Trollip André, Gadde Renuka, Datema Tjeerd, Gatwechi Kamau, Oskam Linda, Katz Zachary, Whitelaw Andrew, Kinyanjui Peter, Njukeng Patrick, Wendifraw Dawit A, Mugerwa Ibrahimm, Najjuka Grace, Dayie Nicholas, Opintan Japheth A, Albert Heidi
Foundation for Innovative New Diagnostics (FIND) South Africa, Cape Town, South Africa.
Becton, Dickinson & Company, Franklin Lakes, New Jersey, United States.
Afr J Lab Med. 2022 Jun 20;11(1):1476. doi: 10.4102/ajlm.v11i1.1476. eCollection 2022.
In low-resource settings, antimicrobial resistance (AMR) is detected by traditional culture-based methods and ensuring the quality of such services is a challenge. The AMR Scorecard provides laboratories with a technical assessment tool for strengthening the quality of bacterial culture, identification, and antimicrobial testing procedures.
To evaluate the performance of the AMR Scorecard in 11 pilot laboratory evaluations in three countries also assessed with the Stepwise Laboratory Quality Improvement Process Towards Accreditation (SLIPTA) checklist.
Pilot laboratory evaluations were conducted in Cameroon, Ethiopia and Kenya between February 2019 and March 2019. Assessors with previous SLIPTA and microbiology experience were trained. Assessors performed the laboratory assessments using the SLIPTA and AMR Scorecard tools.
Weaknesses in technical procedures and the quality management systems were identified in all areas and all laboratories. Safety had the highest mean performance score (SLIPTA: 68%; AMR Scorecard: 73%) while management review had the lowest (SLIPTA: 32%; AMR Scorecard: 8%) across all laboratories. The AMR Scorecard scores were generally consistent with SLIPTA scores. The AMR Scorecard identified technical weaknesses in AMR testing, and SLIPTA identified weaknesses in the quality management systems in the laboratories.
Since the AMR Scorecard identified important gaps in AMR testing not detected by SLIPTA, it is recommended that microbiology laboratories use SLIPTA and the AMR Scorecard in parallel when preparing for accreditation. Expanding the use of the AMR Scorecard is a priority to address the need for quality clinical microbiology laboratory services in support of optimal patient care and AMR surveillance.
在资源匮乏地区，通过传统的基于培养的方法检测抗菌药物耐药性（AMR），而确保此类服务的质量是一项挑战。AMR记分卡为实验室提供了一种技术评估工具，以加强细菌培养、鉴定和抗菌药物检测程序的质量。
在三个国家的11次试点实验室评估中，使用逐步实验室质量改进以实现认可（SLIPTA）检查表对AMR记分卡的性能进行评估。
2019年2月至2019年3月期间，在喀麦隆、埃塞俄比亚和肯尼亚进行了试点实验室评估。对具有SLIPTA和微生物学经验的评估人员进行了培训。评估人员使用SLIPTA和AMR记分卡工具进行实验室评估。
在所有领域和所有实验室中都发现了技术程序和质量管理体系的薄弱环节。在所有实验室中，安全方面的平均绩效得分最高（SLIPTA：68%；AMR记分卡：73%），而管理评审方面的得分最低（SLIPTA：32%；AMR记分卡：8%）。AMR记分卡得分通常与SLIPTA得分一致。AMR记分卡确定了AMR检测中的技术薄弱环节，SLIPTA确定了实验室质量管理体系中的薄弱环节。
由于AMR记分卡发现了SLIPTA未检测到的AMR检测中的重要差距，建议微生物实验室在准备认可时同时使用SLIPTA和AMR记分卡。扩大AMR记分卡的使用是当务之急，以满足高质量临床微生物实验室服务的需求，以支持最佳患者护理和AMR监测。
