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Abstract：
BACKGROUND: An electronic reporting system (ERS) for the enhanced surveillance of carbapenemase-producing Gram-negative bacteria (CPGNB) was launched by Public Health England in May 2015.
OBJECTIVE: This evaluation aimed to assess uptake, timeliness and completeness of data provided and explore potential barriers and facilitators to adopting the system.
METHODS: The evaluation comprised a retrospective analysis of surveillance data and semi-structured interviews with ERS users.
RESULTS: The proportion of organisms referred for investigation of carbapenem resistance via ERS increased over the first 12 months post-implementation from 35% to 73%; uptake varied widely across regions of England. Completeness of enhanced data fields was poor in 78% of submitted isolates. The median number of days to report confirmatory test results via ERS was 1 day for the regional service and nine days for the national reference laboratory, which additionally conducts phenotypic testing to confirm carbapenemase negativity. Hindrances to ERS utility included: a lack of designated, ongoing resource for system maintenance, technical support and development; uncertainty about how and when to use ERS and workload. Incomplete data prevented gaining a better understanding of important risk factors and transmission routes of CPGNB in England.
CONCLUSIONS: The ERS is the only surveillance system in England with the potential to gather intelligence on important risk factors for CPGNB to inform public health measures to control their spread. Although the ERS captures more information on CPGNB than other surveillance systems, timeliness and completeness of the enhanced data require substantial improvements in order to deliver the desired health benefits.
OBJECTIVE: This evaluation aimed to assess uptake, timeliness and completeness of data provided and explore potential barriers and facilitators to adopting the system.
METHODS: The evaluation comprised a retrospective analysis of surveillance data and semi-structured interviews with ERS users.
RESULTS: The proportion of organisms referred for investigation of carbapenem resistance via ERS increased over the first 12 months post-implementation from 35% to 73%; uptake varied widely across regions of England. Completeness of enhanced data fields was poor in 78% of submitted isolates. The median number of days to report confirmatory test results via ERS was 1 day for the regional service and nine days for the national reference laboratory, which additionally conducts phenotypic testing to confirm carbapenemase negativity. Hindrances to ERS utility included: a lack of designated, ongoing resource for system maintenance, technical support and development; uncertainty about how and when to use ERS and workload. Incomplete data prevented gaining a better understanding of important risk factors and transmission routes of CPGNB in England.
CONCLUSIONS: The ERS is the only surveillance system in England with the potential to gather intelligence on important risk factors for CPGNB to inform public health measures to control their spread. Although the ERS captures more information on CPGNB than other surveillance systems, timeliness and completeness of the enhanced data require substantial improvements in order to deliver the desired health benefits.
摘要：
背景：2015年5月，英国公共卫生部推出了一种电子报告系统（ERS），用于加强对产生碳青霉烯酶的革兰氏阴性菌（CPGNB）的监测。
目的：这项评估旨在评估摄取，提供的数据的及时性和完整性，并探索采用该系统的潜在障碍和促进者。
方法：评估包括对监测数据的回顾性分析和对ERS用户的半结构化访谈。
结果：在实施后的前12个月中，通过ERS进行碳青霉烯耐药性调查的生物体比例从35％增加到73％；英格兰各地区的摄取差异很大。在78％的提交的分离株中，增强数据字段的完整性较差。通过ERS报告验证性测试结果的平均天数为区域服务1天，国家参考实验室9天，另外进行表型测试以确认碳青霉烯酶的阴性。阻碍ERS公用事业的因素包括：缺乏指定的，用于系统维护的持续资源，技术支持和开发；不确定如何以及何时使用ERS和工作负载。不完整的数据无法更好地了解英国CPGNB的重要风险因素和传播途径。
结论：ERS是英格兰唯一有可能收集有关CPGNB重要危险因素的情报的监测系统，以告知公共卫生措施以控制其传播。尽管ERS比其他监视系统捕获更多关于CPGNB的信息，增强数据的及时性和完整性需要进行重大改进，以实现预期的健康益处。
目的：这项评估旨在评估摄取，提供的数据的及时性和完整性，并探索采用该系统的潜在障碍和促进者。
方法：评估包括对监测数据的回顾性分析和对ERS用户的半结构化访谈。
结果：在实施后的前12个月中，通过ERS进行碳青霉烯耐药性调查的生物体比例从35％增加到73％；英格兰各地区的摄取差异很大。在78％的提交的分离株中，增强数据字段的完整性较差。通过ERS报告验证性测试结果的平均天数为区域服务1天，国家参考实验室9天，另外进行表型测试以确认碳青霉烯酶的阴性。阻碍ERS公用事业的因素包括：缺乏指定的，用于系统维护的持续资源，技术支持和开发；不确定如何以及何时使用ERS和工作负载。不完整的数据无法更好地了解英国CPGNB的重要风险因素和传播途径。
结论：ERS是英格兰唯一有可能收集有关CPGNB重要危险因素的情报的监测系统，以告知公共卫生措施以控制其传播。尽管ERS比其他监视系统捕获更多关于CPGNB的信息，增强数据的及时性和完整性需要进行重大改进，以实现预期的健康益处。
