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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评估多重实时 PCR 检测在全球淋病奈瑟菌序列中预测头孢曲松敏感性降低的普遍性

摘要

目标

系统地总结关于如何收集、分析和报告抗菌素耐药性 (AMR) 监测数据的证据，以告知抗菌素管理 (AMS) 团队，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关于 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审查。 AMR 监测和 AMS 之间的联系。

结果

确定的问题侧重于 AMS 团队组成；AMR 监测的最低基础设施要求；要报告的生物体、样本和易感性模式；数据分层策略；报告频率；推动经验性治疗的耐药阈值；在高风险医院单位、长期护理、门诊和兽医环境中进行监测；以及来自其他国家的监测数据。作为 AMS 计划的一部分，关于实施 AMR 监测的 20 项指南和 7 项原创研究被纳入文献综述。

结论

本综述中总结的证据为制定程序以报告 AMR 监测数据以推动 AMS 干预的更综合过程提供了有用的基础。这些程序应扩展到急性护理机构之外的环境，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负担。