WS 283-2020 in English
VALIDDiagnosis for anthrax
- Issued on:2020-04-21
- Implemented on:2020-11-01
- File Format:PDF
- Delivery:Via email within 1~3 business days
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本标准规定了炭疽的诊断依据、诊断原则、诊断和鉴别诊断。
本标准适用于全国各级各类医疗机构及其医务人员对炭疽的诊断。
Introduction
Background of Standard Revision and Technological Evolution
WS 283-2020 replaces the 2008 version of the standard. The main technical updates include: New nucleic acid detection (Appendix D), Antigen detection (Appendix E) methods, improved specimen storage and transportation requirements (Appendix A), and strengthened biosafety specifications (Appendix B). The standard was jointly revised by 8 units including the China Center for Disease Control and Prevention, reflecting the current level of development of anthrax prevention and control technology.
Analysis of core diagnostic elements
| Diagnosis type | Epidemiological basis | Clinical manifestations | Laboratory examination |
|---|---|---|---|
| Suspected case | Contact history within 14 days | Any symptom of skin/pulmonary/intestinal anthrax | — |
| Clinically diagnosed case | + | + | Positive antibody/microscopy/environmental culture |
| Confirmed case | + | + | Bacterial culture is positive or two items are positive |
Laboratory testing technical specifications
1. Bacteriological examination (Appendix B)
It needs to be carried out in a biosafety level 2 laboratory, emphasizing:
• Gram staining shows large bacilli with flat ends (4.3.3)
• Blood agar plate culture characteristics: curly colonies (B.3.2)
• Penicillin inhibition test as the gold standard for identification
2. Nucleic acid detection (Appendix D)
Two new detection methods are added:
• Conventional PCR: targeting pagA/cap gene (Table D.1)
• Real-time fluorescence PCR: Ct≤35 is considered positive (Table D.2)
Clinical implementation recommendations
- Specimen collection: Completed before antibiotic use, skin lesions need to be sampled in stages (A.1.3)
- Biosafety: Transportation in accordance with UN2814/3373 specifications (A.5), laboratory operations require secondary protection
- Result interpretation: Meningitis type requires cerebrospinal fluid testing (4.3.1), sepsis type pays attention to DIC indicators
Comparison of old and new standards
| Technical indicators | 2008 edition | 2020 edition |
|---|---|---|
| Detection method | Bacterial culture + serology | New nucleic acid/antigen testing |
| Specimen requirements | Storage temperature not specified | 2-8℃/-20℃ graded storage |
| Diagnostic criteria | 3 types of cases | Refine the laboratory evidence chain |
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