Detection of Antimicrobial Resistance
Antimicrobial Susceptibility Tests
For most commonly isolated bacterial and fungal pathogens, reliable antimicrobial susceptibility testing can be performed by routine hospital, community, public health, food, and veterinary laboratories. The most common methods utilized are the disk diffusion susceptibility test method (also known as Kirby-Bauer) and minimal inhibitory concentration (MIC) determination.
- Manual for the Laboratory Identification and Antimicrobial Susceptibility Testing of Bacterial Pathogens of Public Health Importance in the Developing World
- Manual de Laboratorio para la Identificación y Prueba de Susceptibilidad a los Antimicrobianos de Patógenos Bacterianos de Importancia para la Salud Pública en el Mundo en Desarrollo (3.02M) (2003)
For viruses, parasites, and some bacterial species, the expertise and resources needed for susceptibility testing are beyond the capacity of most routine microbiology laboratories. Consequently susceptibility testing either is not performed or is conducted primarily in reference laboratories.
Laboratory capacity-building and quality assurance
The value of laboratory findings to clinicians and public health authorities depends critically on the reliability of the test results. This requires the use of reagents and equipment of good quality and the training, experience, and motivation of laboratory staff. CLSI, EUCAST, and others describe strategies and protocols for assuring the quality of antimicrobial susceptibility test results.
WHO Headquarters, Lyon Office, Regional Offices, national offices, and Collaborating Centres are active in supporting training activities, quality assurance programs, and resources to laboratories.
- WHO Lyon Office
- TB Global Laboratory Initiative (GLI)
- HIV Laboratory Network
- Global survey of laboratory quality standards and External Quality Assessment Schemes (EQAS)
- WHO Collaborating Centres
- Policy and procedures of the WHO/NICD Microbiology External Quality Assessment Programme in Africa (1.42M) (2007)
- PAHO Recommendations of a Group of Experts: Standards for the Use of Automated Identification Systems for Bacteria and Susceptibility to Antimicrobials. Brasilia, Brazil, 26–28 October 2004
- PAHO Recommendations of an Expert Committee: Performance Evaluation Standards for the Kirby-Bauer Antibiogram (Areas of Inhibition or Interpretation). Santiago, Chile, 24–26 February 2003