Using information technology to improve surveillance of antimicrobial resistance in South East Asia

Vong, Sirenda; Anciaux, Amaury; Hulth, Anette; Stelling, John; Thamlikitkul, Visanu; Gupta, Sunil; Fuks, Jonas M.; Walia, Kāmini; Rattanumpawan, Pinyo; Eremin, Sergey; Tisócki, Klára; Sedai, Tika; Sharma, Anuj

doi:10.1136/bmj.j3781

Cited by 21 publications

(22 citation statements)

References 3 publications

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“…This could be because the interventions are poorly designed resulting in reduced prescribing of certain antibiotics but a parallel rise in prescribing alternative antibiotics, and the scarcity/ lack of integration of microbiology services in designing and implementing ASPs in hospitals. Further, microbiologists in the region report a lack of a standardised method for phenotypic and genotypic methods for antimicrobial susceptibility testing, and the sporadic and inconsistent reporting of antibiotic resistance bacteria; when antimicrobial resistance surveillance is conducted, it is typically in laboratories of large hospitals that are not linked within a national network [80].…”

Section: Discussionmentioning

confidence: 99%

Hospital adoption of antimicrobial stewardship programmes in Gulf Cooperation Council countries: A review of existing evidence

Alghamdi

Shebl

Aslanpour

et al. 2018

Journal of Global Antimicrobial Resistance

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Antimicrobial resistance is increasing at an alarming rate in the Gulf Cooperation Council (GCC) owing to the overuse and misuse of antimicrobials. Novel and rare multidrug-resistant strains can spread globally since the region is host to the largest expatriate population in the world as well as a pilgrimage destination for more than 4 million people annually. Adoption of antimicrobial stewardship programmes (ASPs) could improve the use of antimicrobials and reduce antimicrobial resistance in the region. However, despite the established benefits of these interventions, little is known about the level of their adoption in the region and the impact of these programmes on antimicrobial use and resistance. This study aimed to review existing evidence on the level of adoption of ASPs, the facilitators and barriers to their adoption, and outcomes of their adoption in GCC hospitals.

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Section: Discussionmentioning

confidence: 99%

Hospital adoption of antimicrobial stewardship programmes in Gulf Cooperation Council countries: A review of existing evidence

Alghamdi

Shebl

Aslanpour

et al. 2018

Journal of Global Antimicrobial Resistance

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“…Electronic capture of microbiology laboratory data remains a challenge in these countries (105), and use of Information and Technology (IT) for AMR surveillance is limited (177). The barriers to electronic capture include lack of data standards, lack of trained local and national IT workforces, technical problems, and system interoperability (177). Laboratories often rely on paper-based data capture, with limited use of laboratory information management systems (LIMS).…”

Section: Electronic Data Capturingmentioning

confidence: 99%

Antimicrobial Resistance Surveillance in Low- and Middle-Income Countries: Progress and Challenges in Eight South Asian and Southeast Asian Countries

Alvarez-Uria²,

et al. 2020

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SUMMARY Antimicrobial resistance (AMR) is a serious global health threat and is predicted to cause significant health and economic impacts, particularly in low- and middle-income countries (LMICs). AMR surveillance is critical in LMICs due to high burden of bacterial infections; however, conducting AMR surveillance in resource-limited settings is constrained by poorly functioning health systems, scarce financial resources, and lack of skilled personnel. In 2015, the United Nations World Health Assembly endorsed the World Health Organization’s Global Action Plan to tackle AMR; thus, several countries are striving to improve their AMR surveillance capacity, including making significant investments and establishing and expanding surveillance networks. Initial data generated from AMR surveillance networks in LMICs suggest the high prevalence of resistance, but these data exhibit several shortcomings, such as a lack of representativeness, lack of standardized laboratory practices, and underutilization of microbiology services. Despite significant progress, AMR surveillance networks in LMICs face several challenges in expansion and sustainability due to limited financial resources and technical capacity. This review summarizes the existing health infrastructure affecting the establishment of AMR surveillance programs, the burden of bacterial infections demonstrating the need for AMR surveillance, and current progress and challenges in AMR surveillance efforts in eight South and Southeast Asian countries.

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“…Thus, generating pathogen-susceptibility data sets or reports for sharing locally, nationally and internationally remains challenging. 49 In the absence of a LIMS, WHONET provides a robust solution for standardised AMR data capture, deduplication, analysis and sharing. Where automated analysis tools are in use, some instruments can be connected directly to the internet or converted using BacLink to WHONET 50 and fed into surveillance.…”

Section: Data Collection and Sharingmentioning

confidence: 99%

Leapfrogging laboratories: the promise and pitfalls of high-tech solutions for antimicrobial resistance surveillance in low-income settings

et al. 2020

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The scope and trajectory of today’s escalating antimicrobial resistance (AMR) crisis is inadequately captured by existing surveillance systems, particularly those of lower income settings. AMR surveillance systems typically collate data from routine culture and susceptibility testing performed in diagnostic bacteriology laboratories to support healthcare. Limited access to high quality culture and susceptibility testing results in the dearth of AMR surveillance data, typical of many parts of the world where the infectious disease burden and antimicrobial need are high. Culture and susceptibility testing by traditional techniques is also slow, which limits its value in infection management. Here, we outline hurdles to effective resistance surveillance in many low-income settings and encourage an open attitude towards new and evolving technologies that, if adopted, could close resistance surveillance gaps. Emerging advancements in point-of-care testing, laboratory detection of resistance through or without culture, and in data handling, have the potential to generate resistance data from previously unrepresented locales while simultaneously supporting healthcare. Among them are microfluidic, nucleic acid amplification technology and next-generation sequencing approaches. Other low tech or as yet unidentified innovations could also rapidly accelerate AMR surveillance. Parallel advances in data handling further promise to significantly improve AMR surveillance, and new frameworks that can capture, collate and use alternate data formats may need to be developed. We outline the promise and limitations of such technologies, their potential to leapfrog surveillance over currently available, conventional technologies in use today and early steps that health systems could take towards preparing to adopt them.

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Using information technology to improve surveillance of antimicrobial resistance in South East Asia

Abstract: Sirenda Vong and colleagues argue that investing in information technology surveillance systems to detect trends is an essential first step in tackling antimicrobial resistance in South East Asian countries

Cited by 21 publications

References 3 publications

Hospital adoption of antimicrobial stewardship programmes in Gulf Cooperation Council countries: A review of existing evidence

Hospital adoption of antimicrobial stewardship programmes in Gulf Cooperation Council countries: A review of existing evidence

Antimicrobial Resistance Surveillance in Low- and Middle-Income Countries: Progress and Challenges in Eight South Asian and Southeast Asian Countries

Leapfrogging laboratories: the promise and pitfalls of high-tech solutions for antimicrobial resistance surveillance in low-income settings

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