Turner Paul, Ashley Elizabeth A, Celhay Olivier J, Douangnouvong Anousone, Hamers Raph L, Ling Clare L, Lubell Yoel, Miliya Thyl, Roberts Tamalee, Soputhy Chansovannara, Ngoc Thach Pham, Vongsouvath Manivanh, Waithira Naomi, Wannapinij Prapass, van Doorn H Rogier
Cambodia Oxford Medical Research Unit, Angkor Hospital for Children, Siem Reap, Cambodia.
Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, Oxford, UK.
Wellcome Open Res. 2020 Jun 1;5:13. doi: 10.12688/wellcomeopenres.15681.2. eCollection 2020.
: Antimicrobial resistance (AMR) / drug resistant infections (DRIs) are a major global health priority. Surveillance data is critical to inform infection treatment guidelines, monitor trends, and to assess interventions. However, most existing AMR / DRI surveillance systems are passive and pathogen-based with many potential biases. Addition of clinical and patient outcome data would provide considerable added value to pathogen-based surveillance. : The aim of the ACORN project is to develop an efficient clinically-oriented AMR surveillance system, implemented alongside routine clinical care in hospitals in low- and middle-income country settings. In an initial pilot phase, clinical and microbiology data will be collected from patients presenting with clinically suspected meningitis, pneumonia, or sepsis. Community-acquired infections will be identified by daily review of new admissions, and hospital-acquired infections will be enrolled during weekly point prevalence surveys, on surveillance wards. Clinical variables will be collected at enrolment, hospital discharge, and at day 28 post-enrolment using an electronic questionnaire on a mobile device. These data will be merged with laboratory data onsite using a flexible automated computer script. Specific target pathogens will be spp and . A bespoke browser-based app will provide sites with fully interactive data visualisation, analysis, and reporting tools. : ACORN will generate data on the burden of DRI which can be used to inform local treatment guidelines / national policy and serve as indicators to measure the impact of interventions. Following development, testing and iteration of the surveillance tools during an initial six-month pilot phase, a wider rollout is planned.
抗菌药物耐药性（AMR）/耐药性感染（DRIs）是全球主要的卫生优先事项。监测数据对于制定感染治疗指南、监测趋势以及评估干预措施至关重要。然而，现有的大多数AMR/DRI监测系统都是被动的且基于病原体检测，存在许多潜在偏差。增加临床和患者结局数据将为基于病原体的监测提供相当大的附加价值。：ACORN项目的目标是开发一个高效的以临床为导向的AMR监测系统，该系统将在低收入和中等收入国家的医院日常临床护理中实施。在初始试点阶段，将从临床疑似脑膜炎、肺炎或败血症的患者中收集临床和微生物学数据。社区获得性感染将通过每日审查新入院患者来确定，医院获得性感染将在每周的监测病房现患率调查中纳入。临床变量将在入组时、出院时以及入组后第28天使用移动设备上的电子问卷进行收集。这些数据将使用灵活的自动化计算机脚本在现场与实验室数据合并。特定的目标病原体将是[具体病原体1]和[具体病原体2]。一个定制的基于浏览器的应用程序将为各站点提供完全交互式的数据可视化、分析和报告工具。：ACORN将生成有关DRI负担的数据，这些数据可用于制定当地治疗指南/国家政策，并作为衡量干预措施影响的指标。在最初为期六个月的试点阶段对监测工具进行开发、测试和迭代之后，计划进行更广泛的推广。
