ACORN (A Clinically-Oriented Antimicrobial Resistance Surveillance Network) II: protocol for case based antimicrobial resistance surveillance
Issued Date
2023-01-01
Resource Type
eISSN
2398502X
Scopus ID
2-s2.0-85177451484
Journal Title
Wellcome Open Research
Volume
8
Rights Holder(s)
SCOPUS
Bibliographic Citation
Wellcome Open Research Vol.8 (2023)
Suggested Citation
Mo Y., Ding Y., Cao Y., Hopkins J., Ashley E.A., Waithira N., Wannapinij P., Lee S.J., Ling C.L., Hamers R.L., Roberts T., Lubell Y., Karkey A., Akech S., Lissauer S., Opintan J., Okeke I., Eremin S., Tornimbene B., Hsu L.Y., Thwaites L., Lam M.Y., Pham N.T., Pham T.K., Teo J., Kwa A.L.H., Marimuthu K., Ng O.T., Vasoo S., Kitsaran S., Anunnatsiri S., Kosalaraksa P., Chotiprasitsakul D., Santanirand P., Plongla R., Chua H.H., Tiong X.T., Wong K.J., Ponnampalavanar S.S.L.S., Sulaiman H.B., Mazlan M.Z., Salmuna Z.N., Rajahram G.S., Zaili M.Z.B.M., Francis J.R., Sarmento N., Guterres H., Oakley T., Yan J., Tilman A., Khalid M.O.R., Hashmi M., Mahmood S.F., Dhiloo A.K., Fatima A., Lubis I.N.D., Wijaya H., Abad C.L., Roman A.D., Lazarte C.C.M., Mamun G.M.S., Asli R., Momin M.H.F.b.H.A., Nyamdavaa K., Gurjav U., Bory S., Varghese G.M., Gupta L., Tantia P., Sinto R., Doi Y., Khanal B., Malijan G., Lazaro J., Gunasekara S., Withanage S., Liu P.Y., Xiao Y., Wang M., Paterson D.L., Doorn H.R.v., Turner P. ACORN (A Clinically-Oriented Antimicrobial Resistance Surveillance Network) II: protocol for case based antimicrobial resistance surveillance. Wellcome Open Research Vol.8 (2023). doi:10.12688/wellcomeopenres.19210.2 Retrieved from: https://repository.li.mahidol.ac.th/handle/20.500.14594/91227
Title
ACORN (A Clinically-Oriented Antimicrobial Resistance Surveillance Network) II: protocol for case based antimicrobial resistance surveillance
Author(s)
Mo Y.
Ding Y.
Cao Y.
Hopkins J.
Ashley E.A.
Waithira N.
Wannapinij P.
Lee S.J.
Ling C.L.
Hamers R.L.
Roberts T.
Lubell Y.
Karkey A.
Akech S.
Lissauer S.
Opintan J.
Okeke I.
Eremin S.
Tornimbene B.
Hsu L.Y.
Thwaites L.
Lam M.Y.
Pham N.T.
Pham T.K.
Teo J.
Kwa A.L.H.
Marimuthu K.
Ng O.T.
Vasoo S.
Kitsaran S.
Anunnatsiri S.
Kosalaraksa P.
Chotiprasitsakul D.
Santanirand P.
Plongla R.
Chua H.H.
Tiong X.T.
Wong K.J.
Ponnampalavanar S.S.L.S.
Sulaiman H.B.
Mazlan M.Z.
Salmuna Z.N.
Rajahram G.S.
Zaili M.Z.B.M.
Francis J.R.
Sarmento N.
Guterres H.
Oakley T.
Yan J.
Tilman A.
Khalid M.O.R.
Hashmi M.
Mahmood S.F.
Dhiloo A.K.
Fatima A.
Lubis I.N.D.
Wijaya H.
Abad C.L.
Roman A.D.
Lazarte C.C.M.
Mamun G.M.S.
Asli R.
Momin M.H.F.b.H.A.
Nyamdavaa K.
Gurjav U.
Bory S.
