Practical approaches to monitoring AMR development and transmission

We know from step 1.7 that AMR can be transmitted between bacteria and between animals, and hopefully you should have a good understanding of how this happens. In this article, Professor Roberto La Ragione discusses the ways we can monitor AMR development and transmission.

Monitoring AMR development:

There are several ways to monitor the development of antimicrobial resistance. These include:

• Classic disc diffusion assays.
• Minimum inhibitory concentration (MIC) – minimum concentration of the antibiotic required to stop bacterial growth.
• Rapid diagnostics (PCR, LAMP, sequencing):
  • Monitor gene presence.
  • Monitor the development of genetic mutations.
  • Monitor bacterial behaviour in the lab (respiration, growth etc.).

It is important to always investigate treatment failures thoroughly.

Click to enlarge

Monitoring AMR development:

Practical approaches to this include:

• Monitoring marker organisms (e.g. E. coli) in animals and the environment.
• Looking for resistance in different pathogens.
• Looking for different resistance patterns, and specifically for multiple resistance.
• Active surveillance:
  • Taking samples from healthy animals.
  • Performing culture and sensitivity.
  • Whole genome sequencing of isolates to determine their genetic background.
• Microbiome studies (identifying all bacteria and their genes in a sample), to determine the spread of AMR genes in pathogens and commensals.

AMR transmission should be monitored through the environment, animals and bacteria. Click to enlarge

In summary:

Antibiotic resistance can be monitored through passive and active surveillance.

Classical and molecular laboratory techniques can be used to monitor the emergence of resistance.

Sampling should include animals and the environment.

Antibiotic spread can be detected by monitoring marker organisms and thoroughly investigating treatment failures.

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Please use the comments section below to discuss methods that you have witnessed being implemented.