title: Antimicrobial susceptibility testing of Streptococcus pneumoniae and Haemophilus influenzae --internal quality control as a quality tool on a national level.
abstract: Knowledge of the quality and conformity of antimicrobial resistance data is important for comparing resistance rates regionally and over time. In this study, we have evaluated these features of the Finnish national susceptibility surveillance data for two respiratory tract pathogens, Streptococcus pneumoniae and Haemophilus influenzae. For this purpose internal quality control results for two isolates (S. pneumoniae ATCC 49619 and H. influenzae ATCC 49247) were analyzed from 21 clinical microbiology laboratories over a 3-year period. The results show that standardization of the susceptibility testing methods has proceeded well. The number of protocols used for susceptibility testing has declined (from seventeen methods to two with S. pneumoniae and from eleven to three with H. influenzae) and the reproducibility is good. Nevertheless, we noticed that a few laboratories test and report susceptibility results without defined break-points and even include antimicrobials with questionable therapeutic effect. Another non-compliance with the standard was a lack of a regular control system to verify the attainment of the intended quality of results in some laboratories. Interlaboratory analysis of quality control results is a good way to evaluate the quality and conformity of national resistance data. Finnish laboratories have produced very reproducible and accurate susceptibility results in the pre-EUCAST period, which ended in 2011.
authors.affiliation: Päijät-Häme Social and Health Care Group, Clinical Microbiology, Lahti, Finland. pauliina.karpanoja@phsotey.fi
authors.forename: Pauliina
authors.initials: P
authors.lastname: Kärpänoja
authors.forename: Antti
authors.initials: A
authors.lastname: Nissinen
authors.forename: Pentti
authors.initials: P
authors.lastname: Huovinen
authors.forename: Hannu
authors.initials: H
authors.lastname: Sarkkinen
mesh_terms: D019980:Amoxicillin-Potassium Clavulanate Combination / Q000494:pharmacology; D000900:Anti-Bacterial Agents / Q000494:pharmacology*; D017963:Azithromycin / Q000494:pharmacology; D052978:Disk Diffusion Antimicrobial Tests / Q000592:standards*; D005387:Finland; D006193:Haemophilus influenzae / Q000187:drug effects*; D011786:Quality Control; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D013296:Streptococcus pneumoniae / Q000187:drug effects*; D011795:Surveys and Questionnaires
chemical_list: D000900:Anti-Bacterial Agents; D019980:Amoxicillin-Potassium Clavulanate Combination; D017963:Azithromycin