Rapid assessment of antimicrobial resistance prevalence using a Lot Quality Assurance sampling approach

Future Microbiol. 2017 Apr:12:369-377. doi: 10.2217/fmb-2016-0170. Epub 2017 Mar 24.

Abstract

Aim: Increasing antimicrobial resistance (AMR) requires rapid surveillance tools, such as Lot Quality Assurance Sampling (LQAS).

Materials & methods: LQAS classifies AMR as high or low based on set parameters. We compared classifications with the underlying true AMR prevalence using data on 1335 Escherichia coli isolates from surveys of community-acquired urinary tract infection in women, by assessing operating curves, sensitivity and specificity.

Results: Sensitivity and specificity of any set of LQAS parameters was above 99% and between 79 and 90%, respectively. Operating curves showed high concordance of the LQAS classification with true AMR prevalence estimates.

Conclusion: LQAS-based AMR surveillance is a feasible approach that provides timely and locally relevant estimates, and the necessary information to formulate and evaluate guidelines for empirical treatment.

Keywords: Lot Quality Assurance Sampling; antimicrobial resistance; empirical treatment; urinary tract infection.

Publication types

  • Evaluation Study

MeSH terms

  • Anti-Infective Agents / pharmacology*
  • Anti-Infective Agents / therapeutic use
  • Drug Resistance, Bacterial*
  • Epidemiologic Methods
  • Escherichia coli / drug effects*
  • Escherichia coli / isolation & purification
  • Escherichia coli Infections / drug therapy
  • Escherichia coli Infections / epidemiology
  • Escherichia coli Infections / microbiology
  • Female
  • Humans
  • Lot Quality Assurance Sampling
  • Prevalence
  • Sensitivity and Specificity
  • Urinary Tract Infections / drug therapy
  • Urinary Tract Infections / epidemiology
  • Urinary Tract Infections / microbiology

Substances

  • Anti-Infective Agents