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. 2025 Jan 15:11:e57457.
doi: 10.2196/57457.

Availability and Key Characteristics of National Early Warning Systems for Emerging Profiles of Antimicrobial Resistance in High-Income Countries: Systematic Review

Jessica Iera  1   2 , Claudia Isonne  1   3 , Chiara Seghieri  2 , Lara Tavoschi  4 , Mariateresa Ceparano  1 , Antonio Sciurti  1 , Alessia D'Alisera  5 , Monica Sane Schepisi  5 , Giuseppe Migliara  6 , Carolina Marzuillo  1 , Paolo Villari  1 , Fortunato D'Ancona  3 , Valentina Baccolini  1
Affiliations

Availability and Key Characteristics of National Early Warning Systems for Emerging Profiles of Antimicrobial Resistance in High-Income Countries: Systematic Review

Jessica Iera et al. JMIR Public Health Surveill. .

Abstract

Background: The World Health Organization (WHO) recently advocated an urgent need for implementing national surveillance systems for the timely detection and reporting of emerging antimicrobial resistance (AMR). However, public information on the existing national early warning systems (EWSs) is often incomplete, and a comprehensive overview on this topic is currently lacking.

Objective: This review aimed to map the availability of EWSs for emerging AMR in high-income countries and describe their main characteristics.

Methods: A systematic review was performed on bibliographic databases, and a targeted search was conducted on national websites. Any article, report, or web page describing national EWSs in high-income countries was eligible for inclusion. EWSs were identified considering the emerging AMR-reporting WHO framework.

Results: We identified 7 national EWSs from 72 high-income countries: 2 in the East Asia and Pacific Region (Australia and Japan), 3 in Europe and Central Asia (France, Sweden, and the United Kingdom), and 2 in North America (the United States and Canada). The systems were established quite recently; in most cases, they covered both community and hospital settings, but their main characteristics varied widely across countries in terms of the organization and microorganisms under surveillance, with also different definitions of emerging AMR and alert functioning. A formal system assessment was available only in Australia.

Conclusions: A broader implementation and investment of national surveillance systems for the early detection of emerging AMR are still needed to establish EWSs in countries and regions lacking such capabilities. More standardized data collection and reporting are also advisable to improve cooperation on a global scale. Further research is required to provide an in-depth analysis of EWSs, as this study is limited to publicly available data in high-income countries.

Keywords: antimicrobial resistance; early warning system; emerging AMR; high-income countries; surveillance.

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Conflict of interest statement

Conflicts of Interest: None declared.

Figures

Figure 1.
Figure 1.. PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) flow diagram of the review process. EWSs: early warning systems.
Figure 2.
Figure 2.. Availability of early warning systems for emerging antimicrobial resistance at the national level in high-income countries.
See this image and copyright information in PMC

References

    1. Antimicrobial resistance. World Health Organization. [30-09-2024]. https://www.who.int/news-room/fact-sheets/detail/antimicrobial-resistance URL. Accessed.
    1. About antimicrobial resistance. Centers for Disease Control and Prevention (CDC) [30-09-2024]. https://www.cdc.gov/antimicrobial-resistance/about/index.html URL. Accessed.
    1. O’Neill J. Review on Antimicrobial Resistance; 2016. [24-12-2024]. Tackling drug-resistant infections globally: final report and recommendations.https://amr-review.org/sites/default/files/160525_Final%20paper_with%20c... URL. Accessed.
    1. O’Neill J. Review on Antimicrobial Resistance; 2014. [24-12-2024]. Antimicrobial resistance: tackling a crisis for the health and wealth of nations the review on antimicrobial resistance.https://amr-review.org/sites/default/files/AMR%20Review%20Paper%20-%20Ta... URL. Accessed.
    1. Centers for Disease Control and Prevention (CDC); 2019. [30-09-2024]. Antibiotic resistance threats in the United States, 2019.https://stacks.cdc.gov/view/cdc/82532 URL. Accessed.

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