Limited availability of supporting material and training has been raised by Member States as a challenge for further implementation of national AMR surveillance and the Global AMR Surveillance System (GLASS). In response to these needs, the WHO AMR Surveillance and Quality Assessment Collaborating Centre Network provides a webinar series, as a flexible and interactive way to provide training and support to Member States. Each session is recorded and published below.
The Proof-of-Principle AMR routine diagnostics (PoP) project: successes and challenges
In many countries, underuse of bacteriology diagnostics in routine clinical practice is a barrier to implementing AMR surveillance. This webinar discusses how the Proof-of-Principle AMR routine diagnostics (PoP) project promotes the use of blood cultures and AMR susceptibility testing in clinical practice, thereby aiming to provide a starting point for a national AMR surveillance system. We provide an overview of the PoP project methodology. Furthermore, we discuss the experience gained with PoP project implementation in the WHO European region and address commonly faced challenges. The PoP protocol is available at the WHO Regional Office for Europe website.
Detection and Reporting of Colistin Resistance
Detection of colistin resistance has proven difficult in the past due to interactions of the antimicrobial with diverse laboratory materials and reagents. Moreover, there are doubts regarding the adequacy of current cut-offs for classification of isolates from different species as wild-type or non-wild-type, and clinically susceptible or clinically resistant to the antimicrobial. These issues will be addressed, accompanied by discussion of the advantages and pitfalls of current phenotypic and genotypic methods for detection of colistin resistance.
Data Entry Using WHONET
The first webinar in this series discusses how WHONET can be used to capture relevant patient, location, specimen, and microbiology results, either by manual data entry or by downloading data from existing information systems. We also cover how WHONET can be utilized to export national data for upload to the GLASS IT platform.
AMR surveillance requires the right clinical specimens to be collected and in the right way, which is the practice of proper diagnostic stewardship. The webinar sessions on Diagnostic Stewardship provide an overall definition, explaining how it involves the diagnostic pathway for infections and the way to properly organized it, as set out in the WHO GLASS Guide to Implementation. Practical protocols for the proper collection of the four groups of specimens, namely blood, urine, faeces and urethral/cervical swabs needed for GLASS participation are provided, with precise guidance on good practice.
Interpretation of AMR Surveillance Data
When interpreting results, one should always assess whether the results reflect reality. The validity and representativeness of AMR surveillance results may be negatively affected at different points in the data generation process. Different sources or error and bias, and how they influence the representativeness of the results, are addressed.