Besides supporting direct care of patients, diagnostic tests can also be used to characterize and monitor infectious agents, resistance trends and transmission episodes, in the form of surveillance systems which can help limit the further emergence and spread of resistant bacteria. For example, bioMérieux and Lumed have partnered on an Antimicrobial Prescription Surveillance System to help clinicians monitor clinical data and verify that the ongoing treatment remains appropriate. (see Automation and Big Data)
Antibiotic resistance surveillance systems generate essential information and are a valuable tool for governments, hospital stewardship programs and healthcare systems in general. This information is also used to measure and anticipate resistance trends, in order to assist research and development efforts in the creation of new antibiotics and diagnostics. As well, the spatial and temporal evolution of an infectious agent, along with its pattern of resistance to antibiotics, determines the public health measures to be taken in order to avoid dangerous outbreaks.
Several countries have set up surveillance programs, which vary widely in their scope (healthy animals, diseased animals, food, healthy humans, sick humans), and in their focus (Staphylococcus aureus, Clostridium difficile, Salmonella, Campylobacter, Escherichia coli, Enterococcus, animal pathogens, etc.). The UK boasts a successful example of such a surveillance system, which contributed to understanding and curbing MRSA and C. difficile infections in hospitals.(44)
Many countries have not yet set up such monitoring programs, especially in low-resource settings. A global network based on harmonized surveillance protocols is taking shape through the deployment of WHO’s Global Antimicrobial Resistance Surveillance System. (110)
Standardized methodologies for surveillance were developed and described in the Global Antimicrobial Resistance Surveillance System Manual, but the processes for reporting the emergence and detection of new AMR mechanisms and associated public health events were not defined. The goal of "GLASS-EAR" – launched in 2018 by WHO – is to enable standardized and comparable data on emerging forms of AMR to be collected, analyzed and shared internationally.