Jundishapur Scientific Medical Journal

Jundishapur Scientific Medical Journal

Evaluation of Results from 30 Courses of Iran's National External Quality Control Program for Microbiology (2013-2023)

Document Type : Original Article

Authors
Alireza Ekrami 1
Arshid Yousefi Avarvand 2
1 Associate Professor Department of Clinical Laboratory Sciences, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
2 Assistant Professor Department of Clinical Laboratory Sciences, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
10.32592/jsmj.24.2.114
Abstract
Background and Objectives Accurate laboratory results play a vital role in diagnosing diseases and determining the proper course of treatment. The reliability of laboratory results is especially important in clinical microbiology, where identifying infectious agents can guide life-saving interventions. External Quality Assessment (EQA) programs serve as a pivotal mechanism to evaluate the performance of laboratories, ensure standardization, and enhance diagnostic quality. This study assesses the ten-year outcomes (2013–2023) of Iran's national external quality control program for medical microbiology. It examines trends in diagnostic accuracy, identifies common errors, and offers insights for quality improvement in Iranian clinical laboratories.
Subjects and Methods Data were collected from the official website of the Iranian Association of Laboratory Sciences. This dataset encompassed responses submitted by participating laboratories between 2013 and 2023. SPSS software was used for data analysis. The study extracted microbial identification results from various rounds of external quality assessments. The focus was on the correct identification of key bacterial species: Gram-positive, Gram-negative, and acid-fast bacteria. Furthermore, the study analyzed response rates, accuracy percentages, and the frequency of false positives and semi-correct identifications across all rounds.
Results Response rates were high, with over 95% of laboratories submitting results, and more than 97% of these were deemed valid. The highest correct identification rate was for Escherichia coli in cycle 45 (92.5%), while the lowest was for Aeromonas hydrophila in cycle 22 (3.9%). The mean correct, partially correct, and combined correct/partially correct identification rates were 42.3%, 20.3%, and 62.7%, respectively. Among the 30 evaluated cycles, 9 focused on Gram-positive and 21 on Gram-negative bacteria. The mean correct identification rate for Gram-positive bacteria (59.3%) was higher than for Gram-negative bacteria (34.1%), although this difference was not statistically significant. The mean correct identification rate for acid-fast bacteria was 57.2%, a finding of notable concern.
Conclusion The results of this study reveal an unfavorable landscape of laboratory diagnostic performance in this field. Therefore, prioritized attention in national planning and policy-making is essential.
Keywords
Clinical Laboratory Sciences
External Quality Control
Quality Improvement
Standardized Methods
Subjects

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  • Receive Date 15 February 2025
  • Revise Date 12 April 2025
  • Accept Date 19 April 2025