5.1 National surveillance systems

PHE’s Fingertips

Public Health England (PHE) is an executive agency under the Department of Health and Social Care in the UK, which coordinates the national AMR surveillance platform known as Fingertips. Established in 2016, Fingertips [Tip: hold Ctrl and click a link to open it in a new tab. (Hide tip)] collects routine hospital, general practice and care home laboratory isolate data in a systematic and reliable manner. A comprehensive list of organisms that must be reported to PHE is listed on the UK government’s website, and includes key bacterial species such as Escherichia coli, Staphylococcus aureus, Acinetobacter baumannii, Klebsiella spp., Pseudomonas aeruginosa, Enterobacteriales and Enterococcus spp.

ISIS-AR

The Infectious Diseases Surveillance Information System for Antimicrobial Resistance (ISIS-AR) was set up in 2008 by the Dutch National Institute for Public Health and the Environment. The system was set up in close collaboration with the Dutch Society for Medical Microbiology and relies on routine antimicrobial susceptibility data submitted by medical laboratories. Its main objective is to monitor trends in AMR in the Netherlands, including retrospective and prospective identification of the emergence of new AMR mechanisms.

The system accepts antimicrobial susceptibility (AST) data from all specimens sampled by medical laboratories, either for diagnostic reasons to treat patients presenting with signs of clinical infection or where routinely collected from patients who are at high risk of developing resistant infections. The data collected support policymaking in public health and healthcare, including the development of empiric antibiotic treatment guidelines. Analyses done via data from this platform helps facilitate scientific research, and contributes to quality, safety and the reduction of healthcare costs.

DANMAP

The Danish Integrated Antimicrobial Resistance Monitoring and Research Programme (DANMAP) platform was set up in 1995 and is a government supported organisation. DANMAP carries out surveillance on the use of antimicrobials in both the animal (food animals, foods of animal origin) and human health sectors. It also carries out surveillance on the occurrence of antimicrobial resistance in bacteria isolates from both the animal and human sectors, namely from hospitals, general practice, veterinary practice, and food-industry laboratories. This is an example of a One Health approach to surveillance.

All antimicrobials prescribed in Denmark, in both the animal and human sectors, are recorded in nationally maintained databases. DANMAP utilises this central resource and reports on antimicrobial use and resistance with a focus on key bacterial species such as Escherichia coli, Campylobacter spp., Salmonella spp., Enterococcus spp., as examples from the animal sector, and Escherichia coli, Pseudomonas aeruginosa, Acinetobacter species, Enterococcus faecium and Enterococcus faecalis as human health sector examples.