Журнал противомикробных средств

Interim Proposal for Surveillance of Multidrug-Resistant, Extensively Drug-Resistant and Pandrug-Resistant Bacteria for the Automated AST User Centres

Abstract

Sastry Apurba Sankar, Priyadarshi Ketan, Rajashekar Deepashree and Rai Sumit

In the era of increased Antimicrobial Resistance (AMR), it is important that Healthcare Facilities (HCFs) should conduct surveillance to know the true estimate of drug resistant organisms such as Multidrug-Resistant (MDR), Extensively Drug-Resistant (XDR) and pandrug-resistant (PDR) bacteria prevalent in their facility. The limitations of disk diffusion method used for comparison of AMR data are largely overcome by use of MIC based automated AST method. These systems use panels comprising of fixed set of large number of antimicrobials and provide standard testing protocol which remains uniform across the user HCFs. The use of automated AST systems has been increasing in the recent past and is expected to expand further in future. Among the automated AST systems available, VITEK-2 is the most extensively used platform both globally (~63%) and in India (~85%). This study provides the guideline to develop revised templates comprising of antimicrobial classes and agents based on automated AST panels for the purpose of MDR/XDR/PDR categorization. By using these templates, AMR data of various automated AST user centres can be collated to achieve meaningful comparison of AMR data. Furthermore, there is no need for any additional manpower or budget, as the analysis of drug resistant bacteria is performed based on routine AST data, without any additional testing. Therefore, large number of HCFs can contribute their AMR data, which can be collated to give true picture of the current burden of MDR/XDR/PDR at national and global level. This information is essential for developing empirical antimicrobial therapy for diverse epidemiological settings.