48
technology system are still not clear. Most important barriers for improving the
quality are the costs associated with software, hardware, of employing staff and of
maintaining systems. Insufficient infrastructure can also result in limited/sluggish
internet access (Natale et al. 2017; Stelling 2016; Stelling and O’Brien 1997).
Surveillance of antimicrobial resistance in Sweden was reinforced in 2012 by the
initiation of Svebar – a national automated system for culture collection and acquisition of results of antibiotic susceptibility testing from Swedish clinical laboratories (Söderblom et al. 2014; Swedres and Svarm 2013). Swedish Public Health
Agency owns the system, produces immediate early alerts of critically significant
antimicrobial resistance (multi drug resistance and extensive drug resistance) and
owns a database of already characterized microorganisms with all antimicrobial
susceptibility profiles from collaborating laboratories. Quick alert reports are automatically produced and instantly reverted to the laboratory. Such reports rely on
quick warning signal (triggers). Classical examples of “triggers” are carbapenem
resistant K. pneumoniae and colistin resistant E. coli in various clinical samples. In
contrast, the database owned by the collaborating laboratories is utilized to investigate geographical and longitudinal trends in antimicrobial resistance. Svebar creates standardized national and local reports, generating tables of data of cumulative
resistance for each antibiotic and species. To attain good quality data in an information technology system, validation of data is needed that synchronizes routine
nomenclature and cooperation of all laboratories to correct the errors and inconsistency of data. Common antimicrobial susceptibility standards like; the European
Committee on antimicrobial susceptibility testing, which authenticate reference
genotypic and phenotypic methods for antimicrobial susceptibility that are also
important when comparing data from various sources. Further validation of Swedish
data is in progress through global antimicrobial surveillance and the European antimicrobial resistance Network (ECDC 2013a; WHO 2015). Although connecting
with Svebar is voluntary, the system has registered most of the clinical microbiology laboratories of different countries. Public Health Agency of Sweden experts
described that continuous talks between Public Health Agency of Sweden and the
associated laboratories explains the huge participation. E.g., an annual conference
is held at Public Health Agency of Sweden, encouragement of laboratory representatives is conducted to talk about all facets of the system, from early warnings, quality of the underlying data to the produced reports. Professional and public awareness
programs about antimicrobial resistance has also encouraged political commitment
and made it convenient for establishment of the system. In future, Svebar targets to
add the data from sequencing of whole genome in the surveillance of antimicrobial
resistance; and assimilate antibiotic intake and data of veterinary surveillance to
facilitate further amend the policy.
Japan Nosocomial Infections Surveillance (JANIS) is an automated and centralized programme for antimicrobial resistance surveillance to compile, analyze, and
publish the data at regular intervals. Pooling of confidential summary reports from
each participating hospital is conducted; resulted data is compared from all collaborating hospitals. Many countries are also approached by Japan in the region (India
S. Kumar et al.
technology system are still not clear. Most important barriers for improving the
quality are the costs associated with software, hardware, of employing staff and of
maintaining systems. Insufficient infrastructure can also result in limited/sluggish
internet access (Natale et al. 2017; Stelling 2016; Stelling and O’Brien 1997).
Surveillance of antimicrobial resistance in Sweden was reinforced in 2012 by the
initiation of Svebar – a national automated system for culture collection and acquisition of results of antibiotic susceptibility testing from Swedish clinical laboratories (Söderblom et al. 2014; Swedres and Svarm 2013). Swedish Public Health
Agency owns the system, produces immediate early alerts of critically significant
antimicrobial resistance (multi drug resistance and extensive drug resistance) and
owns a database of already characterized microorganisms with all antimicrobial
susceptibility profiles from collaborating laboratories. Quick alert reports are automatically produced and instantly reverted to the laboratory. Such reports rely on
quick warning signal (triggers). Classical examples of “triggers” are carbapenem
resistant K. pneumoniae and colistin resistant E. coli in various clinical samples. In
contrast, the database owned by the collaborating laboratories is utilized to investigate geographical and longitudinal trends in antimicrobial resistance. Svebar creates standardized national and local reports, generating tables of data of cumulative
resistance for each antibiotic and species. To attain good quality data in an information technology system, validation of data is needed that synchronizes routine
nomenclature and cooperation of all laboratories to correct the errors and inconsistency of data. Common antimicrobial susceptibility standards like; the European
Committee on antimicrobial susceptibility testing, which authenticate reference
genotypic and phenotypic methods for antimicrobial susceptibility that are also
important when comparing data from various sources. Further validation of Swedish
data is in progress through global antimicrobial surveillance and the European antimicrobial resistance Network (ECDC 2013a; WHO 2015). Although connecting
with Svebar is voluntary, the system has registered most of the clinical microbiology laboratories of different countries. Public Health Agency of Sweden experts
described that continuous talks between Public Health Agency of Sweden and the
associated laboratories explains the huge participation. E.g., an annual conference
is held at Public Health Agency of Sweden, encouragement of laboratory representatives is conducted to talk about all facets of the system, from early warnings, quality of the underlying data to the produced reports. Professional and public awareness
programs about antimicrobial resistance has also encouraged political commitment
and made it convenient for establishment of the system. In future, Svebar targets to
add the data from sequencing of whole genome in the surveillance of antimicrobial
resistance; and assimilate antibiotic intake and data of veterinary surveillance to
facilitate further amend the policy.
Japan Nosocomial Infections Surveillance (JANIS) is an automated and centralized programme for antimicrobial resistance surveillance to compile, analyze, and
publish the data at regular intervals. Pooling of confidential summary reports from
each participating hospital is conducted; resulted data is compared from all collaborating hospitals. Many countries are also approached by Japan in the region (India
S. Kumar et al.