Integrated Antibiotic Resistance Surveillance: Importance of Harmonization and Quality Assurance of Antibiotic Susceptibility Testing

Antibiotic resistance (AR) is an underestimated emerging One Health problem. Surveillance systems are the core components of AR management programmes. Integrated harmonized surveillance programmes with active watchfulness on the use of antimicrobials and trends of resistance in bacteria of human, animal and environmental origin are required for exact estimation of the true burden of AR. Harmonized surveillance programmes follow uniformity in antibiotic susceptibility testing protocols, targeted bacterial species, tested antimicrobials, reporting clinical limits, susceptibility interpretation criteria and use of control strains. Harmonization of AR surveillance programmes is crucial for reliable data generation and comparison of AR data at regional, national and global levels. Data generated by such programmes can be used to formulate empirical treatment guidelines and policies for the effective management of AR. Standardization of antibiotic susceptibility testing by adopting quality assurance and quality control programmes is essential for generating valid and reliable data under AR surveillance programmes.