Surveillance strategies using routine microbiology for antimicrobial resistance in low and middle-income countries

<p><strong>Background:</strong> Routine microbiology results are a valuable source of antimicrobial resistance (AMR) surveillance data in low- and middle-income countries (LMICs) as well as in high-income countries. Different approaches and strategies are used to generate AMR surve...

Full description

Bibliographic Details
Main Authors: Lim, C, Ashley, EA, Hamers, RL, Turner, P, Kesteman, T, Akech, S, Corso, A, Mayxay, M, Okeke, IN, Limmathurotsakul, D, Doorn, HRV
Format: Journal article
Language:English
Published: Elsevier 2021
_version_ 1826302242056044544
author Lim, C
Ashley, EA
Hamers, RL
Turner, P
Kesteman, T
Akech, S
Corso, A
Mayxay, M
Okeke, IN
Limmathurotsakul, D
Doorn, HRV
author_facet Lim, C
Ashley, EA
Hamers, RL
Turner, P
Kesteman, T
Akech, S
Corso, A
Mayxay, M
Okeke, IN
Limmathurotsakul, D
Doorn, HRV
author_sort Lim, C
collection OXFORD
description <p><strong>Background:</strong> Routine microbiology results are a valuable source of antimicrobial resistance (AMR) surveillance data in low- and middle-income countries (LMICs) as well as in high-income countries. Different approaches and strategies are used to generate AMR surveillance data.</p> <p><strong>Objectives:</strong> We aimed to review strategies for AMR surveillance using routine microbiology results in LMICs and to highlight areas that need support to generate high-quality AMR data.</p> <p><strong>Sources:</strong> We searched PubMed for papers that used routine microbiology to describe the epidemiology of AMR and drug-resistant infections in LMICs. We also included papers that, from our perspective, were critical in highlighting the biases and challenges or employed specific strategies to overcome these in reporting AMR surveillance in LMICs.</p> <p><strong>Content:</strong> Topics covered included strategies of identifying AMR cases (including case-finding based on isolates from routine diagnostic specimens and case-based surveillance of clinical syndromes), of collecting data (including cohort, point-prevalence survey, and case–control), of sampling AMR cases (including lot quality assurance surveys), and of processing and analysing data for AMR surveillance in LMICs.</p> <p><strong>Implications:</strong> The various AMR surveillance strategies warrant a thorough understanding of their limitations and potential biases to ensure maximum utilization and interpretation of local routine microbiology data across time and space. For instance, surveillance using case-finding based on results from clinical diagnostic specimens is relatively easy to implement and sustain in LMIC settings, but the estimates of incidence and proportion of AMR is at risk of biases due to underuse of microbiology. Case-based surveillance of clinical syndromes generates informative statistics that can be translated to clinical practices but needs financial and technical support as well as locally tailored trainings to sustain. Innovative AMR surveillance strategies that can easily be implemented and sustained with minimal costs will be useful for improving AMR data availability and quality in LMICs.</p>
first_indexed 2024-03-07T05:44:35Z
format Journal article
id oxford-uuid:e6c51010-daee-4998-8d73-66154f998f91
institution University of Oxford
language English
last_indexed 2024-03-07T05:44:35Z
publishDate 2021
publisher Elsevier
record_format dspace
spelling oxford-uuid:e6c51010-daee-4998-8d73-66154f998f912022-03-27T10:33:34ZSurveillance strategies using routine microbiology for antimicrobial resistance in low and middle-income countriesJournal articlehttp://purl.org/coar/resource_type/c_dcae04bcuuid:e6c51010-daee-4998-8d73-66154f998f91EnglishSymplectic ElementsElsevier2021Lim, CAshley, EAHamers, RLTurner, PKesteman, TAkech, SCorso, AMayxay, MOkeke, INLimmathurotsakul, DDoorn, HRV<p><strong>Background:</strong> Routine microbiology results are a valuable source of antimicrobial resistance (AMR) surveillance data in low- and middle-income countries (LMICs) as well as in high-income countries. Different approaches and strategies are used to generate AMR surveillance data.