Perceptions of a medical microbiology service: a survey of laboratory users

The Impact of Information Quality of Antimicrobial Susceptibility Test Report on the Rational Antimicrobial Use: A Retrospective Study

Background

Antimicrobial susceptibility test (AST) report was important for rational antimicrobial use. However, the reference value of AST report was sometimes limited due to poor information quality (IQ). This study aimed to measure the IQ of AST and evaluate the impact of IQ of AST report on rational antimicrobial use as a reference for antimicrobial therapy.

Methods

The retrospective study included data of AST report, antimicrobials prescribed after reporting AST results and related inpatient information. The inclusion criteria of the AST report included three conditions: 1. The AST reports were from inpatients with diagnosis of infection. 2. The bacteria were extracted from a sterile-site specimen. 3. The interpretive categories (ie sensitive, intermediary or resistance) were firstly reported during one hospitalization. The IQ of AST report was measured by the total IQ and IQ of completeness, usefulness, accuracy and consistency. The rational antimicrobial use was measured by the antimicrobial adherence to the interpretive categories of AST report. Fractional logit regression model (FLRM) was chosen to evaluate the impact of IQ on the rational antimicrobial use.

Results

The median of the total IQ, completeness, usefulness, accuracy and consistency were 0.7345, 0.6082, 0.9167, 0.8966 and 1.0000, respectively. The results of FLRM showed that usefulness, accuracy and consistency had significant positive impacts on the rational antimicrobial use (β = 4.220, P < 0.001; β = 3.987, P < 0.001; β = 0.511, P = 0.001, respectively), while the total IQ and completeness had no statistically significant impacts on the rational antimicrobial use (β = -0.820, P = 0.35; β = -0.793, P = 0.20, respectively).

Conclusion

This study confirmed that usefulness, accuracy and consistency performed well and had positive impacts on the rational antimicrobial use, which indicated that improving IQ especially usefulness, accuracy and consistency would make AST report play a greater role in promoting the rational antimicrobial use.

A natural history museum visitor survey of perception, attitude and knowledge (PAK) of microbes and antibiotics

A kiosk-based survey at the American Museum of Natural History in New York City in 2016-2018 allowed us to assess public knowledge of antibiotics and public attitudes toward microbes in museum goers. Over 22,000 visitors from 172 countries and territories answered several carefully designed questions about microbes and antibiotics. These visitors also entered age, gender, and country demographic data that allowed for stratification along these demographic and geographic divisions. Because museum goers are likely to be better informed about these and other science-based topics, the results described here can set a potential upper bound for public knowledge on these topics. Surprisingly, the results of our analysis of museum goers' answers about microbes and antibiotics indicate a substantial lack of familiarity with both topics. For example, overall only about 50% of respondents can correctly identify penicillin as an antibiotic and less than 50% of museum visitors view microbes as beneficial. The results described here suggest that we are perhaps off target with our educational efforts in this area and that a major shift in approach toward more basic microbial topics is warranted in our educational efforts.

The impact of laboratory reporting practice on antibiotic utilisation

Microbiology reports are often misinterpreted by clinicians, which may lead to inappropriate antibiotic prescribing. Restricted release of susceptibilities combined with interpretative comments, can have a positive impact on the level of appropriate antibiotic use. Such a system requires two-way communication between the laboratory and the clinician and the laboratory's reporting practices should encourage such communication. The production and transmission of clinically relevant microbiology reports should be an integral part of infectious disease management programmes in hospitals.