Surveillance of Antimicrobial Resistance
Surveillance of antimicrobial resistance tracks changes in microbial populations, permits the early detection of resistant strains of public health importance, and supports the prompt notification and investigation of outbreaks. Surveillance findings are needed to inform clinical therapy decisions, to guide policy recommendations, and to assess the impact of resistance containment interventions.
Types of surveillance
Appropriate strategies for surveillance of antimicrobial resistance should reflect identified scientific or public health objectives, resources and available technical capacity for testing, and sustainability. A combination of complementary approaches is often desirable.
- Alert organism tracking: the identification, confirmation, and communication of specific organisms of great public health importance, such as vancomycin-resistant Staphylococcus aureus or extensively drug-resistant Mycobacterium tuberculosis (XDR-TB).
- Enhanced routine surveillance: the active review, interpretation, confirmation, and investigation of results generated in the course of routine clinical care.
- Targeted surveys: one-time or periodic study protocols to address specific scientific or public policy needs not adequately addressed by routine diagnostic test results.
The role of the microbiology laboratory
A key partner is the microbiology laboratory. Healthcare workers and public health authorities rely on the work and expertise of laboratory staff to determine:
- what organism is causing a patient infection
- what antimicrobials would be effective treatment options
The WHO Global Strategy for Containment of Antimicrobial Resistance identifies the establishment and support of microbiology laboratories as a fundamental priority in guiding and assessing intervention efforts. This requires trained and motivated laboratory professionals, materials and equipment, mechanisms for assuring the quality of test performance, and communication with clinicians and public health authorities.
Software for surveillance of antimicrobial resistance
Surveillance of Antimicrobial Use and Antimicrobial Resistance
Antimicrobial resistance surveillance is enhanced when linked to monitoring of antimicrobial use practices. The collaborative efforts of the European Antimicrobial Resistance Surveillance System (EARSS) and the European Surveillance of Antimicrobial Consumption program (ESAC) have demonstrated that the integrated monitoring of resistance, use, and costs can prove the crucial factor driving political commitment to successful resistance containment campaigns.
- Surveillance of antimicrobial use
- EARSS - European Antimicrobial Resistance Surveillance System
- ESAC - European Surveillance of Antimicrobial Consumption
Antimicrobial resistance surveillance guidelines
Acute bacterial infections
- Antimicrobial Resistance Surveillance: Questionnaire for Assessment of National Networks (228K) (2003)
HIV, Malaria, Tuberculosis
- Implementing Antimicrobial Drug Resistance Surveillance and Containment for HIV, Tuberculosis and Malaria (923K) (2003)
- Monitoring the Emergence of Antiretroviral Resistance. Report of a WHO Consultation. Rome, 10-11 October 2000 (228K) (2001)
Human, Animal, and Food Isolates
- First Meeting of the WHO Advisory Group on Integrated Surveillance of Antimicrobial Resistance. Copenhagen, 15-19 June 2009
- Community-Based Surveillance of Antimicrobial Use and Resistance in Resource-Constrained Settings : Report on Five Pilot Projects (1.40M) (2009)