The The Quality Improvement of Anti-microbial Susceptibility Test Using Individualized Quality Control Plan (IQCP) in Samutprakan Hospital

Abstract

Drug-resistant bacterial infection is a major medical problem. The result of antimicrobial susceptibility testing is important for physician decision making to select the appropriate antimicrobial agent and its level. In the anti-microbial susceptibility testing, the quality control is necessary for reliable results. However, general quality control plans may not be suitable for clinical microbiology laboratories. In this study, we implemented the Individualized Quality Control Plan (IQCP), a quality control plan specific to each laboratory in the laboratory work process, comprising pre-analytical, analytical, and post-analytical processes. This study identified 37 risk factors that caused the unreliable results. A total of 13 risk factors were required to be controlled by IQCP, 3 factors in the pre-analytical process, 6 factors in the analytical process and 4 factors in the post-analytical process.  After 1 year of IQCP implementation, the number of risk factors was reduced from 13 to only 2 factors, one in the pre-analytical process, namely non-isolated colony, and the other in the analytical process, namely the incorrect measurement of the inhibition zone size. The implementation of the IQCP for the quality control of antimicrobial susceptibility testing is very useful for improving specific laboratory work process to ensure that the laboratory is expecting and providing reliable results.