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Cirad

Guidance for evaluating integrated surveillance of antimicrobial use and resistance

Rüegg S.R., Antoine-Moussiaux N., Aenishaenslin C., Alban L., Bordier M., Bennani H., Schauer B., Arnold J.C., Gabain I., Sauter-Louis C., Berezowski J., Goutard F., Häsler B.. 2022. CABI One Health, 2022 : 13 p..

DOI: 10.1079/cabionehealth.2022.0007

Antimicrobial resistance (AMR) resulting from antimicrobial use (AMU) is an emerging threat to global health. One of the key elements for a better understanding and management of AMU and AMR is to develop effective and efficient integrated surveillance systems that consider the complex epidemiology of these issues and the impacts of resistance on humans, animals and the environment. Consequently, for this project, an international consortium of experts from multiple fields called CoEvalAMR was formed with the objectives to study user needs, characterise and compare existing tools for the evaluation of integrated AMU and AMR surveillance, apply them to case studies, and elaborate guidance on the purpose-fit selection and the use of the tools. For the comparison of evaluation tools, questions were extracted from existing tools and attributed to themes, to assess the user needs, interviews were conducted with national key stakeholders, and we applied a series of different evaluation tools to understand and document their strengths and weaknesses. The guidance was refined iteratively. From 12 evaluation tools, 1117 questions/indicators were extracted and attributed to seven emerging themes. Twenty-three experts were interviewed, who suggested to increase the ease-of-use, grant open access, provide web-based interfaces and allow results to be automatically generated. Respondents also wished for tools providing the flexibility to conduct a rapid review, or an in-depth analysis of the surveillance system, depending on the evaluation objectives. The case studies emphasised that proper evaluations require adequate resources, typically requiring the involvement of several assessors and/or stakeholders, and can take weeks or months to complete. The resulting web-based guidance comprises six main sections: 1. Introduction to surveillance evaluation, 2. Evaluation of surveillance for AMU and AMR, 3. Evaluation tools, 4. Support for selecting an evaluation tool, 5. Case studies a

Mots-clés : résistance aux antimicrobiens; antimicrobien; utilisation; système de surveillance; système global d'observation; enquête; système d'aide à la décision; système expert; évaluation de l'impact; approche une seule santé; one health

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