Amin Md Al, Pasha Monirul Haque, Hoque M Nazmul, Siddiki Amam Zonaed, Saha Sukumar, Kamal Md Mostofa
Quality Control Laboratory, Department of Livestock Services, Savar, Dhaka-1341, Bangladesh.
Bangladesh Accreditation Board, Dhaka-1000, Bangladesh.
Vet World. 2022 Apr;15(4):1066-1079. doi: 10.14202/vetworld.2022.1066-1079. Epub 2022 Apr 25.
Antimicrobial resistance (AMR) is a crucial and emerging multifactorial "One Health" problem involving human and animal health, agriculture, aquaculture, and environment; and posing a potential public health hazard globally. The containment of AMR justifies effective surveillance programs to explicate the magnitude of the problem across the contributing sectors. Laboratory-based AMR testing and characterization is the key component of an AMR surveillance program. An AMR surveillance program should have a "top management" for fund mobilization, planning, formulating, and multilateral coordinating of the surveillance activities. The top management should identify competent participating laboratories to form a network comprising a reference laboratory and an adequate number of sentinel laboratories. The responsibilities of the reference laboratory include the development of standardized test methods for ensuring quality and homogeneity of surveillance activities, providing training to the laboratory personnel, and in-depth AMR characterization. The sentinel laboratories will take the responsibilities of receiving samples, isolation and identification of microbes, and initial AMR characterization. The sentinel laboratories will use simple antimicrobial susceptibility test (AST) methods such as disk diffusion tests, whereas the reference laboratories should use automated quantitative AST methods as well as advanced molecular methods to explicit AMR emergence mechanisms. Standard guidelines set by Clinical Laboratory Standards Institute or the European Committee on Antimicrobial Susceptibility Testing, should be followed to bring about conformity and harmonization in the AST procedures. AMR surveillance program in animals is eventually similar to that in human health with the exception is that veterinary antibiotics and veterinary pathogens should be given preference here. Hence, the review study was envisaged to look deep into the structure of the AMR surveillance program with significance on laboratory-based AMR testing and characterization methods.
抗菌药物耐药性（AMR）是一个关键且新出现的多因素“同一健康”问题，涉及人类和动物健康、农业、水产养殖及环境；并在全球构成潜在的公共卫生危害。控制AMR需要有效的监测计划，以阐明各相关部门问题的严重程度。基于实验室的AMR检测和特征分析是AMR监测计划的关键组成部分。一个AMR监测计划应具备“高层管理”，用于资金筹集、监测活动的规划、制定和多边协调。高层管理应确定有能力的参与实验室，组成一个由参考实验室和足够数量的哨点实验室构成的网络。参考实验室的职责包括制定标准化检测方法，以确保监测活动的质量和同质性，为实验室人员提供培训，以及进行深入的AMR特征分析。哨点实验室将负责接收样本、微生物的分离和鉴定以及初步的AMR特征分析。哨点实验室将使用简单的抗菌药物敏感性试验（AST）方法，如纸片扩散法，而参考实验室应使用自动化定量AST方法以及先进的分子方法来阐明AMR出现的机制。应遵循临床实验室标准协会或欧洲抗菌药物敏感性试验委员会制定的标准指南，以使AST程序达到一致性和协调性。动物中的AMR监测计划最终与人类健康中的监测计划类似，不同之处在于这里应优先考虑兽用抗生素和兽用病原体。因此，设想开展这项综述研究，深入探究AMR监测计划的结构，重点关注基于实验室的AMR检测和特征分析方法。
