EPI-Net One Health reporting guideline for antimicrobial consumption and resistance surveillance data: a Delphi approach

Nithya Babu Rajendran¹, Fabiana Arieti², Carla Alejandra Mena-Benítez², Liliana Galia², Maela Tebon², Julio Alvarez³, Beryl Primrose Gladstone^{1

4}, Lucie Collineau⁵, Giulia De Angelis⁶, Raquel Duro⁷, William Gaze⁸, Siri Göpel^{1

4}, Souha S Kanj⁹, Annemarie Käsbohrer¹⁰, Direk Limmathurotsakul^{11

12}, Estibaliz Lopez de Abechuco¹⁰, Elena Mazzolini¹³, Nico T Mutters^{14

15}, Maria Diletta Pezzani², Elisabeth Presterl^{15

16

17}, Hanna Renk¹⁸, Jesús Rodríguez-Baño^{19

20}, Oana Săndulescu^{21

22}, Federico Scali²³, Robert Skov²⁴, Thirumalaisamy P Velavan^{25

26}, Cuong Vuong^{27

28}, Evelina Tacconelli^{2

15}; EPI-Net One Health consensus working group

Collaborators, Affiliations

Collaborators

EPI-Net One Health consensus working group:
Ayola Akim Adegnika, Lisa Avery, Marc Bonten, Alessandro Cassini, Claire Chauvin, Monica Compri, Peter Damborg, Sabine De Greeff, Maria Dolores Del Toro, Matthias Filter, Alison Franklin, Bruno Gonzalez-Zorn, Kari Grave, Didier Hocquet, Ludwig E Hoelzle, Erta Kalanxhi, Ramanan Laxminarayan, Leonard Leibovici, Surbhi Malhotra-Kumar, Marc Mendelson, Mical Paul, Cristina Muñoz Madero, Rita Murri, Laura Jv Piddock, Carolien Ruesen, Maurizio Sanguinetti, Thorben Schilling, Remco Schrijver, Mitchell J Schwaber, Luigia Scudeller, Didem Torumkuney, Thomas Van Boeckel, Wannes Vanderhaeghen, Andreas Voss, Teresa Wozniak

Affiliations

¹ Infectious Diseases, Department of Internal Medicine I, University Hospital Tübingen, Tübingen, Germany.
² Infectious Diseases Section, Department of Diagnostics and Public Health, University of Verona, Verona, Italy.
³ VISAVET Health Surveillance Center and Department of Animal Health, Faculty of Veterinary Medicine, Complutense University, Madrid, Spain.
⁴ German Centre for Infection Research (DZIF) Clinical Research Unit for Healthcare Associated and Antibiotic Resistant Bacterial Infections, Tübingen, Germany.
⁵ French Agency for Food, Environmental and Occupational Health and Safety, ANSES, Maisons-Alfort, France.
⁶ Dipartimento di Scienze Biotecnologiche di base, Cliniche Intensivologiche e Perioperatorie, Universita Cattolica del Sacro Cuore, Rome, Italy.
⁷ Unit for the Prevention and Control of Infection and Antimicrobial Resistance, Centro Hospitalar do Tâmega e Sousa, Penafiel, Porto, Portugal.
⁸ The European Centre for Environment and Human Health, University of Exeter Medical School, University of Exeter, Penryn, Cornwall, UK.
⁹ Department of Internal Medicine, Division of Infectious Diseases, Infection Control Program, Antimicrobial Stewardship Program, American University of Beirut Medical Center, Beirut, Lebanon.
¹⁰ German Federal Institute for Risk Assessment (BfR), Department 4 - Biological Safety, Berlin, Germany.
¹¹ Mahidol Oxford Tropical Medicine Research Unit and Department of Tropical Hygiene, Faculty of Tropical Medicine, Mahidol University, Thailand.
¹² Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, UK.
¹³ Department of Epidemiology, Istituto Zooprofilattico Sperimentale delle Venezie, Udine-Padova, Padua, Italy.
¹⁴ Institute for Hygiene and Public Health, Bonn University Hospital, Bonn, Germany.
¹⁵ European Committee on Infection Control, Basel, Switzerland.
¹⁶ Department of Infection Control and Hospital Epidemiology, Medical University of Vienna, Vienna, Austria.
¹⁷ ESCMID Study Group for Nosocomial Infections, Basel, Switzerland.
¹⁸ Department of Paediatric Cardiology, Pulmology and Intensive Care Medicine, University Children's Hospital Tübingen, Tübingen, Germany.
¹⁹ Infectious Diseases and Microbiology Division, Hospital Universitario Virgen Macarena/Department of Medicine, School of Medicine, University of Seville/Biomedicine Institute of Seville (IBiS)/CSIC, Seville, Spain.
²⁰ CIBERINFEC, Instituto de Salud Carlos III, Madrid, Spain.
²¹ Department of Infectious Diseases I, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania.
²² National Institute for Infectious Diseases "Prof. Dr. Matei Balș", Bucharest, Romania.
²³ Istituto Zooprofilattico Sperimentale della Lombardia e Dell'Emilia Romagna, Brescia, Italy.
²⁴ Epidemiological Infectious Disease Preparedness, Statens Serum Institut, Copenhagen, Denmark.
²⁵ Institute of Tropical Medicine, Universitätsklinikum Tübingen, Tübingen, Germany.
²⁶ Vietnamese - German Center for Medical Research, Hanoi, Vietnam.
²⁷ AiCuris Anti-infective Cures GmbH, Wuppertal, Germany.
²⁸ Jansen Pharmaceuticals, Beerse, Belgium.

