Abstract

Objectives

To systematically summarize the evidence on how to collect, analyse and report antimicrobial resistance (AMR) surveillance data to inform antimicrobial stewardship (AMS) teams providing guidance on empirical antibiotic treatment in healthcare settings.

Methods

The research group identified 10 key questions about the link between AMR surveillance and AMS using a checklist of 9 elements for good practice in health research priority settings and a modified 3D combined approach matrix, and conducted a systematic review of published original studies and guidelines on the link between AMR surveillance and AMS.

Results

The questions identified focused on AMS team composition; minimum infrastructure requirements for AMR surveillance; organisms, samples and susceptibility patterns to report; data stratification strategies; reporting frequency; resistance thresholds to drive empirical therapy; surveillance in high-risk hospital units, long-term care, outpatient and veterinary settings; and surveillance data from other countries. Twenty guidelines and seven original studies on the implementation of AMR surveillance as part of an AMS programme were included in the literature review.

Conclusions

The evidence summarized in this review provides a useful basis for a more integrated process of developing procedures to report AMR surveillance data to drive AMS interventions. These procedures should be extended to settings outside the acute-care institutions, such as long-term care, outpatient and veterinary. Without proper AMR surveillance, implementation of AMS policies cannot contribute effectively to the fight against MDR pathogens and may even worsen the burden of adverse events from such interventions.

中文翻译：

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将抗菌药物耐药性监测与医疗保健环境中的抗生素政策联系起来：COMBACTE-Magnet EPI-Net COACH 项目

摘要

目标

系统地总结有关如何收集、分析和报告抗菌素耐药性 (AMR) 监测数据的证据，为抗菌素管理 (AMS) 团队提供信息，为医疗机构中的经验性抗生素治疗提供指导。

方法

研究小组使用健康研究优先设置中良好实践的 9 个要素清单和修改后的 3D 组合方法矩阵，确定了有关 AMR 监测和 AMS 之间联系的 10 个关键问题，并对已发表的原始研究和指南进行了系统回顾。 AMR 监测和 AMS 之间的联系。

结果

确定的问题集中于 AMS 团队的组成；抗菌素耐药性监测的最低基础设施要求；要报告的生物体、样本和敏感性模式；数据分层策略；报告频率；推动经验治疗的阻力阈值；高风险医院病房、长期护理、门诊和兽医机构的监测；以及其他国家的监测数据。文献综述中纳入了二十项指南和七项关于作为 AMS 计划一部分实施 AMR 监测的原始研究。

结论

本次综述中总结的证据为制定报告 AMR 监测数据的程序以推动 AMS 干预措施提供了有用的基础。这些程序应扩展到急性护理机构以外的环境，例如长期护理、门诊和兽医。如果没有适当的 AMR 监测，AMS 政策的实施就无法有效地促进对抗 MDR 病原体，甚至可能加重此类干预措施带来的不良事件的负担。