31 Cytomegalovirus Whole Blood32 MALDI-TOF Bacterial 32 Version number CAT2012/02 www.qcmd.org Viral EQA Varicella-Zoster virus DNA VZVDNA12 Catalogue Number QAV034103 The human alpha-herpes virus Varicella-Zoster virus (VZV) is the etiological agent for both chicken pox (varicella) and shingles (zoster). Laboratory diagnostics is important for initial determination of VZV infection and distinction between both vaccine and wildtype VZV strains and other viral infections with similar clinical manifestations such as herpes simplex virus (HSV). Detection and quantitation of VZV is also becoming increasingly important in the clinical management of immunocompromised hosts such as transplant recipients and AIDS patients. Feature Specifications Number of Panel Members 8 to 12 Sample NA Target Source Cultured virus Matrix panel format Lyophilised Virus Transport Medium (VTM) Units of Measurement Copies/ml Panel Member Target Range Covering clinical range Panel Member Sample Volume 1.0 ml Panel Sample Pre-treatment Requirement Reconstitution of lyophilised material Panel Analysis type Qualitative & Quantitative Panel Testing Evaluated by various molecular methodologies Storage / Shipment Conditions 2-8°C / Ambient Enterovirus RNA EVRNA12 Catalogue Number QAV984104 Picornaviridae is a family of important human pathogens affecting millions of people throughout the world. Enteroviruses (EV) form a large genus within this family which also includes the genus parechovirus (PEV). The clinical features of EV infection are often indistinguishable from other infections. It is therefore, essential that a rapid and specific method for the diagnosis and clinical management of acute EV infection is routinely used. Feature Specifications Number of Panel Members 8 to 12 Sample NA Target Source Cultured virus Matrix panel format Lyophilised Virus Transport Medium (VTM) Units of Measurement Copies/ml Panel Member Target Range Covering clinical range Panel Member Sample Volume 1.0 ml Panel Sample Pre-treatment Requirement Reconstitution of lyophilised material Panel Analysis type Qualitative & Quantitative Panel Testing Evaluated by various molecular methodologies Storage / Shipment Conditions 2-8°C / Ambient Version number CAT2012/02 2 www.qcmd.org Viral EQA Parechovirus RNA PeVRNA12 Catalogue Number QAV114145 Parechovirus (PEV) is a genus from the Picornaviridae family of viruses. Parechoviruses have been associated with a wide spectrum of disease presentations and are an important cause of severe disease in neonates and young children. The clinical features of PEV infection are often indistinguishable from other (enterovirus) infections. It is therefore, essential that a rapid and specific diagnosis of PEV is made to allow appropriate management of patients. Feature Specifications Number of Panel Members 8 to 12 Sample NA Target Source Cultured virus Matrix panel format Lyophilised Virus Transport Medium (VTM) Units of Measurement Copies/ml Panel Member Target Range Covering clinical range Panel Member Sample Volume 1.0 ml Panel Sample Pre-treatment Requirement Reconstitution of lyophilised material Panel Analysis type Qualitative & Quantitative Panel Testing Evaluated by various molecular methodologies Storage / Shipment Conditions 2-8°C / Ambient Herpes simplex virus 1 & 2 DNA HSVDNA12 Catalogue Number QAV994105 Herpes simplex virus (HSV) causes a wide spectrum of clinical manifestations in the central nervous system (CNS). The diagnosis and management of HSV infection is a common and increasingly important aspect of clinical practice. Early administration of antiviral drugs is essential for the effective treatment of HSV infection, this has led to a need for more accurate and rapid diagnostic methods. The introduction of nucleic acid amplification technologies (NATs) for the detection of HSV DNA has increased utility for the diagnosis of HSV infection; as well as providing a rapid and more sensitive alternative to other methods. Feature Specifications Number of Panel Members 10 to 12 Sample NA Target Source Cultured virus Matrix panel format Lyophilised Virus Transport Medium (VTM) Units of Measurement Copies/ml Panel Member Target Range Covering clinical range Panel Member Sample Volume 1.0 ml Panel Sample Pre-treatment Requirement Reconstitution of lyophilised material Panel Analysis type Qualitative & Quantitative Panel Testing Evaluated by various molecular methodologies Storage / Shipment Conditions 2-8°C / Ambient Version number CAT2012/02 3 www.qcmd.org Viral EQA JC virus and BK virus JCBKDNA12 Catalogue Number QAV074106 The human polyomaviruses JC and BK have a high prevalence in populations throughout the world. JC virus (JCV) and BK virus (BKV) infection is usually completely asymptomatic and can result in a lifelong latent infection in renal tissues and in B lymphocytes. The situation in those with compromised immune systems such as AIDS patients and organ transplant recipients is much more serious with polyomavirus-related disease recognised as an important cause of mortality and morbidity in these groups. It is, therefore, essential that early accurate diagnosis of active JCV/BKV infection is performed which will not only allow pre-emptive treatment of infection but can increase the selectivity of antiviral therapy so reducing drug side-effects. Feature Specifications Number of Panel Members 10 to 12 Sample NA Target Source Clinical or Cultured virus Matrix panel format Lyophilised Virus Transport Medium (VTM) or plasma Units of Measurement Copies/ml Panel Member Target Range Covering clinical range Panel Member Sample Volume 1.0 ml Panel Sample Pre-treatment Requirement Reconstitution of lyophilised material Panel Analysis type Qualitative & Quantitative Panel Testing Evaluated by various molecular methodologies Storage / Shipment Conditions 2-8°C / Ambient HIV-1 DNA HIVDNA12A & HIVDNA12B Catalogue Number QAV034114 Human Immunodeficiency Virus Type 1 (HIV-1) infection remains a significant healthcare problem throughout the world. This problem is perpetuated by vertical transmission of HIV-1 from mother to child which in some areas can reach rates of up to 60% of the 25% of pregnant mothers infected with HIV-1. One of the current challenges is the detection of low levels of HIV-1 proviral DNA to allow investigation of vertical transmission of HIV-1 to assess therapeutic interventions aimed at reducing this transmission and in general, to monitor the pathophysiological dynamics of HIV-1 infection. Studies have also shown that HIV-1 proviral DNA persists even after prolonged treatment and can replenish and revive viral infection upon activation. Therefore, early quantification of HIV-1 proviral DNA infection by HIV-1 DNA Nucleic Acid Technologies (NAT) is essential in the effective treatment of HIV. Feature Specifications Number of Panel Members 8 to 12 Sample NA Target Source Cultured proviral cells Matrix panel format Frozen PBMC in buffer Units of Measurement DNA Copies/Sample Panel Member Target Range Covering clinical range Panel Member Sample Volume 0.1 ml Panel Sample Pre-treatment Requirement Ready for analysis. Treat as clinical samples and analyse accordingly Panel Analysis type Qualitative Panel Testing Evaluated by various molecular methodologies Storage / Shipment Conditions <-20°C / Dry-ice Version number CAT2012/02 4 www.qcmd.org Viral EQA B19 virus B19DNA12 Catalogue Number QAV034116 B19 virus is a widespread virus causing a variety of diseases in humans that range greatly in severity. The situation in persons with compromised immune systems such as AIDS patients and organ transplant recipients can be serious, with B19 virus recognised as an important viral pathogen causing increased rates of mortality and morbidity in these groups. Antiviral drug treatment in the early stages of active B19 virus infection may effectively ameliorate the risk of life threatening disease. It is, therefore, essential that early accurate diagnosis is performed which will not only allow pre-emptive treatment of infection but can increase the selectivity of antiviral therapy so reducing drug side-effects. The introduction of nucleic acid amplification technologies (NAT) has led to the development of sensitive diagnostic tests that can rapidly confirm or exclude active B19 virus infection. As a result, these tests are now of great practical and clinical relevance. Feature Specifications Number of Panel Members 8 to 12 Sample NA Target Source Clinical virus Matrix panel format Frozen Plasma Units of Measurement IU/ml Panel Member Target Range Covering clinical range Panel Member Sample Volume 1.2 ml Panel Sample Pre-treatment Requirement Ready for analysis. Treat as clinical samples and analyse accordingly Panel Analysis type Qualitative & Quantitative Panel Testing Evaluated by various molecular methodologies Storage / Shipment Conditions <-20°C / Dry-ice Human Herpes Virus 6 DNA HHV6DNA12 Catalogue Number QAV084119 Human Herpes virus 6 (HHV-6) is one of the most widespread human beta-herpes viruses. HHV-6 is associated with a number of childhood diseases resulting in the majority of the population being seropositive for HHV-6 before adulthood. Immunosupression in an individual can lead to reactivation of the virus and associated sequelae. Early detection of HHV6 is crucial for effective treatment and immunosuppressive drug therapy amendment which may result in proliferative disease regression. The introduction of nucleic acid amplification technologies (NAT) has led to the development of sensitive diagnostic