PMID: 36895445
PMCID: PMC9989632
DOI: 10.1016/j.lanepe.2022.100563

Review

EPI-Net One Health reporting guideline for antimicrobial consumption and resistance surveillance data: a Delphi approach

Nithya Babu Rajendran et al. Lancet Reg Health Eur. 2022.

. 2022 Dec 22:26:100563.

doi: 10.1016/j.lanepe.2022.100563. eCollection 2023 Mar.

Authors

Collaborators

EPI-Net One Health consensus working group:
Ayola Akim Adegnika, Lisa Avery, Marc Bonten, Alessandro Cassini, Claire Chauvin, Monica Compri, Peter Damborg, Sabine De Greeff, Maria Dolores Del Toro, Matthias Filter, Alison Franklin, Bruno Gonzalez-Zorn, Kari Grave, Didier Hocquet, Ludwig E Hoelzle, Erta Kalanxhi, Ramanan Laxminarayan, Leonard Leibovici, Surbhi Malhotra-Kumar, Marc Mendelson, Mical Paul, Cristina Muñoz Madero, Rita Murri, Laura Jv Piddock, Carolien Ruesen, Maurizio Sanguinetti, Thorben Schilling, Remco Schrijver, Mitchell J Schwaber, Luigia Scudeller, Didem Torumkuney, Thomas Van Boeckel, Wannes Vanderhaeghen, Andreas Voss, Teresa Wozniak

Affiliations

¹ Infectious Diseases, Department of Internal Medicine I, University Hospital Tübingen, Tübingen, Germany.
² Infectious Diseases Section, Department of Diagnostics and Public Health, University of Verona, Verona, Italy.
³ VISAVET Health Surveillance Center and Department of Animal Health, Faculty of Veterinary Medicine, Complutense University, Madrid, Spain.
⁴ German Centre for Infection Research (DZIF) Clinical Research Unit for Healthcare Associated and Antibiotic Resistant Bacterial Infections, Tübingen, Germany.
⁵ French Agency for Food, Environmental and Occupational Health and Safety, ANSES, Maisons-Alfort, France.
⁶ Dipartimento di Scienze Biotecnologiche di base, Cliniche Intensivologiche e Perioperatorie, Universita Cattolica del Sacro Cuore, Rome, Italy.
⁷ Unit for the Prevention and Control of Infection and Antimicrobial Resistance, Centro Hospitalar do Tâmega e Sousa, Penafiel, Porto, Portugal.
⁸ The European Centre for Environment and Human Health, University of Exeter Medical School, University of Exeter, Penryn, Cornwall, UK.
⁹ Department of Internal Medicine, Division of Infectious Diseases, Infection Control Program, Antimicrobial Stewardship Program, American University of Beirut Medical Center, Beirut, Lebanon.
¹⁰ German Federal Institute for Risk Assessment (BfR), Department 4 - Biological Safety, Berlin, Germany.
¹¹ Mahidol Oxford Tropical Medicine Research Unit and Department of Tropical Hygiene, Faculty of Tropical Medicine, Mahidol University, Thailand.
¹² Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, UK.
¹³ Department of Epidemiology, Istituto Zooprofilattico Sperimentale delle Venezie, Udine-Padova, Padua, Italy.
¹⁴ Institute for Hygiene and Public Health, Bonn University Hospital, Bonn, Germany.
¹⁵ European Committee on Infection Control, Basel, Switzerland.
¹⁶ Department of Infection Control and Hospital Epidemiology, Medical University of Vienna, Vienna, Austria.
¹⁷ ESCMID Study Group for Nosocomial Infections, Basel, Switzerland.
¹⁸ Department of Paediatric Cardiology, Pulmology and Intensive Care Medicine, University Children's Hospital Tübingen, Tübingen, Germany.
¹⁹ Infectious Diseases and Microbiology Division, Hospital Universitario Virgen Macarena/Department of Medicine, School of Medicine, University of Seville/Biomedicine Institute of Seville (IBiS)/CSIC, Seville, Spain.
²⁰ CIBERINFEC, Instituto de Salud Carlos III, Madrid, Spain.
²¹ Department of Infectious Diseases I, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania.
²² National Institute for Infectious Diseases "Prof. Dr. Matei Balș", Bucharest, Romania.
²³ Istituto Zooprofilattico Sperimentale della Lombardia e Dell'Emilia Romagna, Brescia, Italy.
²⁴ Epidemiological Infectious Disease Preparedness, Statens Serum Institut, Copenhagen, Denmark.
²⁵ Institute of Tropical Medicine, Universitätsklinikum Tübingen, Tübingen, Germany.
²⁶ Vietnamese - German Center for Medical Research, Hanoi, Vietnam.
²⁷ AiCuris Anti-infective Cures GmbH, Wuppertal, Germany.
²⁸ Jansen Pharmaceuticals, Beerse, Belgium.

