National prevalence survey in Brazil to evaluate the quality of microbiology laboratories: the importance of defining priorities to allocate limited resources

Abstract

This report describes a survey of microbiology laboratories (n = 467) serving Brazilian hospitals with ≥10 intensive care beds and/or involved in the government health care adverse event reporting system. Coordinators were interviewed and laboratories classified as follows: Level 0 (no minimal functioning conditions-85.4% of laboratories); Level 1 (minimal functioning conditions but inadequate execution of basic routine-6.7%); Level 2 (minimal functioning conditions and adequate execution of basic routine but no adequate procedures for quality control-5.8%); Level 3 (minimal functioning conditions, adequate execution of basic routine, and adequate procedures for quality control, but no direct communication with the infection control department-0.9%); Level 4 (minimal functioning conditions, adequate execution of basic routine, adequate procedures for quality control, and direct communication with infection control, but no available advanced resources-none); and Level 5 (minimal functioning conditions, adequate execution of basic routine, adequate procedures for quality control, direct communication with infection control, and available advanced resources-0.9%). Twelve laboratories did not perform Ziehl-Neelsen staining; 271 did not have safety cabinets; and >30% without safety cabinets had automated systems. Low quality was associated with serving hospitals not participating in government adverse-event program; private hospitals; nonteaching hospitals; and those outside state capitals. Results may reflect what occurs in many other countries where defining priorities is important due to limited resources.

Desempenho dos programas de prevenção e controle de infecções em pequenos hospitais

“…Outsourcing of microbiology services in many institutions has also been observed in other national studies (15,17) . This fact alerts to the possibility of obstacles to HICC actions, which depend on qualified and timely action regarding the results of microbiological tests.…”

Structure for prevention of health care–associated infections in Brazilian hospitals: A countrywide study

“…22 Besides this, our data reinforce the information from a previous Brazilian study regarding the weakness of structure and process of laboratories of microbiology linked to hospitals. 23 A major strength of our study was the on-site collection of data carried out by trained personnel, minimizing bias and contributing to greater accuracy of the survey. This was implied in an enormous effort from the research team to provide operational and logistic background for all of these visits.…”

Evaluation of the characteristics of infection prevention and control programs and infection control committees in Brazilian hospitals: A countrywide cross-sectional study

“…23,41 Outsourcing microbiology services, as reported by many centers in the present study, may create obstacles to the actions of the ICC, which depends on the turnover of microbiological results for timely IPC actions. 11,42 A strength of our study is the analysis of IPC programs from all 5 Brazilian regions, which provided a broad view of the country's reality that had not been possible in most previous publications. Limitations of the study include the eligibility criteria for inclusion of hospitals in the IMPACTO-MR program, based on which a sample of hospitals with better conditions was selected, which may have led to improved indicators in our survey.…”

“… 23 , 41 Outsourcing microbiology services, as reported by many centers in the present study, may create obstacles to the actions of the ICC, which depends on the turnover of microbiological results for timely IPC actions. 11 , 42 …”