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

Accurate results from the world's microbiology laboratories are essential for care of patients, control of hospital and community infections, and global epidemiology. Yet those laboratories differ greatly in their access to supplies, published literature and standards, training courses, peer interaction, and mandated quality control. Because much of what is needed is information, new information technology should help. In particular, measurements of susceptibility to antimicrobial agents, now increasingly filed in electronic databases, exhibit many kinds of variances due both to test performance and to the diversity of bacteria and of their mechanisms of resistance. In industry, workers' ongoing evaluation of variances in measurements of performance has been the basis of management programs of continuous quality improvement. Examples suggest how collegial evaluation of variances in shared susceptibility test data might similarly improve quality not only of testing but also of other aspects of the management of antimicrobial resistance. Internet access is now making such ongoing evaluation and discussion increasingly possible in most parts of the world.