tests that can rapidly confirm or exclude active HHV-6 infection. As a result, these tests have become of great practical and clinical relevance. Feature Specifications Number of Panel Members 8 to 12 Sample NA Target Source Cultured virus Genotypic Variant Subtypes A and B Matrix panel format Lyophilised Plasma or Virus Transport Medium (VTM) Units of Measurement Copies/ml Panel Member Target Range Covering clinical range Panel Member Sample Volume 1.0 ml Panel Sample Pre-treatment Requirement Reconstitution of lyophilised material Panel Analysis type Qualitative & Quantitative Panel Testing Evaluated by various molecular methodologies Storage / Shipment Conditions 2-8°C / Ambient Version number CAT2012/02 5 www.qcmd.org Viral EQA Human Cytomegalovirus DNA CMVDNA12 Catalogue Number QAV014120 Cytomegalovirus (CMV) is a beta herpes virus with a high prevalence (40-80%) in populations throughout the developed world. CMV is normally a latent lifelong infection that is completely asymptomatic in those infected with the virus. The situation in persons with compromised immune systems such as AIDS patients and organ transplant recipients is much more serious with CMV recognised as one of the most important viral pathogens causing high rates of mortality and morbidity in these groups. Antiviral drug treatment in the early stages of active CMV infection may effectively ameliorate the risk of life threatening disseminated CMV disease. It is, therefore, essential that early accurate diagnosis is performed which will not only allow pre-emptive treatment of infection but can increase the selectivity of antiviral therapy so reducing drug side-effects. The introduction of nucleic acid amplification technologies (NAT) has led to the development of sensitive diagnostic tests that can rapidly confirm or exclude active CMV infection. As a result, these tests are now of great practical and clinical relevance. Feature Specifications Number of Panel Members 8 to 12 Sample NA Target Source Cultured virus Matrix panel format Lyophilised Plasma, Virus Transport Medium (VTM) Units of Measurement Copies/ml Panel Member Target Range Covering clinical range Panel Member Sample Volume 1.0 ml Panel Sample Pre-treatment Requirement Reconstitution of lyophilised material Panel Analysis type Qualitative & Quantitative Panel Testing Evaluated by various molecular methodologies Storage / Shipment Conditions 2-8°C / Ambient Epstein-Barr virus DNA EBVDNA12 Catalogue Number QAV024121 Epstein-Barr virus is a widespread human gamma-herpes virus that is associated with a broad spectrum of epithilio- and lympho-proliferative disorders which are an important cause of mortality and morbidity especially in immuno-compromised hosts such as transplant recipients and AIDS patients. Early detection of EBV is crucial for effective treatment and immunosuppressive drug therapy amendment which may result in proliferative disease regression. The introduction of nucleic acid amplification technologies (NAT) has led to the development of sensitive diagnostic tests that can rapidly confirm or exclude active EBV infection. As a result, these tests have become of great practical and clinical relevance. Feature Specifications Number of Panel Members 8 to 12 Sample NA Target Source Cultured virus Matrix panel format Lyophilised Plasma, Virus Transport Medium (VTM) Units of Measurement Copies/ml Panel Member Target Range Covering clinical range Panel Member Sample Volume 1.0 ml Panel Sample Pre-treatment Requirement Reconstitution of lyophilised material Panel Analysis type Qualitative & Quantitative Panel Testing Evaluated by various molecular methodologies Storage / Shipment Conditions 2-8°C / Ambient Version number CAT2012/02 6 www.qcmd.org Viral EQA West Nile Virus RNA Catalogue Number QAV104141 WNVRNA12 West Nile virus (WNV) is part of the Japanese encephalitis virus group of flaviviruses. WNV is an arthropod borne virus which cycles between insect and vertebrate hosts causing mild flu-like symptoms to clinical encephalitis in the human population. The introduction of nucleic acid amplification technologies (NAT) has led to the development of sensitive diagnostic tests that can rapidly confirm or exclude WNV infection. As a result, these tests are now of great practical and clinical relevance. Feature Specifications Number of Panel Members 8 to 12 Sample NA Target Source Cultured Virus Matrix panel format Lyophilised Virus Transport Medium (VTM) Units of Measurement Copies/ml Panel Member Target Range Covering clinical range Panel Member Sample Volume 1.0ml Panel Sample Pre-treatment Requirement Reconstitution of lyophilised material Panel Analysis type Qualitative Panel Testing Evaluated by various molecular methodologies Storage / Shipment Conditions 2-8°C / Ambient Dengue virus RNA DENVRNA12 Catalogue Number QAV114148 Dengue virus (DENV) belongs to the flavivirus group of viruses and is an important arthropod borne virus infecting humans. DENV infection can range from asymtomatic to the severe Dengue heamorrhagic fever (DHF) or Dengue shock syndrome (DSS). The introduction of nucleic acid amplification technologies (NAT) has led to the development of sensitive diagnostic tests that can rapidly confirm or exclude DENV infection and determine the serotype of the virus involved. As a result, these tests are now of great practical and clinical relevance. Feature Specifications Number of Panel Members 8 to 12 Sample NA Target Source Cultured Virus Matrix panel format Lyophilised Virus Transport Medium (VTM) Units of Measurement Copies/ml Panel Member Target Range Covering clinical range Panel Member Sample Volume 1.0ml Panel Sample Pre-treatment Requirement Reconstitution of lyophilised material Panel Analysis type Qualitative Panel Testing Evaluated by various molecular methodologies Storage / Shipment Conditions 2-8°C / Ambient Version number CAT2012/02 7 www.qcmd.org Viral EQA Cytomegalovirus Dried Blood Spots CMVDBS12 Catalogue Number QAV064127 Cytomegalovirus (CMV) is a highly prevalent congenital infectious agent throughout the developed world. The clinical consequences of infection may be present at birth or manifest themselves during childhood. It is essential that early accurate diagnosis of infected neonates is performed, not only to allow clinical treatment of infection but also to facilitate prompt recognition of sequelae during monitoring. Dried blood spots (DBS) are routinely collected at birth for metabolic and genetic screening. The introduction of nucleic acid amplification technologies (NAT) has led to the development of sensitive diagnostic tests that can detect CMV in a variety of sample types including DBS. As a result, these tests are now of great practical and clinical relevance. Feature Specifications Number of Panel Members 8 to 12 Sample NA Target Source Cultured virus and clinical material Matrix panel format Whole blood on DBS collection card Units of Measurement Copies/ml Panel Member Target Range Covering clinical range Panel Sample Pre-treatment Requirement DNA extraction from dried blood spot Panel Analysis type Qualitative & Quantitative Panel Testing Evaluated by various molecular methodologies Storage / Shipment Conditions Ambient Human Papillomavirus DNA HPVDNA12 Catalogue Number QAV094130 Human Papillomavirus (HPV) infection has been detected in over 95% of cervical cancers, the second most common cancer detected in females worldwide. The detection of HPV infections is an important part of the triage with cytomorphological examination in the early detection of cervical cancer in scrapings. For the detection in triage both the quantitative, clinical relevant sensitivity as well as accurate HPV-typing are essential. The introduction of nucleic acid amplification technologies (NAT) and nucleic acid hybridisation assays has led to the development of sensitive, type specific diagnostic tests that can rapidly identify HPV infection. As a result, these tests are now of great practical and clinical relevance. Feature Specifications Number of Panel Members 8 to 12 Sample NA Target Source Cultured virus Matrix panel format Clinically relevant or transport medium Panel Member Target Range Covering clinical range Panel Analysis type Qualitative Panel Testing Evaluated by various molecular methodologies Storage / Shipment Conditions 2-8°C / Ambient Version number CAT2012/02 8 www.qcmd.org Viral EQA Adenovirus DNA ADVDNA12 Catalogue Number QAV054133 Human adenovirus (AdV) is a widespread genus of human viruses associated with a broad spectrum of infectious diseases. Adenoviruses are also an important cause of mortality and morbidity in immunocompromised hosts especially allogeneic bone marrow and stem cell transplant recipients. Early detection of AdV is crucial for effective treatment and immunosuppressive drug therapy amendment in such patients. The introduction of nucleic acid amplification technologies (NAT) has led to the development of sensitive diagnostic tests that can rapidly confirm or exclude AdV infection. As a result, these tests have become of great practical and clinical relevance. Feature Specifications Number of Panel Members 8 to 12 Sample NA Target Source Cultured virus Matrix panel format Frozen Virus Transport Medium (VTM) Units of Measurement Copies/ml Panel Member Target Range Covering clinical range Panel Member Sample Volume 1.0 ml Panel Sample Pre-treatment Requirement Ready for analysis. Treat as clinical samples and analyse accordingly Panel Analysis type Qualitative & Quantitative Panel Testing Evaluated