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.

中文翻译：

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低收入和中等收入国家的抗菌药物耐药性监测：八个南亚和东南亚国家的进展和挑战。

抗菌素耐药性 (AMR) 是一种严重的全球健康威胁，预计将造成重大的健康和经济影响，特别是在低收入和中等收入国家 (LMIC)。由于细菌感染负担重，AMR 监测对于中低收入国家至关重要；然而，在资源有限的环境中进行抗菌素耐药性监测受到卫生系统运作不良、财政资源匮乏和缺乏熟练人员的限制。2015年，联合国世界卫生大会批准了世界卫生组织应对抗菌素耐药性全球行动计划；因此，一些国家正在努力提高其抗菌素耐药性监测能力，包括进行大量投资以及建立和扩大监测网络。中低收入国家抗菌素耐药性监测网络生成的初步数据表明耐药性的患病率很高，但这些数据存在一些缺点，例如缺乏代表性、缺乏标准化实验室实践以及微生物学服务利用不足。尽管取得了重大进展，但由于财政资源和技术能力有限，中低收入国家的抗菌素耐药性监测网络在扩展和可持续性方面面临着一些挑战。本综述总结了影响 AMR 监测计划建立的现有卫生基础设施、表明 AMR 监测必要性的细菌感染负担，以及八个南亚和东南亚国家 AMR 监测工作的当前进展和挑战。