The methodology of surveillance for antimicrobial resistance and healthcare-associated infections in Europe (SUSPIRE): a systematic review of publicly available information

Abstract

Publicly available information about the methods and indicators of the surveillance system is frequently lacking. Despite the efforts of European Centre for Disease Control and Prevention (ECDC) and other organizations, wide heterogeneity in procedures and indicators still exists.

Surveillance of antimicrobial resistance in low- and middle-income countries: a scattered picture

“…Some countries may report data from national surveillance systems with broad population coverage, and others may report data from a subset of local laboratories, clinics, and healthcare settings focusing on one area and limiting the representativeness of data on the national level [55]. As the validity of surveillance systems relies on the comparability of participating laboratories [180], each may have different trends of AMR surveillance and different level of capacity for identifying the microorganisms and may show differences in the applied methodology and quality assurance limiting benchmarking [55,181,182]. Other inconsistencies across participating laboratories include differences in sampling, the use of different clinical case definitions, and the heterogeneous healthcare utilization [181].…”

“…The rationale behind the constant search for newer techniques lies in the remarkable increase of multidrug-resistant organisms that requires rapid actions in the treatment and administration of the accurate drug [188]. Standard bacterial culture and antimicrobial testing can take several days while WGS takes only 24 h and could be used for rapid diagnosis and in urgent cases [180].…”

Antimicrobial Resistance Surveillance and New Drug Development

“…It has been demonstrated that the magnitude of PK-PD targets associated with different levels of reduction in bacterial infection burden, as generated using data from in vivo studies, is similar to the magnitude of PK-PD indices associated with successful responses among infected patients enrolled in clinical trials [66]. The concordance between nonclinical and clinical PK-PD targets for efficacy across numerous classes of agents provides the basis for applying PK-PD principles to reduce risk in drug development [2, 67, 68].…”

“…The worldwide spread of antimicrobial resistance continues to challenge physicians and drug development researchers, and it has been recognized as a global public health threat [1]. Because of the geographical diversity, complexity, and continuously evolving dynamics of resistant organisms and complex resistance mechanisms, structured surveillance is a key tool for planning actions to manage this problem [2]. Antimicrobial resistance surveillance (ARS) programs may have many different objectives, including the following: (1) detecting the emergence of novel resistance phenotypes and mechanisms of resistance; (2) recognizing, understanding, and predicting trends in resistance; (3) monitoring the impact of the introduction/clinical use of new antimicrobial agents; (4) identifying outbreaks of resistant organisms; (5) guiding infection control and public health measures; and (6) providing data for new drug applications (NDAs) or other submissions to regulatory agencies, such as the US Food and Drug Administration (FDA) and European Medicines Agency (EMA).…”

The Importance of Antimicrobial Resistance Monitoring Worldwide and the Origins of SENTRY Antimicrobial Surveillance Program

“…Antimicrobial resistance (AMR) is an ongoing problem with multidrug-resistant strains of bacteria and fungi impacting medical progress in many regions of the world. Collecting AMR surveillance data is an essential approach to (1) define the scope of the resistance problem, (2) develop interventions that improve the appropriate application of antimicrobial agents, and (3) decrease resistance selection pressure [1, 2]. Other important efforts are underway to understand the mechanisms of resistance whereby microorganisms avoid the effects of antimicrobials and to use that information to discover/develop new compounds, or modify older agents, that retain potent activity against key target pathogens [3].…”