by various molecular methodologies Storage / Shipment Conditions <-20°C / Dry-ice Influenza A & B virus RNA INFRNA12 Catalogue Number QAV054134 Influenza virus (InfV) is an important cause of mortality and morbidity throughout the world especially in the elderly and those with other respiratory complications. Early detection of InfV is crucial for effective treatment and immunosuppressive drug therapy amendment in such patients. The introduction of nucleic acid amplification technologies (NAT) has led to the development of sensitive diagnostic tests that can rapidly confirm or exclude InfV infection. As a result, these tests have become of great practical and clinical relevance. Feature Specifications Number of Panel Members 8 to 12 Sample NA Target Source Cultured virus Matrix panel format Frozen Virus Transport Medium (VTM) Panel Member Target Range Covering clinical range Panel Member Sample Volume 1.0 ml Panel Sample Pre-treatment Requirement Ready for analysis. Treat as clinical samples and analyse accordingly Panel Analysis type Qualitative Panel Testing Evaluated by various molecular methodologies Storage / Shipment Conditions <-20°C / Dry-ice Version number CAT2012/02 9 www.qcmd.org Viral EQA Human Metapneumovirus MPV12 Catalogue Number QAV054135 Human metapneumovirus (hMPV) is a commonly occurring viral pathogen responsible for respiratory infection particularly in the young and elderly as well as those with underlying immunological and respiratory complications. Early detection of hMPV is crucial for effective treatment and immunosuppressive drug therapy amendment. The introduction of nucleic acid amplification technologies (NAT) has led to the development of sensitive diagnostic tests that can rapidly confirm or exclude hMPV infection. As a result, these tests have become of great practical and clinical relevance. Feature Specifications Number of Panel Members 8 to 12 Sample NA Target Source Cultured virus Matrix panel format Frozen Virus Transport Medium (VTM) Panel Member Target Range Covering clinical range Panel Member Sample Volume 1.0 ml Panel Sample Pre-treatment Requirement Ready for analysis. Treat as clinical samples and analyse accordingly Panel Analysis type Qualitative Panel Testing Evaluated by various molecular methodologies Storage / Shipment Conditions <-20°C / Dry-ice Respiratory Syncytial virus RSV12 Catalogue Number QAV054142 Human respiratory syncytial virus (RSV) is an important cause of mortality and morbidity in young children, the elderly and immuno-compromised hosts, as well as those with underlying respiratory complications. Early detection of RSV is crucial for effective treatment and immunosuppressive drug therapy amendment in such patients The introduction of nucleic acid amplification technologies (NAT) has led to the development of sensitive diagnostic tests that can rapidly confirm or exclude RSV infection. As a result, these tests have become of great practical and clinical relevance. Feature Specifications Number of Panel Members 8 to 12 Sample NA Target Source Cultured virus Matrix panel format Frozen Virus Transport Medium (VTM) Panel Member Target Range Covering clinical range Panel Member Sample Volume 1.0 ml Panel Sample Pre-treatment Requirement Ready for analysis. Treat as clinical samples and analyse accordingly Panel Analysis type Qualitative Panel Testing Evaluated by various molecular methodologies Storage / Shipment Conditions <-20°C / Dry-ice Version number CAT2012/02 10 www.qcmd.org Viral EQA Parainfluenza virus RNA PINFRNA12 Catalogue Number QAV064136 Parainfluenza virus (PIV) is an important cause of upper and lower respiratory tract disease especially in infants and immunocompromised hosts. PIV can be divided into four genetically and antigenically different types which are associated with severity and clinical importance of the PIV infection. The use of classic diagnostic methods such as viral isolation and serology can results in delays of several weeks before results are available. The introduction of nucleic acid amplification technologies (NAT) has led to the development of sensitive diagnostic tests that can rapidly confirm or exclude PIV infection. As a result, these tests are becoming of great practical and clinical relevance. Feature Specifications Number of Panel Members 8 to 12 Sample NA Target Source Cultured virus Matrix panel format Frozen Virus Transport Medium (VTM) Panel Member Target Range Covering clinical range Panel Member Sample Volume 1.0 ml Panel Sample Pre-treatment Requirement Ready for analysis. Treat as clinical samples and analyse accordingly Panel Analysis type Qualitative Panel Testing Evaluated by various molecular methodologies Storage / Shipment Conditions <-20°C / Dry-ice Coronavirus RNA CVRNA12 Catalogue Number QAV064137 Human coronavirus (CV) is one of the major causes of common cold infections throughout the world. CV can also cause more severe respiratory infections especially in young children, the elderly and immuno-compromised hosts. Early detection of CV infection is essential in these at risk groups to allow effective treatment and drug therapy amendment. Viral culture is still the main method for laboratory diagnosis of respiratory infections. The introduction of nucleic acid amplification technologies (NAT) has led to the development of much more sensitive diagnostic tests that can rapidly confirm or exclude CV infection. As a result, these tests have become of great practical and clinical importance. Feature Specifications Number of Panel Members 8 to 12 Sample NA Target Source Cultured virus Matrix panel format Frozen Virus Transport Medium (VTM) Panel Member Target Range Covering clinical range Panel Member Sample Volume 1.0 ml Panel Sample Pre-treatment Requirement Ready for analysis. Treat as clinical samples and analyse accordingly Panel Analysis type Qualitative Panel Testing Evaluated by various molecular methodologies Storage / Shipment Conditions <-20°C / Dry-ice Version number CAT2012/02 11 www.qcmd.org Viral EQA Rhinovirus RNA RVRNA12 Catalogue Number QAV064143 Rhinovirus (RV) is one of the major causes of common cold infections and is an important cause of more severe infection in at risk groups.The introduction of nucleic acid amplification technologies (NAT) has led to the development of sensitive diagnostic tests that can rapidly confirm or exclude RV infection. As a result, these tests are now of great practical and clinical relevance in the effective treatment of patients. Feature Specifications Number of Panel Members 8 to 12 Sample NA Target Source Cultured virus Matrix panel format Frozen Virus Transport Medium (VTM) Panel Member Target Range Covering clinical range Panel Member Sample Volume 1.0 ml Panel Sample Pre-treatment Requirement Ready for analysis. Treat as clinical samples and analyse accordingly Panel Analysis type Qualitative Panel Testing Evaluated by various molecular methodologies Storage / Shipment Conditions <-20°C / Dry-ice Norovirus RNA NVRNA12 Catalogue Number QAV084139 Norovirus (NV) is a single stranded RNA virus of the family caliciviridae. NV is one of the most important causes of non-bacterial acute gastroenteritis in humans. The stability of NV in the environment, multiple routes of transmission and very low infectious dose all contribute to the high impact of NV outbreaks. It is therefore important that NV infection is quickly identified to allow rapid intervention and isolation to prevent further spread of the virus. The use of nucleic acid amplification technologies (NAT) has led to the development of sensitive diagnostic tests that can rapidly identify NV infection. As a result, these tests are now of great practical and clinical relevance. Feature Specifications Number of Panel Members 8 to 12 Sample NA Target Source Cultured whole virus or RNA Transcripts Matrix panel format Frozen Virus Transport Medium (VTM) or buffer Panel Member Sample Volume 1.0ml VTM, 0.1ml Buffer Panel Sample Pre-treatment Requirement Ready for analysis. Treat as clinical or semi-processed samples Panel Analysis type Qualitative Panel Testing Evaluated by various molecular methodologies Storage / Shipment Conditions <-20°C / Dry-ice Version number CAT2012/02 12 www.qcmd.org Viral EQA EQA Regulatory Range The frequency of challenge within an annual EQA survey varies considerably between different EQA providers and the types of EQA schemes they offer. In general the number of EQA distributions or challenges within a calendar year is driven by professional opinion, both scientific and clinical. Key factors include the number of tests the laboratory performs per year; pathogen prevalence; and the range & complexity of tests used. In addition, the EQA provider also has to consider the different needs of the national regulatory agencies and accreditation bodies which sometimes set the minimum number of challenges per year. In response to these requirements QCMD has established the regulatory EQA programmes for HIV, HBV and HCV viral load in order to further support individual laboratory’s local regulatory requirements. The regulatory programme format will comprise of four challenges per year. Two full EQA panels (8-10 panel members) and two core EQA panels consisting of 4 panel members. The focus of the programmes is on quantitative detection and following each EQA challenge ‘on-line’ reporting will enable participating laboratories to monitor their cumulative performance over time. On completion of the four challenges, laboratories will be provided with an annual