Setting priorities for patient-centered surveillance of drug-resistant infections

Elizabeth A Ashley; Alistair McLean; Francesca Chiara; Nicholas Feasey; Walter Jaoko; Japheth A Opintan; Sharon J Peacock; Priscilla Rupali; Paul Turner

doi:10.1016/j.ijid.2020.05.121

Setting priorities for patient-centered surveillance of drug-resistant infections

Int J Infect Dis. 2020 Aug:97:60-65. doi: 10.1016/j.ijid.2020.05.121. Epub 2020 Jun 2.

Authors

Elizabeth A Ashley¹, Alistair McLean², Francesca Chiara³, Nicholas Feasey⁴, Walter Jaoko⁵, Japheth A Opintan⁶, Sharon J Peacock⁷, Priscilla Rupali⁸, Paul Turner⁹

Affiliations

¹ Lao-Oxford-Mahosot Hospital-Wellcome Trust Research Unit, Microbiology Laboratory, Mahosot Hospital, Vientiane, Lao PDR; Myanmar Oxford Clinical Research Unit, Yangon, Myanmar; Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, Oxford, UK. Electronic address: liz@tropmedres.ac.
² Myanmar Oxford Clinical Research Unit, Yangon, Myanmar; Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, Oxford, UK; Infectious Diseases Data Observatory (IDDO), Centre for Tropical Medicine and Global Health, University of Oxford, UK.
³ Drug-Resistant Infections Priority Programme, Wellcome, London, UK.
⁴ Malawi-Liverpool-Wellcome Trust Clinical Research Programme, Blantyre, Malawi; Department of Clinical Sciences, Liverpool School of Tropical Medicine, Liverpool, UK.
⁵ Department of Medical Microbiology, University of Nairobi, Kenya.
⁶ Department of Medical Microbiology, University of Ghana, Accra, Ghana.
⁷ Department of Medicine, University of Cambridge, UK.
⁸ Department of Infectious Diseases, Christian Medical College, Vellore, Tamil Nadu, India.
⁹ Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, Oxford, UK; Cambodia Oxford Medical Research Unit, Angkor Hospital for Children, Siem Reap, Cambodia.

PMID: 32502663
DOI: 10.1016/j.ijid.2020.05.121

Abstract

Methods: A priority-setting process (PSP) was launched to define priorities for patient-centered antimicrobial resistance (AMR) surveillance and research in low- and middle-income countries (LMICs). A list of uncertainties related to AMR surveillance in human health was generated using an online survey of stakeholders in LMICs, which asked for unanswered questions about diagnosis, treatment, or prevention of antibiotic resistance.

Results: A total of 445 respondents generated 1076 questions that were mapped to a final shortlist of 107 questions. The most common theme was the treatment of drug-resistant infections, followed by diagnosis, then prevention, and requests for local AMR data. The most asked question was a request for local AMR data, revealing the lack of basic information in many LMICs to guide actions to tackle AMR. The steering group recommended three research areas to be prioritized for funding in the next five years: infection prevention and control in LMICs, improved electronic patient records, starting with laboratory information management systems, and sustainable behavior change among doctors and other health care professionals with a focus on diagnostic stewardship.

Keywords: Antimicrobial resistance; drug-resistant infections; low- and middle-income countries; priority-setting; surveillance.

MeSH terms

Adult
Drug Resistance, Microbial*
Female
Health Personnel
Health Surveys
Humans
Infection Control
Infections / diagnosis
Infections / drug therapy*
Male
Middle Aged
Patient-Centered Care
Socioeconomic Factors
Young Adult