Antimicrobial Resistance Surveillance Questionnaire for Assessment of National Networks DEPARTMENT OF

Comprehensive quality systems are essential in order to ensure the validity of results from
microbiological investigations and epidemiological analyses in antimicrobial resistance
(AMR) surveillance. To be effective such systems should:
be focused on the organisms of greatest public health importance (i.e. with high mortality
and/or morbidity, and where therapeutic options may be severely limited by antimicrobial
resistance);
include organisms that are readily transmissible (i.e. may give rise to outbreaks and epidemics);
provide information for action at the local, intermediate and national levels.
The laboratories involved must be suitably staffed and equipped in order to produce
meaningful antimicrobial resistance data. The work must be organized in a way that will
detect unacceptable levels of random and systematic errors and initiate remedial actions. The
primary clinical objective of antimicrobial susceptibility testing is to guide the clinician in
the treatment of individual patients. This requires the transmission of valid information to the
decision-maker in a timely manner with appropriate interpretation for the non-expert. For
antimicrobial resistance surveillance networks it is equally important to realize that data
generated for clinical purposes will need to be adapted for epidemiological use. This includes
a precise definition of the population from which the samples are collected. It is also
desirable to include mechanisms to avoid duplicates and to be able to sort isolates according
to specific properties such as specimen type, gender, age, hospital versus community
acquisition of infection, etc. No surveillance programme can fulfil all the suggested criteria,
but a description of the programme needs to address these issues.
The present questionnaire is only one component of a strategy for quality assessment. The
aim is to provide a means for laboratory networks currently active in antimicrobial resistance
surveillance to assess the status of the individual laboratories in the network (Component I)
with respect to basic laboratory capacity and infrastructure (Part 1), the ability to isolate and
identify bacterial isolates (Part 2), and the performance of antimicrobial susceptibility testing
(Part 3). Component II is a tool for evaluation of the network coordinating centre and the
overall functioning of the surveillance network. A comprehensive description of quality
systems specifically tailored for AMR surveillance is presently being prepared by WHO.
http://www.who.int/drugresistance/whocdscsrrmd20031.pdf