summary report. The report will provide an overview of the laboratories annual performance, a cumulative score for the annual EQA, participant trend analysis (continued in future participant rounds), and where appropriate, feedback aimed at supporting quality improvement in line with the laboratories regulatory requirements. For further information download the Regulatory EQA manual through your profile area Version number CAT2012/02 13 www.qcmd.org Viral EQA HIV-1 RNA regulatory programme HIVRNAReg12 Catalogue Number QAS124158 HIV nucleic acid viral load measurement is used to diagnose, predict, and monitor disease progression and has become a primary healthcare parameter for disease management. The risks of developing AIDS and the link between HIV viral load is well documented and maintaining low viral loads through antiretroviral therapy (ART) is essential as it slows disease progression, reduces the risk of complications and ultimately prolongs patient life. Therefore the accurate measurement of HIV viral load during treatment is essential as changes in viral load during treatment can also indicate the development of resistance to the antiretroviral therapy. Within clinical practice Copies/ml has become the common unitage for the reporting of HIV viral loads. However with the introduction of the WHO International Standard commercial HIV viral load test manufacturers generally express their results in IU/ml and provide a method / technology specific conversion factor where appropriate. The HIV regulatory EQA programme allows the laboratory to independently assess their laboratory procedure and viral load assay through the year and supports the laboratory’s requirements in line with ISO15189 or equivalent. Feature Specifications Number of Panel Members 2 full EQA (8 to 10 panel members), 2 core EQA (4 panel members) Sample NA Target Source Cultured virus or Clinical material Matrix panel format Frozen Plasma Units of Measurement IU/ml, Copies/ml Panel Member Target Range Covering clinical range Panel Member Sample Volume 1.2 ml Panel Sample Pre-treatment Requirement Ready for analysis. Treat as clinical samples and analyse accordingly Panel Analysis type Qualitative & Quantitative Panel Testing Evaluated by various molecular methodologies Storage / Shipment Conditions <-20°C / Dry-ice Hepatitis B virus regulatory programme HBVDNAReg12 Catalogue Number QAS124159 With the increased availability of approved HBV treatment options over the last 10 years, HBV viral load determination has become an important clinical tool in the diagnosis and monitoring of disease. In chronically infected individuals HBV viral loads can cover large clinical ranges (zero to 1010 copies/ml of HBV-DNA) in serum / plasma samples. As the aim of HBV therapy is to treat until the virus is at an undetectable level, it is essential that the viral load assay is capable of detecting very low levels of the HBV virus. In contrast, it is also important for the viral load assay to be able to quantify high levels of virus (over 100 million IU/ml) as this provides an indication for further treatment or potential drug resistance. Therefore current molecular assays for the detection of HBV need to be able to provide robust and repeatable results over a large dynamic assay range. This can impact on the accuracy of the quantitative result especially the low and upper limit of detections of the assay and with different genotypes. Hence appropriate quality control and quality assessment is essential in the routine laboratory for the management, maintenance, and improvement of assay performance. The HBV regulatory EQA programme allows the laboratory to independently assess their laboratory procedure and viral load assay through the year and supports the laboratory’s requirements in line with ISO15189 or equivalent. Feature Specifications Number of Panel Members 2 full EQA (8 to 10 panel members), 2 core EQA (4 panel members) Sample NA Target Source Clinical material Matrix panel format Frozen Plasma Units of Measurement IU/ml, Copies/ml Panel Member Target Range Covering clinical range Panel Member Sample Volume 1.2 ml Panel Sample Pre-treatment Requirement Ready for analysis. Treat as clinical samples and analyse accordingly Panel Analysis type Qualitative & Quantitative Panel Testing Evaluated by various molecular methodologies Storage / Shipment Conditions <-20°C / Dry-ice Version number CAT2012/02 14 www.qcmd.org Viral EQA Hepatitis C virus regulatory programme HCVRNAReg12 Catalogue Number QAS124149 HCV Viral Load determination is primarily used for the diagnosis, monitoring, and clinical management of disease, before, during, and after therapy. Following diagnosis and before treatment a viral load test will normally be performed in order to establish a baseline value. This is used in order to define the appropriate treatment rationale. Viral load measurements will then be taken at regular intervals during therapy in order to gauge efficacy and determine treatment duration. Viral load may be taken periodically after treatment in order to monitor for relapse. The limits of detection (LOD) vary significantly dependant on the platform technology and specific types of quantitative molecular tests have reportable LOD down to 50 IU/ml. Hence assay sensitivity is an important parameter when determining the completion of therapy and also when testing Human blood bank products. Genotype specificity can also influence the viral load with some HCV assays resulting in underquantitation. The common unit of measurement is IU/ml and manufacturers calibrate their tests to the HCV WHO International Standard. The HCV regulatory EQA programme allows the laboratory to independently assess their laboratory procedure and viral load assay through the year and supports the laboratory’s requirements in line with ISO15189 or equivalent. Feature Specifications Number of Panel Members 2 full EQA (8 to 10 panel members), 2 core EQA (4 panel members) Sample NA Target Source Clinical material Matrix panel format Frozen Plasma Units of Measurement IU/ml Panel Member Target Range Covering clinical range Panel Member Sample Volume 1.2 ml Panel Sample Pre-treatment Requirement Ready for analysis. Treat as clinical samples and analyse accordingly Panel Analysis type Qualitative & Quantitative Panel Testing Evaluated by various molecular methodologies Storage / Shipment Conditions <-20°C / Dry-ice HIV-1 RNA HIVRNA12A & HIVRNA12B Catalogue Number QAV994108 Recent breakthroughs have significantly contributed to the care and therapy of the estimated over 50 million people living with HIV/AIDS throughout the world. Clinical management of Human Immunodeficiency Virus Type 1 (HIV-1) infection relies heavily on the direct detection and quantification of HIV-1 RNA in plasma or serum to evaluate viraemia at all stages of viral infection and antiviral therapy. Studies have shown that HIV-1 may be more vulnerable to antiviral treatment during primary infection prior to the development of HIV-1 antibodies, therefore early detection and diagnosis is essential in the effective treatment and continued disease management of HIV infection. Feature Specifications Number of Panel Members 8 to 10 Sample NA Target Source Cultured virus or Clinical material Matrix panel format Frozen Plasma Units of Measurement IU/ml, Copies/ml Panel Member Target Range Covering clinical range Panel Member Sample Volume 1.2 ml Panel Sample Pre-treatment Requirement Ready for analysis. Treat as clinical samples and analyse accordingly Panel Analysis type Qualitative & Quantitative Panel Testing Evaluated by various molecular methodologies Storage / Shipment Conditions <-20°C / Dry-ice Version number CAT2012/02 15 www.qcmd.org Viral EQA Hepatitis B virus DNA HBVDNA12A & HBVDNA12B Catalogue Number QAV994110 The prevalence of Hepatitis B (HBV) infection varies considerably across the world. It is estimated that 350 million people are infected with hepatitis B worldwide, with 50 million new cases diagnosed every year. The course of chronic HBV infection is highly variable, therefore rapid detection and diagnosis of HBV infection is essential in controlling not only spread of disease, but also the severe sequelae. Direct detection and quantitation of HBV in plasma or serum is now routinely performed to detect and evaluate viremia in infected persons; to identify infectious chronic carriers; and to predict and monitor the efficacy of antiviral therapy. Feature Specifications Number of Panel Members 8 to 10 Sample NA Target Source Clinical material Matrix panel format Frozen Plasma Units of Measurement IU/ml, Copies/ml Panel Member Target Range Covering clinical range Panel Member Sample Volume 1.2 ml Panel Sample Pre-treatment Requirement Ready for analysis. Treat as clinical samples and analyse accordingly Panel Analysis type Qualitative & Quantitative Panel Testing Evaluated by various molecular methodologies Storage / Shipment Conditions <-20°C / Dry-ice Hepatitis C virus RNA HCVRNA12A & HCVRNA12B Catalogue Number QAV994112 Due to the extremely low concentration of virus found in Hepatitis C Virus (HCV) infected individuals, direct detection and quantitation of HCV RNA in plasma is now the “gold standard” for detection of viraemia; to identify infectious chronic carriers; and to predict and monitor the efficacy of antiviral therapy. HCV RNA detection allows HCV infection to be diagnosed in early acute disease prior to antibody detection or aminotransferase evaluation, and in immunocompromised individuals who