Active surveillance of antimicrobial resistance

Abstract

The magnitude of the impact of antibiotic resistance (AR) is now well recognised. Implementation of measures for its control is essential, but for them to be efficacious and cost-effective, they must be guided by prior knowledge of the problem that is as up-to-date, real and complete as possible. However, the current scale of AR is difficult to quantify due to the wide heterogeneity of data collection, the existence of large gaps in surveillance capacity and its deficient coordination. Therefore, it is necessary to structure holistic, integrative and high-quality AR surveillance systems that allow the early analysis of combined data (micro-biological, clinical, epidemiological data) from different sources (humans, foods, animals and environment) to guide decision making for the control of AR. Some of the main characteristics that a structure of this scale should have are: a multidisciplinary consensus on protocols, criteria and techniques; the combination and coordination of different approaches seeking to fill possible gaps in surveillance; the deve lopment of a global antibiotic policy that allows and facilitates the existence of common, updated and accessible surveillance systems; the use of agile and compatible computer systems that allow a «real time» dump in common databases; and political involvement to include monitoring of AR in the political agenda and to commit the necessary resources. Supplement information: This article is part of a supplement entitled «SEIMC External Quality Control Programme. Year 2016», which is sponsored by Roche, Vircell Microbiologists, Abbott Molecular and Francisco Soria Melguizo, S.A. © 2019 Elsevier España, S.L.U. and Sociedad Española de Enfermedades Infecciosasy Microbiología Clínica. All rights reserved.

Keywords: Antibiotic resistance; Antibiotic resistance mechanisms; Brotes; Clones; Mecanismos de resistencia; Outbreaks; Resistencia a antibióticos; Surveillance; Vigilancia.