Varghese G.M.
Gupta L.
Tantia P.
Sinto R.
Doi Y.
Khanal B.
Malijan G.
Lazaro J.
Gunasekara S.
Withanage S.
Liu P.Y.
Xiao Y.
Wang M.
Paterson D.L.
Doorn H.R.v.
Turner P.
Ding Y.
Cao Y.
Hopkins J.
Ashley E.A.
Waithira N.
Wannapinij P.
Lee S.J.
Ling C.L.
Hamers R.L.
Roberts T.
Lubell Y.
Karkey A.
Akech S.
Lissauer S.
Opintan J.
Okeke I.
Eremin S.
Tornimbene B.
Hsu L.Y.
Thwaites L.
Lam M.Y.
Pham N.T.
Pham T.K.
Teo J.
Kwa A.L.H.
Marimuthu K.
Ng O.T.
Vasoo S.
Kitsaran S.
Anunnatsiri S.
Kosalaraksa P.
Chotiprasitsakul D.
Santanirand P.
Plongla R.
Chua H.H.
Tiong X.T.
Wong K.J.
Ponnampalavanar S.S.L.S.
Sulaiman H.B.
Mazlan M.Z.
Salmuna Z.N.
Rajahram G.S.
Zaili M.Z.B.M.
Francis J.R.
Sarmento N.
Guterres H.
Oakley T.
Yan J.
Tilman A.
Khalid M.O.R.
Hashmi M.
Mahmood S.F.
Dhiloo A.K.
Fatima A.
Lubis I.N.D.
Wijaya H.
Abad C.L.
Roman A.D.
Lazarte C.C.M.
Mamun G.M.S.
Asli R.
Momin M.H.F.b.H.A.
Nyamdavaa K.
Gurjav U.
Bory S.
Varghese G.M.
Gupta L.
Tantia P.
Sinto R.
Doi Y.
Khanal B.
Malijan G.
Lazaro J.
Gunasekara S.
Withanage S.
Liu P.Y.
Xiao Y.
Wang M.
Paterson D.L.
Doorn H.R.v.
Turner P.
Author's Affiliation
Angkor Hospital for Children
National Centre for Infectious Diseases
Ramathibodi Hospital
Mahidol Oxford Tropical Medicine Research Unit
Fujita Health University Hospital
Oxford University Clinical Research Unit
The First Affiliated Hospital, Zhejiang University School of Medicine
National Cancer Institute Sri Lanka
Duke-NUS Medical School
Malawi-Liverpool-Wellcome Trust Clinical Research Programme
Mongolian National University of Medical Sciences
Raja Isteri Pengiran Anak Saleha Hospital
Hopital Calmette
B.P. Koirala Institute of Health Sciences
San Lazaro Hospital
University of the Philippines Manila
Philippine General Hospital
Kenya Medical Research Institute
Universitas Sumatera Utara
Universitas Indonesia, RSUPN Dr. Cipto Mangunkusumo
Universitas Indonesia
The Aga Khan University Hospital
Ziauddin Medical University
Dow University of Health Sciences Pakistan
National University Hospital
Organisation Mondiale de la Santé
Faculty of Medicine, Khon Kaen University
Menzies School of Health Research
Lok Nayak Hospital
King Chulalongkorn Memorial Hospital
University of Liverpool
Singapore General Hospital
University of Ghana
National University of Singapore
Mahosot Hospital, Lao
University of Malaya Medical Centre
International Centre for Diarrhoeal Disease Research Bangladesh
Fudan University
Sarawak General Hospital
Nuffield Department of Medicine
University of Ibadan
School of Medical Sciences, Universiti Sains Malaysia
Tan Tock Seng Hospital
Christian Medical College, Vellore
Taichung Veteran General Hospital
Ananta Institute of Medical Sciences and Research Center
Ministerio da Saude
Singapore Clinical Research Institute
Sabah Women and Children's Hospital
The Medical City
Queen Elizabeth Hospital
H. Adam Malik Hospital
Sunpasitthiprasong Hospital
Hospital Nacional Guido Valadares
Hospital Queen Elizabeth II
National Hospital of Tropical Diseases
National Centre for Infectious Diseases
Ramathibodi Hospital
Mahidol Oxford Tropical Medicine Research Unit
Fujita Health University Hospital
Oxford University Clinical Research Unit
The First Affiliated Hospital, Zhejiang University School of Medicine
National Cancer Institute Sri Lanka
Duke-NUS Medical School
Malawi-Liverpool-Wellcome Trust Clinical Research Programme
Mongolian National University of Medical Sciences
Raja Isteri Pengiran Anak Saleha Hospital
Hopital Calmette
B.P. Koirala Institute of Health Sciences
San Lazaro Hospital
University of the Philippines Manila
Philippine General Hospital
