Ms Jo An Clemente1, Ms. Katie Desobry1
1LBJ Tropical Medical Center, Pago Pago, American Samoa
Biography:
Ms. Jo An Clemente serves as the Infection Prevention and Control Nurse at LBJ Tropical Medical Center in American Samoa. In addition to her Certification in Infection Prevention and Control (CIC), she has more than 15 years of experience as a Registered Nurse in Pediatrics and OB-GYN.
Abstract:
At LBJ Tropical Medical Center, the only tertiary care facility in American Samoa, annual multidrug-resistant organism (MDRO) rates appeared to rise sharply from 9.8% in 2023 to 21% in 2024. This unexpected increase prompted a quality assurance review by the Infection Prevention Department to determine whether the trend reflected a true rise in resistant cases or artifacts of the existing surveillance methodology.
Historically, MDRO metrics had been calculated using all positive cultures, including multiple isolates from the same patient. To improve data accuracy, the team initiated a retrospective review of 2023 and 2024 microbiology records, re-entering all isolated into a parallel system designed to eliminate duplicate cultures from the same patient. By applying a "patient-first isolate" rule for each organism-year combination, the team aimed to identify whether the apparent increase represented a rise in unique affected patients or was artificially inflated by repeat testing.
This project underscores the critical importance of standardized definitions, deduplication logic, and routine validation in infection surveillance programs, particularly in resource-limited settings. Data quality improvements not only enhance internal reporting but also strengthen external benchmarking and antimicrobial resistance response strategies.