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Final report on APMP regional key comparison APMP.L-K6: Calibration of ball plate and hole plate
Takatsuji, Toshiyuki,Eom, Taebong,Tonmueanwai, Anusorn,Yin, Ruimin,van der Walt, Floris,Gao, Sitian,Thu, Bui Quoc,Singhal, R P,Howick, Eleanor,Doytchinov, Kostadin,Valente de Oliveira, José,Carl Springer-Verlag 2014 METROLOGIA -BERLIN- Vol.51 No.-
<P>The results of the APMP key comparisons on ball plate and hole plate (APMP.L-K6.2007) are reported. Both transfer standards were provided by NMIJ, Japan. The ball plate standard is 532 mm by 532 mm in nominal dimension and 25 spheres are embedded. Thirteen National Metrology Institutes (8 from APMP, 5 from other Regional Metrology Organizations) participated in the ball plate measurement comparison. The hole plate standard is 550 mm by 550 mm in nominal dimension and there are 44 cylindrical holes in it. Nine National Metrology Institutes (5 from APMP, 4 from other Regional Metrology Organizations) participated in the hole plate measurement comparison. The comparison started in May 2006 and finished in October 2008. The participants used different measurement techniques which were used for their routine calibration services. For determining the key comparison reference values, a two-dimensional coordinates-based analysis was performed. The measurement results on the ball plate show good agreement in ten out of thirteen participants. In contrast, those on the hole plate are in agreement for five out of nine participants.</P><P>Main text.To reach the main text of this paper, click on Final Report. Note that this text is that which appears in Appendix B of the BIPM key comparison database kcdb.bipm.org/.</P><P>The final report has been peer-reviewed and approved for publication by the CCL, according to the provisions of the CIPM Mutual Recognition Arrangement (CIPM MRA).</P>
Extensive Drug Resistance Acquired During Treatment of Multidrug-Resistant Tuberculosis
Cegielski, J. Peter,Dalton, Tracy,Yagui, Martin,Wattanaamornkiet, Wanpen,Volchenkov, Grigory V.,Via, Laura E.,Van Der Walt, Martie,Tupasi, Thelma,Smith, Sarah E.,Odendaal, Ronel,Leimane, Vaira,Kvasnov Oxford University Press 2014 Clinical Infectious Diseases Vol.59 No.8
<P>Nearly 15% of multidrug-resistant (MDR) tuberculosis cases developed resistance to the fluoroquinolones, the second-line injectable drugs, or both during treatment for MDR tuberculosis. The rate of acquired resistance was significantly lower in programs that met specific performance criteria.</P><P><B><I>Background.</I></B> Increasing access to drugs for the treatment of multidrug-resistant (MDR) tuberculosis is crucial but could lead to increasing resistance to these same drugs. In 2000, the international Green Light Committee (GLC) initiative began to increase access while attempting to prevent acquired resistance.</P><P><B><I>Methods.</I></B> To assess the GLC's impact, we followed adults with pulmonary MDR tuberculosis from the start to the end of treatment with monthly sputum cultures, drug susceptibility testing, and genotyping. We compared the frequency and predictors of acquired resistance to second-line drugs (SLDs) in 9 countries that volunteered to participate, 5 countries that met GLC criteria, and 4 countries that did not apply to the GLC.</P><P><B><I>Results.</I></B> In total, 832 subjects were enrolled. Of those without baseline resistance to specific SLDs, 68 (8.9%) acquired extensively drug-resistant (XDR) tuberculosis, 79 (11.2%) acquired fluoroquinolone (FQ) resistance, and 56 (7.8%) acquired resistance to second-line injectable drugs (SLIs). The relative risk (95% confidence interval [CI]) of acquired resistance was lower at GLC-approved sites: 0.27 (.16–.47) for XDR tuberculosis, 0.28 (.17–.45) for FQ, and 0.15 (.06–.39) to 0.60 (.34–1.05) for 3 different SLIs. The risk increased as the number of potentially effective drugs decreased. Controlling for baseline drug resistance and differences between sites, the odds ratios (95% CIs) were 0.21 (.07–.62) for acquired XDR tuberculosis and 0.23 (.09–.59) for acquired FQ resistance.</P><P><B><I>Conclusions.</I></B> Treatment of MDR tuberculosis involves substantial risk of acquired resistance to SLDs, increasing as baseline drug resistance increases. The risk was significantly lower in programs documented by the GLC to meet specific standards.</P>