National action plans for antimicrobial resistance and variations in surveillance data platforms
Author
Pallett, Scott JcCharani, Esmita
Hawkins, Lois
Mazzella, Andrea
Anton-Vazquez, Vanesa
Banerjee, Rishi
Evans, Terry J
Patterson, Benjamin
Subbarao, Sathyavani
Alqahtani, Saleh
Basarab, Marina
Breathnach, Aodhan S
Mughal, Nabeela
Moore, Luke Sp
Publication date
2023-08-01Subject
Practice of medicinePublic health. Health statistics. Occupational health. Health education
Pharmacology
Metadata
Show full item recordAbstract
Objective: To assess how national antimicrobial susceptibility data used to inform national action plans vary across surveillance platforms. Methods: We identified available open-access, supranational, interactive surveillance platforms and cross-checked their data in accordance with the World Health Organization's (WHO's) Data Quality Assurance: module 1. We compared platform usability and completeness of time-matched data on the antimicrobial susceptibilities of four blood isolate species: Escherichia coli, Klebsiella pneumoniae, Staphylococcus aureus and Streptococcus pneumoniae from WHO's Global Antimicrobial Resistance and Use Surveillance System, European Centre for Disease Control's (ECDC's) network and Pfizer's Antimicrobial Testing Leadership and Surveillance database. Using Bland-Altman analysis, paired t-tests, and Wilcoxon signed-rank tests, we assessed susceptibility data and number of isolate concordances between platforms. Findings: Of 71 countries actively submitting data to WHO, 28 also submit to Pfizer's database; 19 to ECDC; and 16 to all three platforms. Limits of agreement between WHO's and Pfizer's platforms for organism-country susceptibility data ranged from -26% to 35%. While mean susceptibilities of WHO's and ECDC's platforms did not differ (bias: 0%, 95% confidence interval: -2 to 2), concordance between organism-country susceptibility was low (limits of agreement -18% to 18%). Significant differences exist in isolate numbers reported between WHO-Pfizer (mean of difference: 674, P-value: < 0.001, and WHO-ECDC (mean of difference: 192, P-value: 0.04) platforms. Conclusion: The considerable heterogeneity of nationally submitted data to commonly used antimicrobial resistance surveillance platforms compromises their validity, thus undermining local and global antimicrobial resistance strategies. Hence, we need to understand and address surveillance platform variability and its underlying mechanisms.Citation
Pallett SJ, Charani E, Hawkins L, Mazzella A, Anton-Vazquez V, Banerjee R, Evans TJ, Patterson B, Subbarao S, Alqahtani S, Basarab M, Breathnach AS, Mughal N, Moore LS. National action plans for antimicrobial resistance and variations in surveillance data platforms. Bull World Health Organ. 2023 Aug 1;101(8):501-512F. doi: 10.2471/BLT.22.289403. Epub 2023 May 29. PMID: 37529028; PMCID: PMC10388141.Type
ArticleAdditional Links
https://www.who.int/publications/journals/bulletinPMID
37529028Publisher
World Health Organizationae974a485f413a2113503eed53cd6c53
10.2471/BLT.22.289403