New research presented at the European Society of Clinical Microbiology and Infectious Diseases (ESCMID) Global Congress suggests that indirect predictors, including sociodemographic and healthcare indicators, could help bolster antimicrobial resistance (AMR) surveillance in parts of the world where laboratory-based surveillance methods are lacking.
To estimate global AMR prevalence in priority gram-negative bacterial pathogens (Escherichia coli, Klebsiella pneumoniae, Pseudomonas aeruginosa, and Acinetobacter baumannii) in countries lacking surveillance data, researchers with the Amsterdam Institute for Global Health and Development at Amsterdam University Medical Center used data obtained from the Vivli AMR Register and ResistanceMap. They then supplemented that with sociodemographic, healthcare, environmental, and governance-related data from the World Health Organization Health Inequality Data Repository and the World Bank's Development Indicators.
"While the use and overuse of antibiotics are key drivers of AMR, many other factors contribute to its increased prevalence, including poor water quality and sanitation, poor governance (or corruption), and inadequate public spending on health," lead author Sneha Kotian, MBBS, said in an ESCMID press release emailed to reporters. "Although many countries fall short in surveillance of clinical AMR, they collect detailed socioeconomic data."
Shedding light on AMR blind spots
The ensemble model enabled the researchers to estimate AMR rates for nine pathogen-drug combinations in countries without data from 2004 to 2021, improving coverage from 24% to 85%. While the model worked better for certain pathogen-drug combinations than for others, it showed that rates of third-generation cephalosporin-resistant E coli and carbapenem-resistant A baumannii rose sharply in sub-Saharan Africa and South Asia over the period.
Kotian said studies like this can shed light on AMR blind spots.
"Our results show that sociodemographic and health-related indirect predictors of AMR can complement national surveillance data to help guide prioritisation of surveillance in regions currently lacking surveillance data," she said.