countries, and their diagnosis and treatment represent a significant challenge
to the health services in those areas. The World Health Organization has long
been actively involved in developing and promoting standard techniques for
laboratory investigations of such diseases, a first attempt to standardize susceptibility
testing of bacterial pathogens being made in 1960.1 Following on
from this, in 1976, the WHO Expert Committee on Biological Standardization
drew up requirements for antibiotic susceptibility testing using the disc
method.2
At the same time, efforts were being made to introduce quality control into
laboratory performance. In 1981, WHO established an International External
Quality Assessment Scheme for Microbiology. The laboratories that are
involved in this scheme are able to play a leading role in the implementation
of national quality assessment schemes at all levels of the health care system.
The present publication brings together and updates the various guidelines
produced by WHO over the years on sampling of specimens for laboratory
investigation, identification of bacteria, and testing of antimicrobial resistance.
The information included is intended to lead to harmonization of microbiological
investigations and susceptibility testing, and to improve the quality of
laboratories at both central and intermediate levels. It concentrates on the procedures
to be followed, rather than the basic techniques of microscopy and
staining, which have been described in detail in another WHO publication.3
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