Internal quality assurance in diagnostic microbiology: A simple approach for insightful data.

Details

Ressource 1Download: journal.pone.0187263.pdf (1300.70 [Ko])
State: Public
Version: Final published version
Serval ID
serval:BIB_83714D5D0CE7
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
Internal quality assurance in diagnostic microbiology: A simple approach for insightful data.
Journal
PloS one
Author(s)
Scherz V., Durussel C., Greub G.
ISSN
1932-6203 (Electronic)
ISSN-L
1932-6203
Publication state
Published
Issued date
2017
Peer-reviewed
Oui
Volume
12
Number
11
Pages
e0187263
Language
english
Notes
Publication types: Journal Article
Publication Status: epublish
Abstract
Given the importance of microbiology results on patient care, high quality standards are expected. Internal quality assurance (IQA) could mitigate the limitations of internal quality control, competency assessment and external quality assurance, adding a longitudinal insight, including pre- and post-analytical steps. Here, we implemented an IQA program in our clinical microbiology facilities with blind resubmission of routine samples during 22 months. One-hundred-and-twenty-one out of 123 (98.4%) serological analyses and 112 out of 122 (91.8%) molecular analyses were concordant. Among the discordances in molecular biology analyses, 6 results were low positive samples that turned out negative, likely due to stochastic repartition of nucleic acids. Moreover, one identified retranscription error led us to implement automated results transmission from the Applied Biosystems instruments to the laboratory information system (LIS). Regarding Gram stain microscopy, 560 out of 745 (75.2%) of compared parameters were concordant. As many as 67 out of 84 (79.8%) pairs of culture results were similar, including 16 sterile pairs, 27 having identical identification or description and semi-quantification and 24 only showing variations in semi-quantification with identical description or identification of colonies. Seventeen pairs had diverging identification or description of colonies. Culture was twice only done for one member of the pairs. Regarding antibiotic susceptibility testing, a major discrepancy was observed in 5 out of 48 results (10.4%). In conclusion, serological tests were highly reproducible. Molecular diagnosis also revealed to be robust except when the amounts of nucleic acids present in the sample were close to the limits of detection. Conventional microbiology was less robust with major discrepancies reaching 39.5% of the samples for microscopy. Similarly, culture and antibiotic susceptibility testing were prone to discrepancies. This work was ground for reconsidering multiples aspects of our practices and demonstrates the importance of IQA to complete the other quality management procedures.

Keywords
Humans, Longitudinal Studies, Microbial Sensitivity Tests, Microbiology, Quality Assurance, Health Care, Reproducibility of Results, Stochastic Processes
Pubmed
Web of science
Open Access
Yes
Create date
16/11/2017 20:50
Last modification date
20/08/2019 14:43
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