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Vigilancia de la resistencia a antimicrobianos en emplazamientos con recursos limitados – la experiencia de cinco proyectos piloto
Author(s) -
Holloway Kathleen,
Mathai Elizabeth,
Gray Andy
Publication year - 2011
Publication title -
tropical medicine and international health
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.056
H-Index - 114
eISSN - 1365-3156
pISSN - 1360-2276
DOI - 10.1111/j.1365-3156.2010.02696.x
Subject(s) - haemophilus influenzae , antibiotic resistance , escherichia coli , antimicrobial , comparability , biology , medicine , microbiology and biotechnology , antibiotics , mathematics , biochemistry , combinatorics , gene
Summary Objective The rapid increase in antimicrobial resistance (AMR) among bacteria is a major public health concern. The WHO Global Strategy for Containment of Antimicrobial Resistance proposed that model systems be developed for AMR surveillance and for monitoring antimicrobial use. Methods Pilot projects were established in three sites in India and two in South Africa to collect monthly AMR data on target bacteria for at least 12 months. Escherichia coli was used as the target bacterium in four sites (three in India, one in South Africa). One South African site used Streptococcus pneumoniae and Haemophilus influenzae . Each site sought to obtain at least 960 isolates per year. Resistance was determined by disc diffusion or minimum inhibitory concentration (MIC) methods. Results Data were collected for 12 and 16 months respectively in the South African sites and for 14 months in one Indian site and 24 months in the other two. All sites found difficulty collecting the required number of isolates, with three sites failing to do so. Escherichia coli isolates were more easily obtained and two sites developed methods to increase their yield. Disc diffusion testing provided more timely and reliable AMR data than did MIC determinations. Although methodological issues limit the comparability of data, high AMR rates were observed at all five sites. Conclusion All five pilot sites provided data on AMR, but also raised several issues related to logistics of long‐term surveillance in settings under resource constraints. For surveillance of AMR in such settings, E. coli is probably the best indicator bacterium.