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Int J Antimicrob Agents. 2011 Jun;37(6):504-12. doi: 10.1016/j.ijantimicag.2010.12.002. Epub 2011 Feb 3.
Antimicrobial surveillance systems in Denmark (DANMAP), The Netherlands (MARAN), Spain (VAV) and Sweden (SVARM) as well as the European Antimicrobial Susceptibility Surveillance in Animals (EASSA) were reviewed. Data have been considered for extended-spectrum cephalosporins, fluoroquinolones and macrolides against food-borne and commensal bacteria. The greatest challenge arises from the lack of agreement between programmes on what is meant by resistance through the use of different interpretive criteria. Indeed, it is shown here that the extent of the differences depends on the antibacterial compound being investigated, the methodology and the interpretive criteria used. This emphasises a need to agree a definition for resistance and for epidemiological cut-off values and to consider harmonising the antimicrobials used in surveillance. This analysis of the data highlights the usefulness of using both epidemiological cut-off values and clinical resistance breakpoints for the purpose of detection of decreased susceptibility and development of clinical resistance, respectively. It is concluded that harmonisation in resistance monitoring programmes is needed since there is potential for data to be appropriately used within risk analysis, providing the opportunity to implement appropriate risk management steps as a response to the public health issues arising from changes in antibiotic resistance in food-borne pathogens and commensal organisms.
丹麦（DANMAP）、荷兰（MARAN）、西班牙（VAV）和瑞典（SVARM）的抗菌监测系统以及欧洲动物抗菌药物敏感性监测系统（EASSA）进行了审查。数据涉及针对食源性病原体和共生菌的扩展谱头孢菌素、氟喹诺酮类和大环内酯类药物。最大的挑战来自于各项目之间缺乏对使用不同解释标准的耐药性含义的共识。事实上，本文表明，差异的程度取决于所研究的抗菌化合物、方法学和使用的解释标准。这强调了需要就耐药性的定义以及流行病学临界值达成一致，并考虑协调监测中使用的抗菌药物。对数据的分析突出了使用流行病学临界值和临床耐药性断点的重要性，分别用于检测敏感性降低和临床耐药性的发展。结论是需要在耐药性监测项目中实现协调，因为有可能在风险分析中适当使用数据，为应对食源性病原体和共生生物抗生素耐药性变化带来的公共卫生问题提供机会，实施适当的风险管理措施。
