Send to

Choose Destination
Lancet Infect Dis. 2018 Mar;18(3):e99-e106. doi: 10.1016/S1473-3099(17)30485-1. Epub 2017 Nov 5.

Surveillance for control of antimicrobial resistance.

Author information

Division of Infectious Diseases, Tübingen University Hospital, DZIF Center, Tübingen, Germany. Electronic address:
US Medical Affairs Evidence Generation, AstraZeneca Pharmaceuticals LP, Gaithersburg, MD, USA.
Infection Prevention and Control Service, University Hospitals of Geneva, Geneva, Switzerland.
VetEffecT, Bilthoven, Netherlands.
Department of Medical Microbiology and Infection Control, University Medical Center Utrecht, Utrecht, Netherlands.
Department of Medical Microbiology, Radboud University Medical Centre, Nijmegen, Netherlands.
St George's University of London, London, UK.
Division of Infectious Diseases, Tübingen University Hospital, DZIF Center, Tübingen, Germany.
Unidad Clínica de Enfermedades Infecciosas y Microbiología, Hospital Universitario Virgen Macarena, Sevilla, Spain; Instiuto de Biomedicina de Sevilla, Sevilla, Spain; Departamento de Medicina, Universidad de Sevilla, Sevilla, Spain.


Antimicrobial resistance poses a growing threat to public health and the provision of health care. Its surveillance should provide up-to-date and relevant information to monitor the appropriateness of therapy guidelines, antibiotic formulary, antibiotic stewardship programmes, public health interventions, infection control policies, and antimicrobial development. In Europe, although the European Antimicrobial Resistance Surveillance Network provides annual reports on monitored resistant bacteria, national surveillance efforts are still fragmented and heterogeneous, and have substantial structural problems and issues with laboratory data. Most incidence and prevalence data cannot be linked with relevant epidemiological, clinical, or outcome data. Genetic typing, to establish whether trends of antimicrobial resistance are caused by spread of resistant strains or by transfer of resistance determinants among different strains and species, is not routinely done. Furthermore, laboratory-based surveillance using only clinical samples is not likely to be useful as an early warning system for emerging pathogens and resistance mechanisms. Insufficient coordination of surveillance systems of human antimicrobial resistance with animal surveillance systems is even more concerning. Because results from food surveillance are considered commercially sensitive, they are rarely released publicly by regulators. Inaccurate or incomplete surveillance data delay a translational approach to the threat of antimicrobial resistance and inhibit the identification of relevant target microorganisms and populations for research and the revitalisation of dormant drug-discovery programmes. High-quality, comprehensive, and real-time surveillance data are essential to reduce the burden of antimicrobial resistance. Improvement of national antimicrobial resistance surveillance systems and better alignment between human and veterinary surveillance systems in Europe must become a scientific and political priority, coordinated with international stakeholders within a global approach to reduce the burden of antimicrobial resistance.

[Indexed for MEDLINE]

Supplemental Content

Full text links

Icon for Elsevier Science
Loading ...
Support Center