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Title: ACORN (A Clinically-Oriented Antimicrobial Resistance Surveillance Network): A pilot protocol for case based antimicrobial resistance surveillance
Authors: Paul Turner
Elizabeth A. Ashley
Olivier J. Celhay
Anousone Douangnouvong
Raph L. Hamers
Clare L. Ling
Yoel Lubell
Thyl Miliya
Tamalee Roberts
Chansovannara Soputhy
Pham Ngoc Thach
Manivanh Vongsouvath
Naomi Waithira
Prapass Wannapinij
H. Rogier van Doorn
Oxford University Clinical Research Unit
Universitas Indonesia
Shoklo Malaria Research Unit
Mahosot Hospital, Lao
Mahidol University
Nuffield Department of Medicine
National Hospital for Tropical Diseases
Angkor Hospital for Children
Keywords: Biochemistry, Genetics and Molecular Biology;Medicine
Issue Date: 1-Jan-2020
Citation: Wellcome Open Research. Vol.5, (2020)
Abstract: © 2020 Turner P et al. Background: 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. Methods: 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 Streptococcus pneumoniae, Staphylococcus aureus, Salmonella spp ., Klebsiella pneumoniae, Escherichia coli, and Acinetobacter baumannii. A bespoke browser-based app will provide sites with fully interactive data visualisation, analysis, and reporting tools. Discussion: 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.
ISSN: 2398502X
Appears in Collections:Scopus 2020

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