National action plans for antimicrobial resistance and variations in surveillance data platforms
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Published version
Author(s)
Type
Journal Article
Abstract
Objective To assess how national antimicrobial susceptibility data used to inform national action plans vary across surveillance platforms.
Methods We identified available open-access, supranational, interactive surveillance platforms and cross-checked their data in accordance with the World Health Organization’s (WHO’s) Data Quality Assurance: module 1. We compared platform usability and completeness of time-matched data on the antimicrobial susceptibilities of four blood isolate species: Escherichia coli, Klebsiella pneumoniae, Staphylococcus aureus and Streptococcus pneumoniae from WHO’s Global Antimicrobial Resistance and Use Surveillance System, European Centre for Disease Control’s (ECDC’s) network and Pfizer’s Antimicrobial Testing Leadership and Surveillance database. Using Bland–Altman analysis, paired t-tests, and Wilcoxon signed-rank tests, we assessed susceptibility data and number of isolate concordances between platforms.
Findings Of 71 countries actively submitting data to WHO, 28 also submit to Pfizer’s database; 19 to ECDC; and 16 to all three platforms. Limits of agreement between WHO’s and Pfizer’s platforms for organism–country susceptibility data ranged from −26% to 35%. While mean susceptibilities of WHO’s and ECDC‘s platforms did not differ (bias: 0%, 95% confidence interval: −2 to 2), concordance between organism–country susceptibility was low (limits of agreement −18 to 18%). Significant differences exist in isolate numbers reported between WHO–Pfizer (mean of difference: 674, P-value: < 0.001 and WHO–ECDC (mean of difference: 192, P value: 0.04) platforms.
Conclusion The considerable heterogeneity of nationally submitted data to commonly used antimicrobial resistance surveillance platforms compromises their
validity, thus undermining local and global antimicrobial resistance strategies. Hence, we need to understand and address surveillance platform variability and its underlying mechanisms.
Methods We identified available open-access, supranational, interactive surveillance platforms and cross-checked their data in accordance with the World Health Organization’s (WHO’s) Data Quality Assurance: module 1. We compared platform usability and completeness of time-matched data on the antimicrobial susceptibilities of four blood isolate species: Escherichia coli, Klebsiella pneumoniae, Staphylococcus aureus and Streptococcus pneumoniae from WHO’s Global Antimicrobial Resistance and Use Surveillance System, European Centre for Disease Control’s (ECDC’s) network and Pfizer’s Antimicrobial Testing Leadership and Surveillance database. Using Bland–Altman analysis, paired t-tests, and Wilcoxon signed-rank tests, we assessed susceptibility data and number of isolate concordances between platforms.
Findings Of 71 countries actively submitting data to WHO, 28 also submit to Pfizer’s database; 19 to ECDC; and 16 to all three platforms. Limits of agreement between WHO’s and Pfizer’s platforms for organism–country susceptibility data ranged from −26% to 35%. While mean susceptibilities of WHO’s and ECDC‘s platforms did not differ (bias: 0%, 95% confidence interval: −2 to 2), concordance between organism–country susceptibility was low (limits of agreement −18 to 18%). Significant differences exist in isolate numbers reported between WHO–Pfizer (mean of difference: 674, P-value: < 0.001 and WHO–ECDC (mean of difference: 192, P value: 0.04) platforms.
Conclusion The considerable heterogeneity of nationally submitted data to commonly used antimicrobial resistance surveillance platforms compromises their
validity, thus undermining local and global antimicrobial resistance strategies. Hence, we need to understand and address surveillance platform variability and its underlying mechanisms.
Date Issued
2023-05-29
Date Acceptance
2023-04-11
Citation
Bulletin of the World Health Organization, 2023, 101, pp.501-512F
ISSN
0042-9686
Publisher
World Health Organization
Start Page
501
End Page
512F
Journal / Book Title
Bulletin of the World Health Organization
Volume
101
Copyright Statement
Copyright © 2023 The Author(s). This article is available under the Creative Commons Attribution 3.0 IGO licence (CC BY 3.0 IGO) http://creativecommons.org/licenses/by/3.0/igo/legalcode, which permits unrestricted use, distribution and reproduction in any medium, provided the original work is properly cited.
License URL
Identifier
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10388141/pdf/BLT.22.289403.pdf
Publication Status
Published
Article Number
BLT.22.289403
Date Publish Online
2023-05-29