Cornaglia G, Hryniewicz W, Jarlier V, Kahlmeter G, Mittermayer H, Stratchounski L, Baquero F
Department of Pathology, University of Verona, Verona, Italy.
Clin Microbiol Infect. 2004 Apr;10(4):349-83. doi: 10.1111/j.1198-743X.2004.00887.x.
The problem of antimicrobial resistance surveillance in Europe has been debated extensively in many excellent documents issued by national committees that often assume the value of national guidelines. However, a comprehensive document addressing the whole matter from a European perspective, as well as reviewing its present status and drafting future perspectives, has been lacking. The present recommendations have been produced by the ESCMID Study Group for Antimicrobial Resistance Surveillance (ESGARS) through a consensus process involving all members of the Study Group. The recommendations focus on the detection of bacterial resistance and its reporting to clinicians, public health officers and a wider-and ever-increasing-audience. The leading concept is that the basis for resistance monitoring is microbiological diagnostics. The prerequisites for resistance monitoring are findings of adequate quality and quantity, which have been recorded properly and evaluated correctly. Different types of surveillance studies should fulfil different requirements with regard to data collection and reporting, the expected use of data, and the prerequisites for networking such activities. To generate relevant indicators, bacterial resistance data should be reported using adequate denominators and stratification. Reporting of antimicrobial resistance data is necessary for selection of empirical therapy at the local level, for assessing the scale of the resistance problem at the local, national or international levels, for monitoring changes in resistance rates, and for detecting the emergence and spread of new resistances types. Any type of surveillance study should conclude, where appropriate, with a proposal for intervention based on the data obtained.
欧洲抗菌药物耐药性监测问题在国家委员会发布的许多优秀文件中都有广泛讨论，这些文件往往认可国家指南的价值。然而，一直缺乏一份从欧洲视角全面阐述这一问题、审视其现状并起草未来展望的综合性文件。本建议由欧洲临床微生物与感染性疾病学会抗菌药物耐药性监测研究组（ESGARS）通过涉及研究组所有成员的共识过程制定。这些建议聚焦于细菌耐药性的检测及其向临床医生、公共卫生官员以及更广泛且不断增加的受众群体的报告。主导理念是耐药性监测的基础是微生物诊断。耐药性监测的先决条件是有质量和数量都足够的结果，且这些结果已被妥善记录并正确评估。不同类型的监测研究在数据收集与报告、数据的预期用途以及此类活动联网的先决条件方面应满足不同要求。为生成相关指标，应使用适当的分母和分层方法报告细菌耐药性数据。报告抗菌药物耐药性数据对于在地方层面选择经验性治疗、评估地方、国家或国际层面耐药性问题的规模、监测耐药率变化以及检测新耐药类型的出现和传播而言是必要的。任何类型的监测研究都应在适当时根据所获数据得出干预建议。