Kenya Medical Research Institute
Universitas Sumatera Utara
Universitas Indonesia, RSUPN Dr. Cipto Mangunkusumo
Universitas Indonesia
The Aga Khan University Hospital
Ziauddin Medical University
Dow University of Health Sciences Pakistan
National University Hospital
Organisation Mondiale de la Santé
Faculty of Medicine, Khon Kaen University
Menzies School of Health Research
Lok Nayak Hospital
King Chulalongkorn Memorial Hospital
University of Liverpool
Singapore General Hospital
University of Ghana
National University of Singapore
Mahosot Hospital, Lao
University of Malaya Medical Centre
International Centre for Diarrhoeal Disease Research Bangladesh
Fudan University
Sarawak General Hospital
Nuffield Department of Medicine
University of Ibadan
School of Medical Sciences, Universiti Sains Malaysia
Tan Tock Seng Hospital
Christian Medical College, Vellore
Taichung Veteran General Hospital
Ananta Institute of Medical Sciences and Research Center
Ministerio da Saude
Singapore Clinical Research Institute
Sabah Women and Children's Hospital
The Medical City
Queen Elizabeth Hospital
H. Adam Malik Hospital
Sunpasitthiprasong Hospital
Hospital Nacional Guido Valadares
Hospital Queen Elizabeth II
National Hospital of Tropical Diseases
Other Contributor(s)
Abstract
Background: Antimicrobial resistance surveillance is essential for empiric antibiotic prescribing, infection prevention and control policies and to drive novel antibiotic discovery. However, most existing surveillance systems are isolate-based without supporting patient-based clinical data, and not widely implemented especially in low- and middle-income countries (LMICs). Methods: A Clinically-Oriented Antimicrobial Resistance Surveillance Network (ACORN) II is a large-scale multicentre protocol which builds on the WHO Global Antimicrobial Resistance and Use Surveillance System to estimate syndromic and pathogen outcomes along with associated health economic costs. ACORN-healthcare associated infection (ACORN-HAI) is an extension study which focuses on healthcare-associated bloodstream infections and ventilator-associated pneumonia. Our main aim is to implement an efficient clinically-oriented antimicrobial resistance surveillance system, which can be incorporated as part of routine workflow in hospitals in LMICs. These surveillance systems include hospitalised patients of any age with clinically compatible acute community-acquired or healthcare-associated bacterial infection syndromes, and who were prescribed parenteral antibiotics. Diagnostic stewardship activities will be implemented to optimise microbiology culture specimen collection practices. Basic patient characteristics, clinician diagnosis, empiric treatment, infection severity and risk factors for HAI are recorded on enrolment and during 28-day follow-up. An R Shiny application can be used offline and online for merging clinical and microbiology data, and generating collated reports to inform local antibiotic stewardship and infection control policies. Discussion: ACORN II is a comprehensive antimicrobial resistance surveillance activity which advocates pragmatic implementation and prioritises improving local diagnostic and antibiotic prescribing practices through patient-centred data collection. These data can be rapidly communicated to local physicians and infection prevention and control teams. Relative ease of data collection promotes sustainability and maximises participation and scalability. With ACORN-HAI as an example, ACORN II has the capacity to accommodate extensions to investigate further specific questions of interest.