Novel strategies and tools for antimicrobial resistance surveillance
The central objective of this project is to validate, optimize and implement the use of LQAS-based AMR surveillance as a feasible strategy to timely inform local antimicrobial stewardship activities, and to estimate overall AMR prevalence, supported by sustainable enhancement of microbiology capacity through a tele-microbiology approach. This objective is addressed in two closely interacting sub-projects.
The studies take place in two cities on two Indonesian islands (Bandung, Java and Medan, Sumatra) and consist of two sub-projects. The first project focuses on epidemiology and mathematical modeling, addressing the validation and optimization of the use of LQAS-based surveillance, as well as bias introduced by laboratory-based surveillance or negative cultures. The second project focuses on clinical and microbiological aspects, and studies the effect of results of LQAS-based surveillance on antimicrobial stewardship activities and appropriateness of empirical therapy. The SPIN project validates, optimizes, and implements the use of LQAS-based AMR surveillance for urinary tract infections caused by Escherichia coli and Klebsiella pneumoniae. This is paired with extensive capacity building activities in microbiology using state-of-the-art techniques (tele-microbiology approach) to be able to effectively inform local antimicrobial stewardship activities. Other objectives of the study are to assess the appropriateness of empirical therapy for urinary tract infection given the background prevalence of AMR as assessed by LQAS-based surveillance, and to assess clinical and molecular determinant of AMR in urinary tract infections
OutcomeThe publication (Journal of Antimicrobial Chemotherapy, doi: 10.1093/jac/dkw578) reports the results of the initial full-fledged prevalence survey in both the community setting and the hospital setting. The prevalence of antimicrobial resistance was found to be alarmingly high, precluding any empirical treatment with available oral antibiotics. The results provided valuable input for the design of the second round of data collection that is geared towards a prospective LQAS approach. The findings were disseminated within the respective sites, where they formed the basis of institutional discussion on strategies for antimicrobial stewardship and to curb AMR.
UNPAD (Universitas Padjadjaran), Bandung
USU (University of Sumatera Utara), Medan
Koninklijke Nederlandse Akademie van Wetenschappen (KNAW)