39
vancomycin resistance in 10% of enterococcal isolates and carbapenem resistance
in 81% of A. baumannii isolates. Community acquired infections show increased
antimicrobial resistance with variations among countries (ECDC 2013b).
Recent studies of antimicrobial resistance in food chain and animals predicts
further rise in the antimicrobial resistance in relation to human beings. Lower susceptibility to tetracycline, quinolones, sulphonamides and ampicillin has been seen
in Salmonella and E. coli isolates (Schwarz and Johnson 2016). In addition to this,
European Medicines Agency and European Food Safety Authority has reported an
association between antimicrobial intake in food producing animals and increase of
resistance in bacteria isolates of human (ECDC 2015).
Monitoring of antimicrobial resistance is indispensable to support appropriate
antimicrobial use that will optimize clinical outcome of patients while minimizing
unforeseen effects like toxicity and development of resistance (Barlam et al. 2016).
ECDC and many national cohort provides European surveillance data for public
(ONEBRA 2014; PHE 2016). In 1998, European Commission established a largest
publicly funded resistance surveillance system in Europe, which is maintained and
sponsored by ECDC since 2010 (ECDC 2016). This network improved the quality
of surveillance data in Europe and provides data on antimicrobial resistance on
yearly basis; but is greatly affected by heterogeneity among European countries
(i.e., disparity in organization of health care program, reimbursement strategies, and
blood sampling indications). In lieu of emergence of antimicrobial resistance as a
substantial threat, Europe has also implemented many national surveillance systems.
Because of the pressure of escalating antimicrobial resistance, several initiatives
have come into action in the past few years to tackle the limitations of existing surveillance programs. The European Surveillance of Veterinary Antimicrobial
Consumption (ESVAC) project of the European Medicines Agency has collected
and reported data on sales of antimicrobials used in veterinary since 2009 and has
Table 2.1 (continued)
National surveillance systems
Regional
Italy
Regional (Toscana) surveillance of antibiotic resistance (SART)
Italy
Regional (Emilia-Romagna) surveillance of antibiotic resistance and intravenous
antibiotic usage (LAB)
Spain
Regional surveillance system (Asturias; SVPCIP)
Spain
Prevention and control of nosocomial infections and inappropriate usage of
antibiotics (PIRASOA)
Spain
Regional surveillance system (Catalunya; VINCat)
Spain
Regional surveillance system (Galicia; SVIN)
Switzerland Prevention and control of nosocomial infections (HPCI)
UK
Public Health England (PHE)
UK
Health Protection Scotland (HPS)
UK
Welsh Healthcare Associated Infections Programme (WHAIP)
UK
Public Health Agency (PHA)
Adapted from Tacconelli et al. (2018)
2 Global Surveillance Programs on Antimicrobial Resistance
vancomycin resistance in 10% of enterococcal isolates and carbapenem resistance
in 81% of A. baumannii isolates. Community acquired infections show increased
antimicrobial resistance with variations among countries (ECDC 2013b).
Recent studies of antimicrobial resistance in food chain and animals predicts
further rise in the antimicrobial resistance in relation to human beings. Lower susceptibility to tetracycline, quinolones, sulphonamides and ampicillin has been seen
in Salmonella and E. coli isolates (Schwarz and Johnson 2016). In addition to this,
European Medicines Agency and European Food Safety Authority has reported an
association between antimicrobial intake in food producing animals and increase of
resistance in bacteria isolates of human (ECDC 2015).
Monitoring of antimicrobial resistance is indispensable to support appropriate
antimicrobial use that will optimize clinical outcome of patients while minimizing
unforeseen effects like toxicity and development of resistance (Barlam et al. 2016).
ECDC and many national cohort provides European surveillance data for public
(ONEBRA 2014; PHE 2016). In 1998, European Commission established a largest
publicly funded resistance surveillance system in Europe, which is maintained and
sponsored by ECDC since 2010 (ECDC 2016). This network improved the quality
of surveillance data in Europe and provides data on antimicrobial resistance on
yearly basis; but is greatly affected by heterogeneity among European countries
(i.e., disparity in organization of health care program, reimbursement strategies, and
blood sampling indications). In lieu of emergence of antimicrobial resistance as a
substantial threat, Europe has also implemented many national surveillance systems.
Because of the pressure of escalating antimicrobial resistance, several initiatives
have come into action in the past few years to tackle the limitations of existing surveillance programs. The European Surveillance of Veterinary Antimicrobial
Consumption (ESVAC) project of the European Medicines Agency has collected
and reported data on sales of antimicrobials used in veterinary since 2009 and has
Table 2.1 (continued)
National surveillance systems
Regional
Italy
Regional (Toscana) surveillance of antibiotic resistance (SART)
Italy
Regional (Emilia-Romagna) surveillance of antibiotic resistance and intravenous
antibiotic usage (LAB)
Spain
Regional surveillance system (Asturias; SVPCIP)
Spain
Prevention and control of nosocomial infections and inappropriate usage of
antibiotics (PIRASOA)
Spain
Regional surveillance system (Catalunya; VINCat)
Spain
Regional surveillance system (Galicia; SVIN)
Switzerland Prevention and control of nosocomial infections (HPCI)
UK
Public Health England (PHE)
UK
Health Protection Scotland (HPS)
UK
Welsh Healthcare Associated Infections Programme (WHAIP)
UK
Public Health Agency (PHA)
Adapted from Tacconelli et al. (2018)
2 Global Surveillance Programs on Antimicrobial Resistance