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Chapter 5.17 : Quality Assurance Measures for Antimicrobial Susceptibility Testing

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Quality Assurance Measures for Antimicrobial Susceptibility Testing, Page 1 of 2

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Abstract:

Quality Control (QC) is performed to ensure proper performance of antimicrobial susceptibility tests in order to provide accurate, reproducible, and timely results. The basic QC procedure used in clinical laboratories involves testing reference strains (also referred to as QC organisms or strains) that have defined characteristics of susceptibility to the antimicrobial agent(s) tested. These strains must be properly maintained in order to ensure their reliable performance. Testing the QC strains controls many parameters of the antimicrobial susceptibility test; however, testing the QC strains alone does not always ensure reliable results when testing patients’ isolates. Inclusion of supplemental control strains (particularly if recommended in the manufacturer’s instructions when using a commercial test system), evaluation of susceptibility profiles on patients’ isolates, verification of technologist competency, and review of cumulative susceptibility statistics are some of the additional measures that can be taken to further ensure quality of antimicrobial susceptibility test results.

Citation: Leber A. 2016. Quality Assurance Measures for Antimicrobial Susceptibility Testing, p 5.17.1-5.17.13. In Clinical Microbiology Procedures Handbook, Fourth Edition. ASM Press, Washington, DC. doi: 10.1128/9781555818814.ch5.17
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Image of Competency Assessment Checklist–Antimicrobial Susceptibility Testing
Competency Assessment Checklist–Antimicrobial Susceptibility Testing

Competency Assessment Checklist–Antimicrobial Susceptibility Testing

Citation: Leber A. 2016. Quality Assurance Measures for Antimicrobial Susceptibility Testing, p 5.17.1-5.17.13. In Clinical Microbiology Procedures Handbook, Fourth Edition. ASM Press, Washington, DC. doi: 10.1128/9781555818814.ch5.17
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References

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1. College of American Pathologists. 2012. CAP Accreditation Checklist, Microbiology. College of American Pathologists, Northfield, IL.
2. US Department of Health and Human Services, Centers for Medicare and Medicaid Services, and Centers for Disease Control and Prevention. 2003. Medicare, Medicaid, and CLIA programs. 42CFR493.1261. Fed Regist 68:3708.
3. Joint Commission. 2013. Section QSA.04.02.01, laboratory verification of antibacterial, antimycobacterial and antifungal susceptibility testing systems with appropriate reference organisms. In Comprehensive Accreditation Manual for Laboratory and Point of Care Testing. Joint Commission, Chicago, IL.
4. CLSI. 2015. Methods for Dilution Antimicrobial Susceptibility Tests for Bacteria That Grow Aerobically, 10th ed. Approved standard M7-A10. CLSI, Wayne, PA.
5. CLSI. 2015. Performance Standards for Antimicrobial Disk Susceptibility, 12th ed. Approved standard M2-A12. CLSI, Wayne, PA.
6. CLSI. 2015. Performance Standards for Antimicrobial Susceptibility Testing; 25th ed. Informational Supplement M100-S25. CLSI, Wayne, PA.
7. Leclercq R, Cantón R, Brown DFJ, Giske CG, Heisig P, MacGowan AP, Mouton JW, Nordmann P, Rodloff AC, Rossolini GM, C-J Soussy, Steinbakk M, Winstanley TG, Kahlmeter G. 2013. EUCAST expert rules in antimicrobial susceptibility testing. Clin Microbiol Infect, 19:141160. (http://www.eucast.org/expert_rules/)
8. CLSI. 2013. Analysis and Presentation of Cumulative Antimicrobial Susceptibility Test Data, 4th ed. Approved guideline M39-A4. CLSI, Wayne, PA.
9. Hindler JF. 2010. Quality assurance measures for antimicrobial susceptibility testing. In Garcia LS (ed), Clinical Microbiology Procedures Handbook, 3 ed. ASM Press, Washington, DC.
10. Hindler JA. 1990. Nontraditional approaches to quality control of antimicrobial susceptibility tests. Clin Microbiol Newsl 12:6569.
11. Livermore DM, Winstanley TG, Shannon KP. 2001. Interpretative reading: recognizing the unusual and inferring resistance mechanisms from resistance phenotypes. J Antimicrob Chemother 48:87102.
12. Sharp SE, Laurel Elder B. 2004. Competency assessment in the clinical microbiology laboratory. Clin Microbiol Rev 17:681694.
13. Von Graevenitz A. 1991. Use of antimicrobial agents as tools in epidemiology, identification, and selection of microorganisms, p 723–738. In Lorian V (ed), Antibiotics in Laboratory Medicine, 3rd ed. The Williams & Wilkins Co, Baltimore, MD.

Tables

Generic image for table
Suggested QC strains for antimicrobial susceptibility testsa

Suggested QC strains for antimicrobial susceptibility tests

Citation: Leber A. 2016. Quality Assurance Measures for Antimicrobial Susceptibility Testing, p 5.17.1-5.17.13. In Clinical Microbiology Procedures Handbook, Fourth Edition. ASM Press, Washington, DC. doi: 10.1128/9781555818814.ch5.17
Generic image for table
Untitled

Citation: Leber A. 2016. Quality Assurance Measures for Antimicrobial Susceptibility Testing, p 5.17.1-5.17.13. In Clinical Microbiology Procedures Handbook, Fourth Edition. ASM Press, Washington, DC. doi: 10.1128/9781555818814.ch5.17
Generic image for table
Primary variables that must be controlled when performing routine disk diffusion and broth microdilution MIC testsa

Primary variables that must be controlled when performing routine disk diffusion and broth microdilution MIC tests

Citation: Leber A. 2016. Quality Assurance Measures for Antimicrobial Susceptibility Testing, p 5.17.1-5.17.13. In Clinical Microbiology Procedures Handbook, Fourth Edition. ASM Press, Washington, DC. doi: 10.1128/9781555818814.ch5.17
Generic image for table
Untitled

Citation: Leber A. 2016. Quality Assurance Measures for Antimicrobial Susceptibility Testing, p 5.17.1-5.17.13. In Clinical Microbiology Procedures Handbook, Fourth Edition. ASM Press, Washington, DC. doi: 10.1128/9781555818814.ch5.17

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