Public Health Research, Anweshan Private Limited, Lalitpur, Nepal.
Public Health Surveillance Group, LLC, Princeton, New Jersey, USA.
Clin Infect Dis. 2023 Dec 20;77(Suppl 7):S560-S568. doi: 10.1093/cid/ciad581.
Data on antimicrobial resistance (AMR) from sites not participating in the National AMR surveillance network, conducted by National Public Health Laboratory (NPHL), remain largely unknown in Nepal. The "Capturing Data on Antimicrobial Resistance Patterns and Trends in Use in Regions of Asia" (CAPTURA) assessed AMR data from previously untapped data sources in Nepal. A retrospective cross-sectional data review was carried out for the AMR data recorded between January 2017 and December 2019 to analyze AMR data from 26 hospital-based laboratories and 2 diagnostic laboratories in Nepal. Of the 56 health facilities initially contacted to participate in this project activity, 50.0% (28/56) signed a data-sharing agreement with CAPTURA. Eleven of the 28 hospitals were AMR surveillance sites, whereas the other 17, although not part of the National AMR surveillance network, recorded AMR-related data. Data for 663 602 isolates obtained from 580 038 patients were analyzed. A complete record of the 11 CAPTURA priority variables was obtained from 45.5% (5/11) of government hospitals, 63.6% (7/11) of private hospitals, and 54.6% (6/11) of public-private hospitals networked with NPHL for AMR surveillance. Similarly, 80% (8/10) of clinics and 54.6% (6/11) of laboratories outside the NPHL network recorded complete data for the 10 Global Antimicrobial Resistance and Use Surveillance System (GLASS) priority variables and 11/14 CAPTURA priority variables. Retrospective review of the data identified areas requiring additional resources and interventions to improve the quality of data on AMR in Nepal. Furthermore, we observed no difference in the priority variables reported by sites within or outside the NPHL network, thus suggesting that policies could be made to expand the surveillance system to include these sites without substantially affecting the government's budget.
在尼泊尔，国家公共卫生实验室（NPHL）开展的国家抗菌素耐药性监测网络之外的地点的抗菌素耐药性（AMR）数据在很大程度上仍不为人知。“在亚洲各区域收集抗菌素耐药性模式和趋势数据”（CAPTURA）评估了尼泊尔此前未开发的数据来源中的 AMR 数据。对 2017 年 1 月至 2019 年 12 月记录的 AMR 数据进行了回顾性横断面数据审查，以分析尼泊尔 26 家医院实验室和 2 家诊断实验室的 AMR 数据。在最初联系参与该项目活动的 56 个卫生机构中，有 50.0%（28/56）与 CAPTURA 签署了数据共享协议。在这 28 家医院中，有 11 家是 AMR 监测点，而其余 17 家医院虽然不属于国家 AMR 监测网络，但记录了与 AMR 相关的数据。从 580038 名患者中获得的 663602 个分离物的数据进行了分析。从 45.5%（5/11）的政府医院、63.6%（7/11）的私立医院和与 NPHL 联网进行 AMR 监测的公私合营医院获得了 11 个 CAPTURA 优先变量的完整记录。同样，NPHL 网络之外的 80%（8/10）的诊所和 54.6%（6/11）的实验室记录了 10 个全球抗菌素耐药性和使用监测系统（GLASS）优先变量和 11/14 CAPTURA 优先变量的完整数据。对数据的回顾性审查确定了需要额外资源和干预措施的领域，以提高尼泊尔 AMR 数据的质量。此外，我们还观察到，NPHL 网络内或外的监测点报告的优先变量没有差异，这表明可以制定政策，将监测系统扩大到包括这些监测点，而不会对政府预算产生重大影响。
