The role of surveillance systems in confronting the global crisis of antibiotic-resistant bacteria

Abstract

Purpose of Review It is widely accepted that infection control, advanced diagnostics, and novel therapeutics are crucial to mitigate the impact of antibiotic-resistant bacteria. The role of global, national and regional surveillance systems as part of the response to the challenge posed by antibiotic resistance is not sufficiently highlighted. We provide an overview of contemporary surveillance programs, with emphasis on Gram-negative bacteria. Recent Findings The World Health Organization and public health agencies in Europe and the United States recently published comprehensive surveillance reports. These highlight the emergence and dissemination of carbapenem-resistant Enterobacteriaceae (CRE) and other multidrug resistant Gram-negative bacteria. In Israel, public health action to control CRE, especially Klebsiella pneumoniae carbapenemase (KPC) producing-Klebsiella pneumoniae, has advanced together with a better understanding of its epidemiology. Surveillance models adapted to the requirements and capacities of each country are in development. Summary Robust surveillance systems are essential to combat antibiotic resistance, and need to emphasize a “One Health” approach. Refinements in surveillance will come from advances in bioinformatics and genomics that permit the integration of global and local information about antibiotic consumption in humans and animals, molecular mechanisms of resistance, and bacterial genotyping.

Prescription for antibiotics at drug shops and strategies to improve quality of care and patient safety: a cross-sectional survey in the private sector in Uganda

“…An earlier study in Uganda also found that of the patients who sought treatment at private clinics within 1 week of onset of symptoms, only 7% of them were properly managed. [16][17][18][19][20][21][22] Similar findings have been documented in Ghana where a high proportion, 70% of the respondents, practiced self-medication, and the most common antibiotic used was amoxicillin. 23 It is noted that the majority of drug shops (53.3%), were injecting patients probably with gentamicin and penicillin, to treat other bacterial infections like skin infections and urethritis or urinary tract infections.…”

In Vitro Activity of Delafloxacin against Contemporary Bacterial Pathogens from the United States and Europe, 2014

“…Active surveillance and antimicrobial stewardship efforts are essential to combat this threat to patient safety across all health care settings (23, 24). In the present survey, we examined the in vitro susceptibility profiles of 6,485 isolates of GPC and GNB from European and U.S. medical centers for the year 2014.…”

Surveillance of Omadacycline Activity against Clinical Isolates from a Global Collection (North America, Europe, Latin America, Asia-Western Pacific), 2010-2011

“…Active surveillance and antimicrobial stewardship efforts are essential for combating this threat to patient safety across all health care settings (3,19). In the present survey, we have established the baseline in vitro susceptibility profiles of omadacycline for 69,246 isolates of GPC and GNB from medical centers in the APAC region, EU, LA, and NA for the years 2010 and 2011.…”

“…In the United Kingdom, it is estimated that drug-resistant infections might account for 10 million deaths per year by 2050, with total costs of $100 trillion in lost output (1). Collection of AMR surveillance and antibiotic consumption data is an essential approach to both defining the scope of the resistance problem and developing interventions that improve appropriate use of antibiotics and decrease resistance selection pressure (1,3). Another important effort is to understand the mechanisms of resistance whereby bacteria avoid the effects of antibiotics and to use this information to develop new agents, or modify older agents, such that potent activity is retained against the key target pathogens (4-6).…”