[PPT]Microbiology QC - WHO | World Health Organization · Web viewTitle Microbiology QC Author...
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Quality Control of Antimicrobial Susceptibility Tests
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QC Antimicrobial Susceptibility Testing - Module 8 22
Antimicrobial Susceptibility Tests
provide information for selection ofan appropriate agent for antimicrobial therapy
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QC Antimicrobial Susceptibility Testing - Module 8 3
AST Methods Interpretation agar disk diffusion method
provides qualitative interpretive category results of susceptible, intermediate, and resistant
microdilution and agar gradient diffusion methods provide a quantitative result, a minimum inhibitory concentration
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QC Antimicrobial Susceptibility Testing - Module 8 4
AST Methods
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QC Antimicrobial Susceptibility Testing - Module 8 55
Clinical and Laboratory Standards Institute French Society of Microbiology British Society for Antimicrobial Chemotherapy
References
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QC Antimicrobial Susceptibility Testing - Module 8 6
Example from an excerpt from Reference:Selection of Drug to Test
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QC Antimicrobial Susceptibility Testing - Module 8 77
Where errors can occur in susceptibility testing media antimicrobials inoculum incubation equipment interpretation
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QC Antimicrobial Susceptibility Testing - Module 8 88
Agar disk diffusion method Medium Mueller Hinton 4 mm thickness
pH 7.2 to 7.4 Antibiotic storage -20oC minimum disks temperature
Inoculum McFarland 0.5 (108 bacteria/mL) Incubator temperature 35oC
atmosphere ambient air
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QC Antimicrobial Susceptibility Testing - Module 8 99
Reference Strains E. coli ATCC 25922 S. aureus ATCC 25923 P. aeruginosa ATCC 27853
QC organisms must be obtained from reputable source
Use specific QC organisms to test different groups of “drug-bug” combinations
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QC Antimicrobial Susceptibility Testing - Module 8 10
Selection of a Colony to Test
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QC Antimicrobial Susceptibility Testing - Module 8 11
MacFarland 0.5 and Adjusted Test Organism
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QC Antimicrobial Susceptibility Testing - Module 8 1212
Use of Disk Dispensers Advantages
practical, rapid increase
reproducibility
Risks:contaminationreduces personal
judgment skills
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QC Antimicrobial Susceptibility Testing - Module 8 1313
Disk Susceptibility Testing Problems
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QC Antimicrobial Susceptibility Testing - Module 8 14
Disk Susceptibility Testing Problems
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QC Antimicrobial Susceptibility Testing - Module 8 1515
Measuring Conditions
RulerCalipersread with good light, and from the back of the platezone size reading is drug specific magnification may helpmillimeters matter
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QC Antimicrobial Susceptibility Testing - Module 8 16
Etest – antimicrobial gradient method
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QC Antimicrobial Susceptibility Testing - Module 8 17
Patient results may be incorrect if: the organism was misidentified a clerical error was made inappropriate choice of antimicrobials
were tested and reported the wrong patient’s sample was examined the wrong test was ordered the sample was not preserved properly