PMID: 36895445
PMCID: PMC9989632
DOI: 10.1016/j.lanepe.2022.100563

Abstract

Strategic and standardised approaches to analysis and reporting of surveillance data are essential to inform antimicrobial resistance (AMR) mitigation measures, including antibiotic policies. Targeted guidance on linking full-scale AMR and antimicrobial consumption (AMC)/antimicrobial residues (AR) surveillance data from the human, animal, and environmental sectors is currently needed. This paper describes the initiative whereby a multidisciplinary panel of experts (56 from 20 countries-52 high income, 4 upper middle or lower income), representing all three sectors, elaborated proposals for structuring and reporting full-scale AMR and AMC/AR surveillance data across the three sectors. An evidence-supported, modified Delphi approach was adopted to reach consensus among the experts for dissemination frequency, language, and overall structure of reporting; core elements and metrics for AMC/AR data; core elements and metrics for AMR data. The recommendations can support multisectoral national and regional plans on antimicrobials policy to reduce resistance rates applying a One Health approach.

Keywords: Antibiotic policy; Antimicrobial consumption; Antimicrobial resistance; One Health; Surveillance.

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Conflict of interest statement

JA received grants/contracts from the Spanish Ministry of Agriculture, Food and Fisheries and EU Horizon 2020. Work of BPG was funded by the German Center for Infection research Clinical Research Unit (DZIF-CRU) at Tübingen. RD participated on Data Safety Monitoring Board of the ASTARTÉ study (for which no payments were received). WG received grants/contracts from the Horizon Europe grant (supported by UKRI) on AMR and pathogen evolution in costal environments and the UK Natural Environment Research Council grants on AMR Knowledge Exchange NE/V019279/1 and AMR evolution NE/W006251/1; WG received consultation fee for EU DG Sante AMR policy evaluation and recommendations. Work of AK was funded in the context of the project One Health EJP, which has received funding from the European Union's Horizon 2020 research and innovation programme under Grant Agreement No. 773830. EP received grants/contracts from the Austrian Ministry of Health for the National Surveillance Network of healthcare-associated infections (ANISS); EP received honorarium for participation as a chair of the Advisory board on AMR and MDRO Pfizer Austria (27.09.22). MB received grants/contracts from Janssen Vaccines, Novartis, CureVac, and Merck; MB received payment or honoraria for lectures, presentations, speakers bureaus, manuscript writing or educational events from Takeda (November 2019); MB participated on Data Safety Monitoring Board or Advisory Board of Sanofi, Spherecydes, Pfizer, Merck, Novartis, and Astra-Zeneca. MM received support for attending meetings and/or travel from the Global Antibiotic Research and Development Partnership (12.10.22–13.10.2022). LS received grants or contracts from the JPIAMR network grant 2020; LS received support for attending meetings and/or travel from ESCMID for the attendance of ECCMID 2022. DT is an employee of GlaxoSmithKline and holds shares in GlaxoSmithKline. TVB received consultation fees from Stonehaven Consulting; TVB received payment or honoraria for lectures, presentations, speakers bureaus, manuscript writing or educational events from Swedish Veterinary Council. Work of AV was supported by the COMBACTE-MAGNET consortium; AV serves as the ISAC president (International Society of Antimicrobial Chemotherapy) and board member of NVMM (Dutch Microbiology Society). All other authors declare no competing interests.

References

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EPI-Net One Health reporting guideline for antimicrobial consumption and resistance surveillance data: a Delphi approach

Collaborators

Affiliations

EPI-Net One Health reporting guideline for antimicrobial consumption and resistance surveillance data: a Delphi approach

Authors

Collaborators

Affiliations

Abstract

Conflict of interest statement

References

Publication types

LinkOut - more resources

Full Text Sources

Research Materials