fail to generate specific antibodies. Rapid detection and diagnosis is not only critical in controlling the devastating sequelae of HCV infection but also spread of the disease. Feature Specifications Number of Panel Members 8 to 10 Sample NA Target Source Clinical material Matrix panel format Frozen Plasma Units of Measurement IU/ml Panel Member Target Range Covering clinical range Panel Member Sample Volume 1.2 ml Panel Sample Pre-treatment Requirement Ready for analysis. Treat as clinical samples and analyse accordingly Panel Analysis type Qualitative & Quantitative Panel Testing Evaluated by various molecular methodologies Storage / Shipment Conditions <-20°C / Dry-ice Version number CAT2012/02 16 www.qcmd.org Bacterial EQA Chlamydia trachomatis CTDNA12A & CTDNA12B Catalogue Number QAB004101 Chlamydia trachomatis (Ct) is one of the most widespread bacterial sexually transmitted diseases (STD) throughout the world. However, many of the conventional detection techniques lack sensitivity and specificity for accurate diagnosis, especially in asymptomatic infected individuals. This has led to a need for more accurate and rapid diagnostic methods. The introduction of nucleic acid amplification technologies (NATs) has increased utility for the diagnosis of infection; as well as providing a rapid and more sensitive alternative to the conventional methods. Feature Specifications Number of Panel Members 8 to 12 Sample NA Target Source Cultured bacteria Matrix panel format Lyophilised Urine or Physiological Buffer Units of Measurement Copies/vial Panel Member Target Range Covering clinical range Panel Member Sample Volume Dependent on platform Panel Sample Pre-treatment Requirement Reconstitution of lyophilised material Panel Analysis type Qualitative Panel Testing Evaluated by various molecular methodologies Storage / Shipment Conditions 2-8°C / Ambient Chlamydophila pneumoniae & Mycoplasma pneumoniae CP.MP12 Catalogue Number QAB084107 Chlamydophila pneumoniae (Cp) and Mycoplasma pneumoniae (Mp) are atypical bacterial pathogens involved in a significant proportion of respiratory tract infections throughout the world. It is important that accurate diagnosis of Cp and Mp infection is performed to allow effective treatment of infection. Serological diagnosis of Cp and Mp involves complex and time consuming procedures. The introduction of nucleic acid amplification technologies (NAT) has led to the development of fast, sensitive diagnostic tests that can rapidly confirm or exclude Cp/ Mp infection. As a result, these tests are now of great practical and clinical relevance. Feature Specifications Number of Panel Members 10 to 12 Sample NA Target Source Cultured bacteria Matrix panel format Lyophilised bronchoalveolar lavage (BAL) or sample transport medium (STM) Panel Member Target Range Covering clinical range Panel Member Sample Volume 0.5 ml Panel Sample Pre-treatment Requirement Reconstitution of lyophilised material Panel Analysis type Qualitative Panel Testing Evaluated by various molecular methodologies Storage / Shipment Conditions 2-8°C / Ambient Version number CAT2012/02 17 www.qcmd.org Bacterial EQA Legionella pneumophila LPDNA12 Catalogue Number QAB044122 Legionella pneumophila (LP) is responsible for 90% of legionellosis cases and is one of the leading causes of bacterial pneumonia, particularly in elderly and immunocompromised individuals, among whom mortality may exceed 30%. Prognosis of patients depends in part on the rapid identification of the causative agent. However, conventional diagnostic methods have shown limited sensitivity and specificity. Serological methods are inadequate for rapid diagnosis of acute legionellosis due to the absence of seroconversion during the acute phase of the disease. For these reasons, nucleic acid amplification techniques (NATs) are attractive tools for detection of Legionella species in clinical as well as environmental samples. Feature Specifications Number of Panel Members 8 to 12 Sample NA Target Source Cultured bacteria Matrix panel format Bronchoalveolar lavage (BAL) or physiological solution Units of Measurement GEq/ml, CFU/ml Panel Member Target Range Covering clinical range Panel Member Sample Volume 0.5 ml Panel Analysis type Qualitative Panel Testing Evaluated by various molecular methodologies Storage / Shipment Conditions 2-8°C / Ambient Methicillin Resistant S. aureus DNA MRSADNA12 Catalogue Number QAB064124 Methicillin-Resistant S. aureus (MRSA) is a nosocomial pathogen causing a range of conditions of varying severity. The recent dissemination of MRSA into the wider community has further heightened concerns over the spread of this pathogen. Infection control measures within hospitals have been demonstrated to greatly reduce the spread of infection, this depends in part on the rapid identification of MRSA. However, conventional diagnostic methods take a long period to identify MRSA. Nucleic acid amplification techniques (NATs) can quickly and accurately identify MRSA in a variety of samples and are quickly becoming a routine method for the clinical laboratory detection of MRSA. Feature Specifications Number of Panel Members 8 to 12 Sample NA Target Source Inactivated cultured MRSA Matrix panel format Culture Medium Units of Measurement CFU/ml Panel Member Target Range Covering clinical range Panel Member Sample Volume 1.2 ml Panel Sample Pre-treatment Requirement Ready for analysis. Treat as clinical samples and analyse accordingly Panel Analysis type Qualitative Panel Testing Evaluated by various molecular methodologies Storage / Shipment Conditions 2-8°C / Ambient Version number CAT2012/02 18 www.qcmd.org Bacterial EQA Clostridium difficile DNA CDDNA12 Catalogue Number QAB084125 Clostridium difficile (C.diff) is a Gram positive anaerobic bacteria that can cause a range of diseases including pseudomembranous colitis. The situation in elderly persons is much more serious with C.diff recognised as one of the most important gastrointestinal pathogens in this group. Nosocomial infections are most common because of the use of broad spectrum antibiotics that modify the normal gut microflora and increase the chances of C.difficile Associated Disease (CDAD) developing. Accurate and rapid diagnosis is crucial so that medical personnel can isolate and treat patients as early as possible. Feature Specifications Number of Panel Members 8 to 12 Sample NA Target Source Cultured bacteria Matrix panel format Lyophilised culture medium Units of Measurement CFU/ml Panel Member Target Range Covering clinical range Panel Member Sample Volume 1.0 ml Panel Sample Pre-treatment Requirement Reconstitution of lyophilised material Panel Analysis type Qualitative Panel Testing Evaluated by various molecular methodologies Storage / Shipment Conditions 2-8°C / Ambient Neisseria gonorrhoeae DNA NgDNA12 Catalogue Number QAB034126 Neisseria gonorrhoeae (Ng) is one of the most widespread bacterial sexually transmitted diseases (STD) throughout the world. However, many of the conventional detection techniques lack sensitivity and specificity for accurate diagnosis, especially in asymptomatic infected individuals. This has led to a need for more accurate and rapid diagnostic methods. The introduction of nucleic acid amplification technologies (NATs) has increased utility for the diagnosis of infection; as well as providing a rapid and more sensitive alternative to conventional methods. Feature Specifications Number of Panel Members 8 to 12 Sample NA Target Source Cultured bacteria Matrix panel format Lyophilised Urine Units of Measurement Copies/ml Panel Member Target Range Covering clinical range Panel Member Sample Volume Dependent on platform Panel Sample Pre-treatment Requirement Reconstitution of lyophilised material Panel Analysis type Qualitative Panel Testing Evaluated by various molecular methodologies Storage / Shipment Conditions 2-8°C / Ambient Version number CAT2012/02 19 www.qcmd.org Bacterial EQA M. tuberculosis Complex MTBDNA12 Catalogue Number QAB014129 Tuberculosis remains the single greatest cause of mortality due to an infectious agent worldwide. The introduction of nucleic acid amplification technologies (NAT) has led to the development of rapid, specific and sensitive diagnostic tests that can rapidly confirm or exclude Mycobacterium tuberculosis (Mtb) infection. As a result, these tests have become of great practical and clinical relevance. Feature Specifications Number of Panel Members 8 to 12 Sample NA Target Source Cultured Mycobacteria tuberculosis Complex (BCG) Matrix panel format Sputum or protein rich buffer Panel Member Target Range Covering clinical range Panel Member Sample Volume 0.25 ml Panel Sample Pre-treatment Requirement Routine respiratory sample treatment Panel Analysis type Qualitative Panel Testing Evaluated by various molecular methodologies Storage / Shipment Conditions 2-8°C / Ambient Bordetella pertussis Catalogue Number QAB094132 BPDNA12 Whooping cough is caused by the bacterium Bordetella pertussis (BP) infection. Although it is now recognised as a relatively mild disease in adults, there remains a significant mortality rate in infants and immunocompromised patients. Effective immunisation has helped in the control of the disease; however rapid diagnosis of infection is crucial in the treatment of infection. The introduction of nucleic acid amplification technologies (NAT) has led to the development of sensitive, type specific diagnostic tests that can rapidly identify BP infection. As a result, these tests are now of great