External quality assessment of laboratory performance in bacteriology in the Eastern Mediterranean Region, 2011-2019/Evaluation externe de la qualite des performances des laboratoires en bacteriologie dans la Region de la Mediterranee orientale, 2011-2019

Background: Since 2007, national public health laboratories in the WHO Eastern Mediterranean Region (EMR) have participated in a regional external quality assessment scheme in bacteriology to improve testing proficiency. Aims: To assess laboratory performance in bacteriology in the EMR between 2011 and 2019 using the regional external quality assessment scheme. Methods: We analysed the accuracy of participant-reported data in bacterial identification, Gram stain microscopy, and antimicrobial susceptibility testing. For each category, we assessed the performance over time, the performance on multiple organisms, and whether a laboratory repeatedly failed to attain satisfactory results. Results: Between 2011 and 2019, 70% of laboratories achieved satisfactory performance for bacterial identification and antimicrobial susceptibility testing, and 85% performed satisfactory Gram stain microscopy. Testing did not improve on multiple organisms and results were consistently low for some pathogens and test categories. Twenty-nine percent of laboratories underperformed throughout the study period. Conclusion: The unchanged performance over time and underperformance of laboratories highlight the need for improvements in the regional external quality assessment scheme. Participating laboratories and WHO need to work more actively to strengthen the problem areas. Keywords: bacteriology, Eastern Mediterranean Region, external quality assessment scheme, laboratory performance, public health laboratories Contexte : Depuis 2007, les laboratoires de sante publique nationaux de la Region OMS de la Mediterranee orientale ont participe a un systeme regional d'evaluation externe de la qualite en bacteriologie afin d'ameliorer la bonne execution des analyses. Objectifs : Evaluer les performances des laboratoires en bacteriologie dans la Region de la Mediterranee orientale entre 2011 et 2019 a l'aide du systeme regional d'evaluation externe de la qualite. Methodes : Nous avons analyse l'exactitude des donnees communiquees par les participants concernant l'identification bacterienne, la microscopie apres coloration de Gram et les tests de sensibilite aux antimicrobiens. Pour chaque categorie, nous avons evalue la performance au fil du temps, la performance sur plusieurs micro-organismes et avons verifie si un laboratoire n'a pas obtenu des resultats satisfaisants a plusieurs reprises. Resultats : Entre 2011 et 2019, 70 % des laboratoires ont obtenu des resultats satisfaisants pour