Researchers call for antimicrobial resistance surveillance to be improved

Authors of the paper, Antimicrobial resistance patterns in bacteria causing febrile illness in Africa, South Asia and Southeast Asia: A systematic review of published aetiological studies from 1980-2015, have recommended three measures to improve surveillance of AMR nationally and regionally. These include strengthening laboratory capacity, standardised testing and reporting of antimicrobial susceptibility testing results.

AMR is a serious threat to global public health and threatens the treatment of infections caused by bacteria, viruses, parasites and fungi. Over time, these microorganisms change and no longer respond to medicines resulting in treatment failure, a risk of disease spread, more severe illness and ultimately death.

Researchers used the IDDO non-malarial febrile illness (NMFI) map to conduct a systematic review to characterise AMR patterns for bacterial causes of febrile illness in Africa and Asia. A total of 371 unique articles over a period of 30-years included the target pathogen-drug combinations.

The main findings were:

• An increase in the number of studies reporting antimicrobial resistance data over time and a high number of studies reporting 3^rd generation cephalosporin resistance in Asia for Escherichia coli and Klebsiella pneumoniae and in Africa for K. pneumoniae. 
• An increase in the pooled proportion of resistance to fluoroquinolones in Salmonella enterica over time in both regions. 
• Overall, there was a general paucity of data and a lack of standardisation and data quality assurance.
• Strengthening of laboratory capacity and standardised testing and reporting of antimicrobial susceptibility testing results is required to improve surveillance of AMR both nationally and regionally. 

Lead author Tamalee Roberts, Research Scientist at the Lao-Oxford-Mahosot Hospital Wellcome Research Unit (LOMWRU) said: “The results from this review are a base to help understand the AMR situation in these regions. However, we need improved surveillance in countries and increased support for laboratory capacity. Without support for microbiology laboratories to produce high quality results, surveillance will not be possible.”

This new research builds on a collection of systematic reviews published in BMC Medicine in 2020 which evaluated the causes of non-malarial febrile illnesses in Africa, China, Latin America, Southern-Asia, and South-Eastern Asia. The results of these comprehensive reviews have been incorporated into an open access, online database that supports an interactive map that can filter data by country, microorganism type, patient age, sample type, pathogen family, genus and species, study year, geographic region and sub-region.

Read the paper