practical and clinical relevance. Feature Specifications Number of Panel Members 8 to 12 Sample NA Target Source Cultured bacteria Matrix panel format Physiological solution Units of Measurement CFU/ml Panel Member Target Range Covering clinical range Panel Member Sample Volume 1.0ml Panel Sample Pre-treatment Requirement Ready for analysis. Treat as clinical samples and analyse accordingly Panel Analysis type Qualitative & Quantitative Panel Testing Evaluated by various molecular methodologies Storage / Shipment Conditions <-20°C / Dry-ice Version number CAT2012/02 20 www.qcmd.org Bacterial EQA Borrelia burgdorferi BbDNA12 Catalogue Number QAB114147 Lyme borreliosis, caused by the spirochete Borrelia burgdorferi (Bp), is one of the fastest spreading diseases particularly in Europe and the USA. Early treatment of Bp infection can quickly and successfully be treated with oral antibiotics. The introduction of nucleic acid amplification technologies (NAT) has led to the development of sensitive diagnostic tests that can confirm or exclude the presence Bp at the early stages infection. As a result, these tests have become of great practical and clinical relevance. Feature Specifications Number of Panel Members 8 to 12 Sample NA Target Source Cultured / Clinical material Matrix panel format Culture Medium Panel Member Target Range Covering clinical range Panel Analysis type Qualitative Panel Testing Evaluated by various molecular methodologies Storage / Shipment Conditions <-20°C / Dry-ice Version number CAT2012/02 21 www.qcmd.org Specialist EQA HCV Genotyping HCVGT12 Catalogue Number QAS034117 Hepatitis C virus (HCV) is the major cause of Hepatitis worldwide. HCV is an enveloped positive single stranded RNA virus of approximately 9400 nucleotides and, like other RNA viruses, is characterised by a high degree of genetic heterogeneity. It is now evident that HCV genotype has a significant influence on disease outcome and response to anti-viral therapy. Therefore, the typing of HCV to identify its genotype has become increasingly important in the patient management of HCV infected individuals. Feature Specifications Number of Panel Members 8 to 12 Sample NA Target Source Clinical material Genotypic Variant Various HCV subtypes Matrix panel format Frozen Plasma Panel Member Target Range Covering clinical range Panel Member Sample Volume 1.2 ml Panel Sample Pre-treatment Requirement Ready for analysis. Treat as clinical samples and analyse accordingly Panel Analysis type Molecular typing Panel Testing Evaluated by various molecular methodologies Storage / Shipment Conditions <-20°C / Dry-ice HBV Genotyping HBVGT12 Catalogue Number QAS064118 It is estimated that 350 million people are infected with Hepatitis B worldwide, with 50 million new cases diagnosed every year. The course of chronic Hepatitis B infection is highly variable and it is becoming evident that HBV genotype has an influence on disease outcome and response to anti-viral therapy. Therefore, the typing of HBV to identify its genotype has become increasingly important in the patient management of HBV infected individuals. Feature Specifications Number of Panel Members 8 to 12 Sample NA Target Source Clinical material Genotypic Variant Various HBV subtypes Matrix panel format Frozen Plasma Panel Member Target Range Covering clinical range Panel Member Sample Volume 1.2 ml Panel Sample Pre-treatment Requirement Ready for analysis. Treat as clinical samples and analyse accordingly Panel Analysis type Molecular typing Panel Testing Evaluated by various molecular methodologies Storage / Shipment Conditions <-20°C / Dry-ice Version number CAT2012/02 22 www.qcmd.org Specialist EQA Methicillin Resistant S. aureus Typing MRSATP12 Catalogue Number QAS074128 Methicillin-Resistant S. aureus (MRSA) is a nosocomial pathogen causing a range of conditions of varying severity. The recent dissemination of MRSA into the wider community has increased concerns over the spread of this pathogen. MRSA surveillance measures have been integral to monitoring the spread of antimicrobial resistance within the community, this depends in part on the rapid and accurate typing of MRSA. Molecular-based typing methods can quickly and accurately genotype MRSA in a variety of samples and are quickly becoming the method of choice for MRSA outbreak analysis. Feature Specifications Number of Panel Members 8 to 12 Sample NA Target Source Cultured MRSA strains Matrix panel format Culture Medium Panel Member Target Range Genetic variants of S. aureus Panel Member Sample Volume 0.2 ml Panel Sample Pre-treatment Requirement Culture followed by standard NA extraction Panel Analysis type Molecular typing Panel Testing Evaluated by various methodologies Storage / Shipment Conditions 2-8°C / Ambient HIV-1 Drug Resistance ENVA12 Catalogue Number QAV024131 Antiviral therapy that targets the reverse transcriptase (RT) and protease (Pro) genes within human immunodeficiency virus type 1 (HIV-1) is now a routine part of the patient management of HIV-1 infection. Unfortunately viral mutations have allowed the generation of HIV-1 strains that are less sensitive to antiviral drug therapies. As a result the rapid genotyping of HIV-1 RT and Pro genes in plasma has become an integral part of the management of HIV-1 antiviral drug therapy for infected individuals. Genotyping HIV-1 RT and Pro genes allows the determination of base-line HIV-1 RT and Pro genotype before and during drug therapy and provides information with which to identify, implement and modify rational drug regimes for the treatment of infected individuals. HIV genotyping compliments standard HIV diagnosis by providing additional information on a patient’s disease status thus allowing the clinician to differentiate between resistance caused by viral mutation and other potential sources of increased HIV viral load. Feature Specifications Number of Panel Members 4 to 7 Sample NA Target Source Cultured virus or Clinical material Matrix panel format Lyophilised Plasma Panel Member Target Range Various mutations - Reverse Transcriptase (RT) and Protease (PR) genes Panel Member Sample Volume 1.0 ml Panel Sample Pre-treatment Requirement Reconstitution of lyophilised material Panel Analysis type Sequencing Panel Testing Evaluated by various molecular methodologies Storage / Shipment Conditions 2-8°C / Ambient Version number CAT2012/02 23 www.qcmd.org Specialist EQA HIV-1 Drug Resistance (Integrase) ENVAINT12 Catalogue Number QAV114146 Integrase inhibitors that target the intergase (INT) within human immunodeficiency virus type 1 (HIV-1) are now a routine part of the patient management of HIV-1 infection. Unfortunately viral mutations have allowed the generation of HIV-1 strains that are less sensitive to antiviral drug therapies. As a result, the rapid genotyping of HIV-1 integrase genes in plasma has become part of the management of HIV-1 antiviral drug therapy for infected individuals. Genotyping the HIV-1 INT gene allows the determination of base-line HIV-1 INT genotype before and during drug therapy and provides information with which to identify, implement and modify rational drug regimes for the treatment of infected individuals. HIV genotyping compliments standard HIV diagnosis by providing additional information on a patient’s disease status thus allowing the clinician to differentiate between resistance caused by viral mutation and other potential sources of increased HIV viral load. Feature Specifications Number of Panel Members 4 to 7 Sample NA Target Source Cultured virus or Clinical material Matrix panel format Lyophilised Plasma Panel Member Target Range Various mutations - Integrase (INT) gene Panel Member Sample Volume 1.0 ml Panel Sample Pre-treatment Requirement Reconstitution of lyophilised material Panel Analysis type Sequencing Panel Testing Evaluated by various molecular methodologies Storage / Shipment Conditions 2-8°C / Ambient Influenza Haemagglutinin Typing INFHT12 Catalogue Number QAS064138 Influenza virus (InfV) is a highly contagious acute respiratory disease that can spread rapidly and widely causing high levels of mortality and morbidity. The segmented nature of the influenza genome makes genomic reassortment an important mechanism for generating genetic diversity. This process is particularly important in Influenza A virus because of its role in the generation of new pandemic strains of the virus. Early detection and typing of viral strains is of great importance for the effective treatment and monitoring of influenza outbreaks. The introduction of nucleic acid amplification technologies (NAT) has led to the development of sensitive tests that can rapidly identify the particular strain of virus. As a result, these tests are becoming of great practical and clinical relevance. Feature Specifications Number of Panel Members 8 to 12 Sample NA Target Source Cultured virus Matrix panel format Frozen Virus Transport Meduim (VTM) Panel Member Target Range Covering clinical range Panel Member Sample Volume 1.0ml Panel Sample Pre-treatment Requirement Ready for analysis. Treat as clinical samples and analyse accordingly Panel Analysis type Molecular typing Panel Testing Evaluated by various molecular methodologies Storage / Shipment Conditions <-20°C / Dry-ice Version number CAT2012/02 24 www.qcmd.org Fungal EQA Aspergillus DNA ASPDNA12 Catalogue Number QAF104140 The diagnosis of invasive aspergillosis is challenging because the symptoms are often non-descript and classical mycological methods do not always detect the