Using internet discussion of antimicrobial susceptibility databases for continuous quality improvement of the testing and management of antimicrobialresistance

Accurate results from the world's microbiology laboratories are essential f or care of patients, control of hospital and community infections, and glob al epidemiology. Yet those laboratories differ greatly in their access to s upplies, published literature and standards, training courses, peer interac tion, and mandated quality control. Because much of what is needed is infor mation, new information technology should help. In particular, measurements of susceptibility to antimicrobial agents, now increasingly filed in elect ronic databases, exhibit many kinds of variances due both to test performan ce and to the diversity of bacteria and of their mechanisms of resistance. In industry, workers' ongoing evaluation of variances in measurements of pe rformance has been the basis of management programs of continuous quality i mprovement. Examples suggest how collegial evaluation of variances in share d susceptibility test data might similarly improve quality not only of test ing but also of other aspects of the management of antimicrobial resistance . Internet access is now making such ongoing evaluation and discussion incr easingly possible in most parts of the world.