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Toolbox  –  Measure

Antibiotic resistance

Knowledge about antibiotic resistance levels in bacteria from both humans and animals and how common these bacteria are, is key to guide appropriate treatment of patients and animals, as well as for understanding the scale of the problem and address it appropriately.

This section provides data, information and tools on antibiotic resistance and how to measure antibiotic resistance patterns in bacteria from humans and animals.

Please note that it is useful to examine resistance in both humans and animals in parallel, to track resistance trends and detect for example emerging resistance or outbreaks. The table below collects resources with a cross-sectorial, or ‘One Health’ perspective. Also, several reports present data from both humans and animals, and may therefore be found on all sub-pages.

While the Toolbox contains some references to scientific papers, there is a large quantity of studies of varying quality published in the scientific literature. Search for example for “antibiotics AND [your country]” in one of the the databases below:

Selected Resources

Resources Description
Integrated surveillance of antimicrobial resistance in foodborne bacteria: Application of a One Health approach Guide designed for WHO Member States and other stakeholders for designing an integrated surveillance program using standardized and validated antimicrobial susceptibility testing methods and harmonized interpretative criteria. Read more about the WHO Advisory Group on Integrated Surveillance of Antimicrobial Resistance (AGISAR) here
ECDC, EFSA and EMA Joint Scientific Opinion on a list of outcome indicators as regards surveillance of antimicrobial resistance and antimicrobial consumption in humans and food-producing animals Indicators: Suggestion of outcome indicators with a ‘One Health’ perspective for monitoring progress of surveillance of antimicrobial resistance and antimicrobial consumption in humans and food-producing animals, with methodology for how indicators were selected, and examples of calculation of indicators. Established by European health and food safety agencies.
ECDC/EFSA/EMA joint reports on the integrated analysis of the consumption of antimicrobial agents and occurrence of antimicrobial resistance in bacteria from humans and food-producing animals (JIACRA reports) Report. Using existing data from Europe, ECDC/EFSA/EMA analyze the relationship between antimicrobial consumption and resistance to the same antimicrobials in bacteria from humans and animals.
A conceptual framework for the environmental surveillance of antibiotics and antibiotic resistance Journal article proposing a framework for how to use environmental samples for surveillance of antibiotic consumption and antibiotic resistance. The framework contains five objectives of surveillance together with proposed markers and sampling sites.

Further reading

1.
Huijbers PMC, Flach C-F, Larsson DGJ. A conceptual framework for the environmental surveillance of antibiotics and antibiotic resistance. Environment International [Internet]. 2019 [cited 2019 Jun 28];130:104880. Available from: https://linkinghub.elsevier.com/retrieve/pii/S0160412019304908
1.
ECDC, EMA Committee for Medicinal Products for Veterinary Use (CVMP), EFSA Panel on Biological Hazards (BIOHAZ). ECDC, EFSA and EMA Joint Scientific Opinion on a list of outcome indicators as regards surveillance of antimicrobial resistance and antimicrobial consumption in humans and food-producing animals. EFSA Journal [Internet]. 2017 Oct 1;15(10):n/a-n/a. Available from: http://onlinelibrary.wiley.com/doi/10.2903/j.efsa.2017.5017/abstract
1.
World Health Organization Regional Office for Europe. Central Asian and Eastern European Surveillance of Antimicrobial Resistance (CAESAR). Annual report 2017 [Internet]. 2017 [cited 2017 Dec 4]. Available from: http://www.euro.who.int/en/health-topics/disease-prevention/antimicrobial-resistance/publications/2017/central-asian-and-eastern-european-surveillance-of-antimicrobial-resistancecaesar.-annual-report-2017
1.
Integrated surveillance of antimicrobial resistance in foodborne bacteria: Application of a One Health approach [Internet]. WHO. [cited 2017 Jun 30]. Available from: http://www.who.int/foodsafety/publications/agisar_guidance2017/en/
1.
World Health Organization - WHO. WHO Advisory Group on Integrated Surveillance of Antimicrobial Resistance (AGISAR) [Internet]. WHO. [cited 2016 Mar 10]. Available from: http://www.who.int/foodsafety/areas_work/antimicrobial-resistance/agisar/en/