Antimicrobial susceptibility testing trends and accuracy in the United States. A review of the College of American Pathologists Microbiology Surveys, 1972-1989. Microbiology Resource Committee of the College of American Pathologists

Abstract

The ability of the College of American Pathologists Microbiology Surveys subscriber laboratories to perform antimicrobial susceptibility testing accurately has improved slightly since 1984. Currently (1989 surveys), the accuracies for disk diffusion and minimum inhibitory concentration antimicrobial susceptibility testing were 98.2% and 96.1%, respectively. Disk diffusion testing has recently (since 1986) become more popular, along with rapid automated systems, such as the AMS-Vitek System (St Louis, Mo). Rapid tests for beta-lactamase and chloramphenicol acetyltransferase have performed well. Quality control procedures have switched to a cost-effective weekly frequency pattern for nearly 70% of laboratories. Some antimicrobial susceptibility testing problems still exist among anaerobic bacterial methods, procedures for fastidious organisms (Haemophilus, Streptococcus species, Moraxella, pneumococci, gonococci), tests for oxacillin-resistant staphylococci, and the methods for use against nonenteric gram-negative or gram-positive bacilli. Antimicrobial susceptibility testing users subscribing to the College of American Pathologists surveys should strictly follow the National Committee for Clinical Laboratory Standards interpretive and quality control criteria to assure the best performance with the Clinical Laboratory Improvement Act, 1988, compliant College of American Pathologists proficiency sample program.