Guidelines for antimicrobial resistance surveillance

ABSTRACT

Sets out a logical and practical plan for the systematic monitoring of bacterial resistance to antimicrobial agents in countries of the Eastern Mediterranean Region. Advice on the development of a regional surveillance network is also provided. The booklet opens with background information about the growing problem of antimicrobial resistance, the contributing factors, and the consequences in terms of patient care and costs, particularly in developing countries. Against this background, precise guidelines for the surveillance of antimicrobial resistance are presented in seven sections. The first two provide general rules for the selection of indicator organisms, followed by a list of 36 organisms suggested for inclusion in a monitoring scheme. Organisms that should not be monitored are also listed, together with brief explanations of reasons for their exclusion. Section three provides guidelines for the selection of the most appropriate antibiotics for testing, noting that, for most groups of organisms, six or seven antibiotics are sufficient for routine reporting. Recommended antibiotics are then listed for nine groups of organisms. The remaining sections present summary protocols for antimicrobial susceptibility testing by the disc diffusion method, and discuss both traditional and non-traditional approaches to the quality control of susceptibility tests