pathogen. Those most at risk of invasive aspergillosis are those with compromised immune systems such as AIDS patients and organ transplant recipients. Nucleic acid amplification techniques (NATs) are attractive tools for detection of Aspergillus species in clinical samples. However a lack of standardisation has hindered widespread acceptance. Feature Specifications Number of Panel Members 8 to 12 Sample NA Target Source Cultured / Clinical / Purified Nucleic Acid Matrix panel format Saline solution Panel Member Target Range Covering clinical range Panel Analysis type Qualitative Panel Testing Evaluated by various molecular methodologies Storage / Shipment Conditions <-20°C / Dry-ice Pneumocystis jirovecii pneumonia (PCP) PCPDNA12 Catalogue Number QAF114144 Pneumocystis pneumonia (PCP) is a common opportunistic infection associated with mortality and morbidity especially in immuno-compromised hosts such as transplant recipients and AIDS patients. Early detection of PCP is crucial for effective treatment and immunosuppressive drug therapy amendment which may result in proliferative disease regression. The introduction of nucleic acid amplification technologies (NAT) has led to the development of sensitive diagnostic tests that can rapidly confirm or exclude active PCP infection. As a result, these tests have become of great practical and clinical relevance. Feature Specifications Number of Panel Members 8 to 12 Sample NA Target Source Cultured / Clinical material Matrix panel format Physiological solution Panel Member Target Range Covering clinical range Panel Analysis type Qualitative Panel Testing Evaluated by various molecular methodologies Storage / Shipment Conditions <-20°C / Dry-ice Version number CAT2012/02 25 www.qcmd.org Parasitic EQA Toxoplasma gondii DNA TGDNA12 Catalogue Number QAF044123 Toxoplasma gondii (TG) is an obligate intracellular parasite that is a leading cause of serious infection in susceptible groups such as immunocompromised individuals, transplant patients and pregnant mothers. Prognosis of patients depends in part on the rapid identification of TG infection. However, conventional diagnostic methods have shown limited sensitivity and specificity and serological methods are inadequate for rapid diagnosis due to the absence of seroconversion during the early phase TG infection. For these reasons, nucleic acid amplification techniques (NATs) are attractive tools for detection of TG in a variety of clinical samples. Feature Specifications Number of Panel Members 8 to 12 Sample NA Target Source Cultured T. gondii Matrix panel format Lyophilised amniotic fluid or plasma Units of Measurement Tg /ml Panel Member Target Range Covering clinical range Panel Member Sample Volume 2.0 ml Panel Sample Pre-treatment Requirement Reconstitution of lyophilised material Panel Analysis type Qualitative Panel Testing Evaluated by various molecular methodologies Storage / Shipment Conditions 2-8°C / Ambient Version number CAT2012/02 26 www.qcmd.org New EQA pilot Studies for 2012 Hepatitis A virus HAVRNA12 Catalogue Number QAV124156 Hepatitis A virus (HAV) is a major public health concern due to its epidemiology and it is estimated that tens of millions of individuals are infected with the virus each year. Infection rates are highest within developing countries particularly in regions associated with poor hygiene due to persistent circulation of the virus in the environment. In contrast, HAV infection within developed countries is generally associated with travel to regions with a high incidence of the disease. Vaccination programs have proven successful, but HAV outbreaks remain a global cause of public health, environmental, and economic concern. The HAV is a single stranded RNA virus known to cause liver disease. Although there has only been one serotype of HAV described, genetically the virus has been classified into seven different HAV genotypes. These are designated I to VII. Genotypes I, II, III and VII are associated with human disease, with genotypes I and III considered the most prevalent, and comprising at least 80% of circulating human strains. In addition, genotypes I and III can be further divided into subtypes A and B. HAV can be spread through the direct contact with an infectious individual. However it is primarily spread indirectly via the fecal-oral route and transmitted by the ingestion of contaminated water supplies or the consumption of raw or undercooked food such as shellfish. Molecular techniques have emerged as important diagnostic and monitoring tools within the clinical and environmental setting because of their rapidity, accuracy and sensitivity. A HAV WHO International Standard was introduced in 2007 to allow the calibration of secondary reference materials, support the validation of molecular diagnostic assays, and improve quantification of the virus in the clinical laboratory and within the blood product, IVD manufacturers setting. The primary aim of this HAV EQA pilot study is to evaluate the ability of laboratory in the detection of HAV and investigate comparative molecular quantification in terms of sensitivity and specificity within the clinical context. Feature Specifications Number of Panel Members 8 to 12 Sample NA Target Source Clinical / Cultured Matrix panel format Plasma / clinically relevant matrices Units of Measurement IU/ml, Copies/ml Panel Member Target Range Covering clinical range Panel Member Sample Volume 1.2 ml Panel Sample Pre-treatment Requirement Ready for analysis. Treat as clinical samples and analyse accordingly Panel Analysis type Qualitative & Quantitative Panel Testing Evaluated by various molecular methodologies Storage / Shipment Conditions <-20°C / Dry-ice Version number CAT2012/02 27 www.qcmd.org New EQA pilot Studies for 2012 Hepatitis E virus HEVRNA12 Catalogue Number QAV124157 Hepatitis E virus (HEV) is a single stranded RNA virus belonging to the family of Hepeviridae. This non-enveloped virus behaves in a similar way to Hepatitis A virus and transmission is by the fecal-oral route. There are currently 4 genotypes HEV known (genotypes 1 to 4) Genotype 1 and 2 are related to human disease, while the genotypes 3 and 4 are more generally associated with animal disease, particularly porcine. Genotype 1, 2 and 4 are often prevalent in areas associated with poor hygiene. Recently there have been a number of large human epidemics described in the literature where genotype 1 has been associated with high mortality in pregnant women. In addition, infections with genotype 1 or 2 are mostly travel-related to endemic areas. The genotype 3 has become of increasing interest in recent publications since it may be an important factor in transplant patients with chronic infection or other immunosuppressed patients. In addition, genotype 3 HEV infections have been documented in patients with haematological disorders. At present serological assays are of limited use in the detection of genotype 3 as they predominantly detect genotype 1 and 2 HEV infections. Hence molecular detection and strain determination is becoming an important aspect in the diagnosis and monitoring of HEV infection. The primary goal of this HEV EQA pilot study is to evaluate the ability of laboratories in the detection of the different HEV genotypes and where appropriate investigate the comparative quantitative detection in view of the first WHO International standard and developing treatment options. Feature Specifications Number of Panel Members 8 to 12 Sample NA Target Source Clinical / Cultured Matrix panel format Plasma Units of Measurement Copies/ml Panel Member Target Range Covering clinical range Panel Member Sample Volume 1.2 ml Panel Sample Pre-treatment Requirement Ready for analysis. Treat as clinical samples and analyse accordingly Panel Analysis type Qualitative & Quantitative Panel Testing Evaluated by various molecular methodologies Storage / Shipment Conditions <-20°C / Dry-ice Version number CAT2012/02 28 www.qcmd.org New EQA pilot Studies for 2012 Gastroenteritis Programmes Gastroenteritis can be caused by a wide variety of bacteria, viruses and parasites. It is often associated by severe inflammation of the gastrointestinal tract involving both the stomach and small intestine. This results in acute diarrhoea and vomiting. Diagnosis is primarily based on clinical symptoms, but laboratory diagnosis on the etiological cause is often needed to provide optimal patient care and to take preventive measures. In recent years Molecular Diagnostic techniques such as real-time PCR have also been introduced for the laboratory diagnosis of gastroenteritis, including the ability to simultaneously screen for a wide range of enteric pathogens using multiplex assays. As a result, molecular diagnostics are increasingly being used in the routine laboratory setting for detection, determination and surveillance of a wide range of enteric pathogens. The aim of the Gastroenteritis EQA pilot portfolio is to allow laboratories to assess their ability in the use of molecular diagnostic tests for a range of viral, bacterial and parasitic enteric pathogens. For convenience, the EQA portfolio has been split into viral, bacterial, and parasitic Gastroenteritis panels. Viral Gastroenteritis GastroV12 Catalogue Number QAV124152 Viruses are a major cause of gastroenteritis outbreaks. It has been estimated that at least 50% of foodborne gastroenteritis cases are caused by noroviruses. Approximately another 20% of cases, and the majority of severe cases in children, are due to rotavirus. Other