Ann Lab Med.  2015 Nov;35(6):635-638. 10.3343/alm.2015.35.6.635.

Establishing Quality Control Ranges for Antimicrobial Susceptibility Testing of Escherichia coli, Pseudomonas aeruginosa, and Staphylococcus aureus: A Cornerstone to Develop Reference Strains for Korean Clinical Microbiology Laboratories

• Hong SK
• Choi SJ
• Shin S
• Lee W
• Pinto N
• Shin N
• Lee K
• Hong SG
• Kim YA
• Lee H
• Kim H
• Song W
• Lee SH
• Yong D
• Lee K
• Chong Y

• KMID: 2363268
• DOI: http://doi.org/10.3343/alm.2015.35.6.635

Abstract

Quality control (QC) processes are being performed in the majority of clinical microbiology laboratories to ensure the performance of microbial identification and antimicrobial susceptibility testing by using ATCC strains. To obtain these ATCC strains, some inconveniences are encountered concerning the purchase cost of the strains and the shipping time required. This study was focused on constructing a database of reference strains for QC processes using domestic bacterial strains, concentrating primarily on antimicrobial susceptibility testing. Three strains (Escherichia coli, Pseudomonas aeruginosa, and Staphylococcus aureus) that showed legible results in preliminary testing were selected. The minimal inhibitory concentrations (MICs) and zone diameters (ZDs) of eight antimicrobials for each strain were determined according to the CLSI M23. All resulting MIC and ZD ranges included at least 95% of the data. The ZD QC ranges obtained by using the CLSI method were less than 12 mm, and the MIC QC ranges extended no more than five dilutions. This study is a preliminary attempt to construct a bank of Korean QC strains. With further studies, a positive outcome toward cost and time reduction can be anticipated.

Keyword

Agar dilution test; Antimicrobial susceptibility test; Clinical microbiology laboratory; Disk diffusion test; Quality control; Reference strain

MeSH Terms

Anti-Bacterial Agents/*pharmacology
Asian Continental Ancestry Group
Escherichia coli/*drug effects
Humans
Laboratories
Microbial Sensitivity Tests/*methods
Pseudomonas aeruginosa/*drug effects
Quality Control
Reference Values
Republic of Korea
Staining and Labeling
Staphylococcus aureus/*drug effects
Anti-Bacterial Agents

Reference

1. Turnidge J, Bordash G. Statistical methods for establishing quality control ranges for antibacterial agents in Clinical and Laboratory Standards Institute susceptibility testing. Antimicrob Agents Chemother. 2007; 51:2483–2488. PMID: 17438045.

2. Clinical and Laboratory Standards Institute. Development of in vitro susceptibility testing criteria and quality control parameters; approved guideline-third ed. M23-A3. Wayne, PA: Clinical and Laboratory Standards Institute;2008.

3. Gavan TL, Jones RN, Barry AL, Fuchs PC, Gerlach EH, Matsen JM, et al. Quality control limits for ampicillin, carbenicillin, mezlocillin, and piperacillin disk diffusion susceptibility tests: a collaborative study. J Clin Microbiol. 1981; 14:67–72. PMID: 6455443.

4. Clinical and Laboratory Standards Institute. Performance standards for antimicrobial susceptibility testing. Twenty-second informational supplement, M100-S22. Wayne, PA: Clinical Laboratory Standards Institute;2012.

5. Clinical and Laboratory Standards Institute. Methods for dilution antimicrobial susceptibility tests for bacteria that grow aerobically; approved standard-eighth ed. M07-A8. Wayne, PA: Clinical and Laboratory Standards Institute;2009.

6. Clinical and Laboratory Standards Institute. Performance standards for antimicrobial disk susceptibility tests; approved standard-tenth ed. M02-A10. Wayne, PA: Clinical and Laboratory Standards Institute;2009.

7. Kuper KM, Boles DM, Mohr JF, Wanger A. Antimicrobial susceptibility testing: a primer for clinicians. Pharmacotherapy. 2009; 29:1326–1343. PMID: 19857149.

8. Shin SY, Koo SH, Kwon KC, Park JW, Ko CS, Song JH, et al. Evaluation of the Vitek 2 Korean Antimicrobial Susceptibility Testing Cards AST N056 and AST N055. Korean J Clin Microbiol. 2008; 11:23–28.

9. Njoroge SW. Risk management in the clinical laboratory. Ann Lab Med. 2014; 34:274–278. PMID: 24982831.