</p> <p><strong>Objectives:</strong> We aimed to review strategies for AMR surveillance using routine microbiology results in LMICs and to highlight areas that need support to generate high-quality AMR data.</p> <p><strong>Sources:</strong> We searched PubMed for papers that used routine microbiology to describe the epidemiology of AMR and drug-resistant infections in LMICs. We also included papers that, from our perspective, were critical in highlighting the biases and challenges or employed specific strategies to overcome these in reporting AMR surveillance in LMICs.</p> <p><strong>Content:</strong> Topics covered included strategies of identifying AMR cases (including case-finding based on isolates from routine diagnostic specimens and case-based surveillance of clinical syndromes), of collecting data (including cohort, point-prevalence survey, and case–control), of sampling AMR cases (including lot quality assurance surveys), and of processing and analysing data for AMR surveillance in LMICs.</p> <p><strong>Implications:</strong> The various AMR surveillance strategies warrant a thorough understanding of their limitations and potential biases to ensure maximum utilization and interpretation of local routine microbiology data across time and space. For instance, surveillance using case-finding based on results from clinical diagnostic specimens is relatively easy to implement and sustain in LMIC settings, but the estimates of incidence and proportion of AMR is at risk of biases due to underuse of microbiology. Case-based surveillance of clinical syndromes generates informative statistics that can be translated to clinical practices but needs financial and technical support as well as locally tailored trainings to sustain. Innovative AMR surveillance strategies that can easily be implemented and sustained with minimal costs will be useful for improving AMR data availability and quality in LMICs.</p>
spellingShingle Lim, C
Ashley, EA
Hamers, RL
Turner, P
Kesteman, T
Akech, S
Corso, A
Mayxay, M
Okeke, IN
Limmathurotsakul, D
Doorn, HRV
Surveillance strategies using routine microbiology for antimicrobial resistance in low and middle-income countries
title Surveillance strategies using routine microbiology for antimicrobial resistance in low and middle-income countries
title_full Surveillance strategies using routine microbiology for antimicrobial resistance in low and middle-income countries
title_fullStr Surveillance strategies using routine microbiology for antimicrobial resistance in low and middle-income countries
title_full_unstemmed Surveillance strategies using routine microbiology for antimicrobial resistance in low and middle-income countries
title_short Surveillance strategies using routine microbiology for antimicrobial resistance in low and middle-income countries
title_sort surveillance strategies using routine microbiology for antimicrobial resistance in low and middle income countries
work_keys_str_mv AT limc surveillancestrategiesusingroutinemicrobiologyforantimicrobialresistanceinlowandmiddleincomecountries
AT ashleyea surveillancestrategiesusingroutinemicrobiologyforantimicrobialresistanceinlowandmiddleincomecountries
AT hamersrl surveillancestrategiesusingroutinemicrobiologyforantimicrobialresistanceinlowandmiddleincomecountries
AT turnerp surveillancestrategiesusingroutinemicrobiologyforantimicrobialresistanceinlowandmiddleincomecountries
AT kestemant surveillancestrategiesusingroutinemicrobiologyforantimicrobialresistanceinlowandmiddleincomecountries
AT akechs surveillancestrategiesusingroutinemicrobiologyforantimicrobialresistanceinlowandmiddleincomecountries
AT corsoa surveillancestrategiesusingroutinemicrobiologyforantimicrobialresistanceinlowandmiddleincomecountries
AT mayxaym surveillancestrategiesusingroutinemicrobiologyforantimicrobialresistanceinlowandmiddleincomecountries
AT okekein surveillancestrategiesusingroutinemicrobiologyforantimicrobialresistanceinlowandmiddleincomecountries
AT limmathurotsakuld surveillancestrategiesusingroutinemicrobiologyforantimicrobialresistanceinlowandmiddleincomecountries
AT doornhrv surveillancestrategiesusingroutinemicrobiologyforantimicrobialresistanceinlowandmiddleincomecountries