Antibiotic Resistance Surveillance Systems: A Review.

Abstract Objective Epidemiological surveillance is one critical approach to estimate and fight against the burden of antibiotic resistance (AR). Herein, we summarize the characteristics of surveillance systems devoted to the surveillance of AR worldwide and published in literature. Methods We performed a systematic review of the literature available on PubMed from January 2007 to July 2019 (12.5 years). The key words (“surveillance system" OR "laboratory-based surveillance" OR "syndromic surveillance" OR "sentinel surveillance" OR "integrated surveillance" OR "population-based surveillance") AND ("antibiotic resistance" OR "antimicrobial resistance") were used. This research was completed with antibiotic resistance monitoring systems available on websites. Results We identified 71 antibiotic resistance surveillance systems described by 90 publications from 35 countries: 65 (91.5%) national surveillance systems and 6 (8.5%) multinational. Two regions accounted for 73% of admissions: European region (37; 52.9%), and region of the Americas (14; 20.2%). Fifty-three focused on AR suveillance in human, 12 studied both humans and animals, and 3 focused only on animals. The two most common bacterial species reported were Staphylococcus aureus (42; 59.2%) and Escherichia coli (39; 54.9%). Twenty out of 71 (28.2%) antibiotic resistance surveillance systems used prevalence as indicator, 3 (4.2%) used incidence and 7 (9.9%) both. Methicillin-resistant S. aureus, vancomycin resistance for Enterococcus spp, S. aureus and Streptococcus pneumoniae, penicillin-resistant-S. pneumoniae, Extended Spectrum Beta-Lactamase and carbapenem resistance for E. coli and Klebsiella pneumoniae were monitored. Conclusion Our results showed heterogeneous surveillance systems. A "one health approach" is needed to monitor antibiotic resistance, with reference to the WHO Global Action Plan.