학술논문
ACORN (A Clinically-Oriented Antimicrobial Resistance Surveillance Network) II: protocol for case based antimicrobial resistance surveillance [version 2; peer review: 2 approved]
Document Type
article
Author
Andrea Lay-Hoon Kwa; Jeanette Teo; Oon Tek Ng; Kalisvar Marimuthu; Suwatthiya Kitsaran; Shawn Vasoo; Pope Kosalaraksa; Siriluck Anunnatsiri; Pitak Santanirand; Elizabeth A. Ashley; Darunee Chotiprasitsakul; Hock Hin Chua; Rongpong Plongla; Ke Juin Wong; Xun Ting Tiong; Naomi Waithira; Helmi Bin Sulaiman; Sasheela Sri La Sri Ponnampalavanar; Zeti Norfidiyati Salmuna; Prapass Wannapinij; Mohd Zulfakar Mazlan; Mohd Zaki Bin Mohd Zaili; Giri Shan Rajahram; Nevio Sarmento; Joshua R. Francis; Tessa Oakley; Helio Guterres; Ari Tilman; Jennifer Yan; Madiha Hashmi; Muhammad Osama Rehman Khalid; Azizullah Khan Dhiloo; Syed Faisal Mahmood; Inke Nadia D. Lubis; Ambreen Fatima; Cybele L. Abad; Hendri Wijaya; Cecilia C. Maramba Lazarte; Arthur Dessi Roman; Rosmonaliza Asli; Gazi Md. Salahuddin Mamun; Khurelbaatar Nyamdavaa; Muhd Haziq Fikry bin Haji Abdul Momin; Sotharith Bory; Yin Mo; Ulziijargal Gurjav; Lalit Gupta; George M. Varghese; Robert Sinto; Pratik Tantia; Basudha Khanal; Yohei Doi; Jezreel Lazaro; Greco Malijan; Sumudu Withanage; Samanmalee Gunasekara; Yonghong Xiao; Po Yu Liu; Minggui Wang; Yang Cao; Ying Ding; David L. Paterson; Jill Hopkins; Sue J. Lee; H. Rogier van Doorn; Paul Turner; Raph L. Hamers; Claire L. Ling; Yoel Lubell; Tamalee Roberts; Samuel Akech; Abhilasha Karkey; Japheth Opintan; Samantha Lissauer; Sergey Eremin; Iruka Okeke; Li Yang Hsu; Barbara Tornimbene; Minh Yen Lam; Louise Thwaites; Tieu Kieu Pham; Ngoc Thach Pham
Source
Wellcome Open Research, Vol 8 (2023)
Subject
Language
English
ISSN
2398-502X
Abstract
Background: Antimicrobial resistance surveillance is essential for empiric antibiotic prescribing, infection prevention and control policies and to drive novel antibiotic discovery. However, most existing surveillance systems are isolate-based without supporting patient-based clinical data, and not widely implemented especially in low- and middle-income countries (LMICs). Methods: A Clinically-Oriented Antimicrobial Resistance Surveillance Network (ACORN) II is a large-scale multicentre protocol which builds on the WHO Global Antimicrobial Resistance and Use Surveillance System to estimate syndromic and pathogen outcomes along with associated health economic costs. ACORN-healthcare associated infection (ACORN-HAI) is an extension study which focuses on healthcare-associated bloodstream infections and ventilator-associated pneumonia. Our main aim is to implement an efficient clinically-oriented antimicrobial resistance surveillance system, which can be incorporated as part of routine workflow in hospitals in LMICs. These surveillance systems include hospitalised patients of any age with clinically compatible acute community-acquired or healthcare-associated bacterial infection syndromes, and who were prescribed parenteral antibiotics. Diagnostic stewardship activities will be implemented to optimise microbiology culture specimen collection practices. Basic patient characteristics, clinician diagnosis, empiric treatment, infection severity and risk factors for HAI are recorded on enrolment and during 28-day follow-up. An R Shiny application can be used offline and online for merging clinical and microbiology data, and generating collated reports to inform local antibiotic stewardship and infection control policies. Discussion: ACORN II is a comprehensive antimicrobial resistance surveillance activity which advocates pragmatic implementation and prioritises improving local diagnostic and antibiotic prescribing practices through patient-centred data collection. These data can be rapidly communicated to local physicians and infection prevention and control teams. Relative ease of data collection promotes sustainability and maximises participation and scalability. With ACORN-HAI as an example, ACORN II has the capacity to accommodate extensions to investigate further specific questions of interest.