The French National Reference Centre (NRC) for Whooping Cough carried out an external quality control (QC) analysis in 2010 for the PCR diagnosis of whooping cough. The main objective of the study was to assess the impact of this QC in the participating laboratories through a repeat analysis in 2012.W hooping cough, a highly contagious respiratory disease affecting humans (1), can be diagnosed by culture, PCR, or serology (2). PCR, and particularly real-time PCR (RT-PCR) methods, overcomes some of the limitations of culture and serology and has become the most widely used method for diagnosing Bordetella infection. Insertion sequences IS481 and IS1001 are the most frequently used targets for the detection of B. pertussis and B. parapertussis, respectively. However, the IS481 sequence is also present in the B. holmesii genome (3). Moreover, B. bronchiseptica is causing problems for current consensus molecular diagnostic tests for pertussis, because some isolates harbor IS481 (4) and/or IS1001 (5). Following on the initial proficiency program (6), the French National Reference Centre (NRC) offered quality controls (QCs) to the pediatric hospital laboratory network (7) and some other hospital and private medical laboratories in 2010 (QC-2010) and 2012 (QC-2012. The main objectives were (i) to provide an overview of the PCR methods used by the laboratories and of the interpretation of the data obtained and (ii) to assess the impact of QC-2010 on the participating laboratories by repeat evaluation in 2012. Participation was voluntary, with 33 laboratories participating in QC-2010 and 35 in QC-2012. The participating laboratories were asked to complete a technical questionnaire (Table 1) to provide information about their equipment, reagents, and methods. The DNA samples of Bordetella isolates harboring the IS481 or IS1001 sequence in their genome were prepared by NRC and sent to the participating laboratories (Table 2). Each proficiency panel consisted of six specimens, each containing DNA at a concentration of 0.01 to 100.00 pg/l or molecular biology-quality water. The participants were asked to report the positive or negative result obtained for DNA detection for each tube, together with the crossover threshold (Ct) value and the conclusive sentence routinely used for such situations in their analysis reports. The correct interpretation for a sample that tests positive for IS481 or IS1001 should be "detection of Bordetella species DNA." The conclusive sentence was considered incorrect if the laboratory interpreted a positive test for IS481 as indicating that the sample corresponded to B. pertussis or a positive test for IS1001 as indicating that the sample corresponded to B. parapertussis. The results were compiled and analyzed by NRC and then transmitted to all participants.A summary of the technical questionnaire completed by the laboratories is presented in Table 1. In 2010 and 2012, half of the laboratories routinely used commercial kits, a third used an automated system for DNA extraction from respiratory samp...