clinically significant viral enteropathogens include adenovirus, particularly types 40 and 41, and astroviruses. The aim of the viral Gastroenteritis EQA pilot study is to assess the laboratory’s ability to detect a range of viral pathogens known to cause gastroenteritis using their routine molecular diagnostic platform and procedures. The panel members will resemble clinical samples and will include current clinically relevant norovirus, rotavirus, and adenovirus strains. Feature Specifications Number of Panel Members 8 to 12 Sample NA Target Source Clinical / Cultured Matrix panel format Physiological / synthetic faecal substitute Panel Member Target Range Covering clinical range Panel Analysis type Qualitative Panel Testing Evaluated by various molecular methodologies Storage / Shipment Conditions <-20°C / Dry-ice Version number CAT2012/02 29 www.qcmd.org New EQA pilot Studies for 2012 Bacterial Gastroenteritis GastroB12 Catalogue Number QAB124153 Different species of pathogenic bacteria are known to cause gastroenteritis. The most common include Salmonella, Shigella, Yersinia, Campylobacter species and various toxicogenic Escherichia Coli species. In severe cases of gastroenteritis for example when hospitalisation is required (often in infants), it is important to distinguish between bacterial and viral enteropathogens. The aim of the bacterial Gastroenteritis EQA pilot study is to assess the laboratory’s ability to detect a range of bacterial pathogens known to cause gastroenteritis using their routine molecular diagnostic platform and procedures. The panel members will resemble clinical samples and will include current clinically relevant strains of Salmonella, Shigella, Yersinia or Campylobacter species. Feature Specifications Number of Panel Members 8 to 12 Sample NA Target Source Clinical / Cultured Matrix panel format Physiological / synthetic faecal substitute Panel Member Target Range Covering clinical range Panel Analysis type Qualitative Panel Testing Evaluated by various molecular methodologies Storage / Shipment Conditions <-20°C / Dry-ice Parasitic Gastroenteritis GastroP12 Catalogue Number QAP124154 Parasites are another frequent cause of Gastroenteritis, and also are a growing risk in this age of global travel. Diagnosis is increasingly important within the routine clinical setting and in the management of potential outbreaks, The aim of the Parasitic Gastroenteritis EQA pilot study is to assess the laboratory’s ability to detect a range of parasitic pathogens known to cause gastroenteritis using their routine molecular diagnostic platform and procedures. The panel members this pilot programme will resemble clinical samples and will include current clinically relevant strains of Giardia, Cryptosporidium, and Entamoeba. Feature Specifications Number of Panel Members 8 to 12 Sample NA Target Source Clinical / Cultured Matrix panel format Physiological / synthetic faecal substitute Panel Member Target Range Covering clinical range Panel Analysis type Qualitative Panel Testing Evaluated by various molecular methodologies Storage / Shipment Conditions <-20°C / Dry-ice Version number CAT2012/02 30 www.qcmd.org New EQA pilot Studies for 2012 Candida albicans C.ALBDNA12 Catalogue Number QAF124151 Candida albicans (C. albicans) is a fungus that grows both as yeast and in filamentous form. The fungus is a human commensal organism found in the mouth, gastrointestinal tract, and is an integral part of the normal gut flora. Overgrowth of the fungus results in candidiasis (candidosis) and a common form is thrush, which is usually easily treated in people who are not immunocompromised. However, C. albicans has emerged as an important cause of opportunistic infection in immunocompromised patient groups such as those receiving chemotherapy, transplantation, or with conditions such as HIV/ AIDS. In addition, C. albicans has been documented to form biofilms on the surface of implantable medical devices and it has become a major nosocomial health concern, reportedly representing 8% of hospital-acquired bloodstream infections. During the process of host tissue infection it is thought that the usual unicellular yeast-like form of C. albicans reacts to environmental signals and switches into an invasive, multicellular filamentous form (dimorphism). Invasive candidiasis (IC) is a serious cause of morbidity and mortality and over 50% of cases are not diagnosed until after death. The gold standard for the diagnosis of IC has generally been blood culture. However, blood culture can take over 48 hours to give a positive result and identification of a particular Candida species can take a lot longer. This can result in delayed administration of antifungal therapy and appropriate patient care. In addition, because of the historical lack of appropriate diagnostics, patients categorized as high risk are often prescribed antifungal treatment without a diagnosis which increases the risk of future ecological and economic issues. Molecular Diagnostics have been developed in order to assist in the rapid diagnosis of infections, the monitoring of infection persistence, and supporting species-oriented therapy. The aim of this EQA pilot study is to evaluate the current range of molecular techniques reported and ability of the laboratory to use these technologies for the detection of C. albicans. The programme will investigate the diagnostic accuracy of laboratory methods on clinical relevant sample types and the relative reported sensitivity and specificity of the methods used during the EQA pilot. Feature Specifications Number of Panel Members 8 to 10 Sample NA Target Source Cultured / Clinical / Purified Nucleic Acid Matrix panel format Blood / culture matrix Panel Member Target Range Covering clinical and analytical range Panel Analysis type Qualitative Panel Testing Evaluated by various molecular methodologies Storage / Shipment Conditions <-20°C / Dry-ice Version number CAT2012/02 31 www.qcmd.org New EQA pilot Studies for 2012 Cytomegalovirus Whole Blood CMVWB12 Catalogue Number QAV124150 Cytomegalovirus (CMV) is an important cause of illness in immunocompromised patients, especially after allogeneic organ or stem cell transplantation. As a result, the measurement for CMV viral load is an essential element in patient management and whole blood is often the matrix of choice for some laboratories when monitoring CMV in patients with haematological diseases. In addition, guidelines including the European Conference on Infections in Leukemia (ECIL 2009) recommend that peripheral blood is used for the diagnosis of CMV. The primary aim of this EQA pilot study is to evaluate the ability of the laboratory in the detection of CMV from whole blood samples. The EQA will investigate quantification ranges in relation to those defined within current guidelines and the precision of the molecular assays at clinically relevant viral loads. Comparisons will also be made to other biologically important matrices including plasma. Feature Specifications Number of Panel Members 8 to 12 Sample NA Target Source Clinical / Cultured Matrix panel format Whole blood Units of Measurement IU/ml, Copies/ml Panel Member Target Range Covering clinical range Panel Member Sample Volume 1.0 ml Panel Sample Pre-treatment Requirement Ready for analysis. Treat as clinical samples and analyse accordingly Panel Analysis type Qualitative & Quantitative Panel Testing Evaluated by various molecular methodologies Storage / Shipment Conditions <-20°C / Dry-ice MALDI-TOF Bacterial MALDIBAC12 Catalogue Number QAB124155 Matrix-Assisted Laser Desorption Ionisation – Time of Flight (MALDI-TOF) is becoming an important diagnostic tool in the microbiological laboratory for the routine identification of bacterial species based on protein and in some cases nucleic acid composition. MALDI-TOF and similar technologies have been shown to be fast, reliable and cost-effective. The technology has potential to reduce the risk of misidentifying unusual organisms and is reportedly capable of correctly identifying the most common bacterial isolates at the species level in 84.1 to 93.6% instances. MALDI-TOF therefore has the potential to complement or possibly replace conventional bacterial phenotypic identification methods. MALDI-TOF does still have some current limitations and these include the identification of some microbial species including; Shigella, pneumococci, and streptococci. These current limitations are often due to the lack of suitable reference strains, standards and in some cases clinical isolates. This means that it can be difficult to obtain sufficient quality data with which to define appropriate reference spectra to update the reference databases. The primary goal of this EQA pilot study is to evaluate the ability of laboratories in the detection and determination of different clinically relevant bacterial strains using MALDI-TOF and other similar mass spectrometry based technologies in the routine microbiology laboratory. Feature Specifications Number of Panel Members 8 to 12 Sample NA Target Source Clinical material Matrix panel format Physiological Panel Member Target Range Clinically relevant range of bacteria for detection & determination Panel Analysis type Qualitative Storage / Shipment Conditions <-20°C / Dry-ice Version number CAT2012/02 32 www.qcmd.org In memory of, Stephen Wilson QCMD Quality Manager 1958 to 2011 “To live in hearts we leave behind is not to die.” Thomas Campbell, “Hallowed Ground” Version number CAT2012/02 www.qcmd.org