PDF(Pubmed)
Abstract：
BACKGROUND: Antimicrobial resistance (AMR) has become a significant public health threat. Without any interventions, it has been modelled that AMR will account for an estimated 10 million deaths annually by 2050, this mainly affects low/middle-income countries. AMR has a systemic negative perspective affecting the overall healthcare system down to the patient\'s personal outcome. In response to this issue, the WHO urged countries to provide antimicrobial stewardship programmes (ASPs). ASPs in hospitals are a vital component of national action plans for AMR, and have been shown to significantly reduce AMR, in particular in low-income countries such as Madagascar.As part of an ASP, AMR surveillance provides essential information needed to guide medical practice. We developed an AMR surveillance tool-Technique de Surveillance Actualisée de la Résistance aux Antimicrobiens (TSARA)-with the support of the Mérieux Foundation. TSARA combines bacteriological and clinical information to provide a better understanding of the scope and the effects of AMR in Madagascar, where no such surveillance tool exists.
METHODS: A prospective, observational, hospital-based study was carried out for data collection using a standardised data collection tool, called TSARA deployed in 2023 in 10 hospitals in Madagascar participating in the national Malagasy laboratory network (Réseau des Laboratoires à Madagascar (RESAMAD)). Any hospitalised patient where the clinician decided to take a bacterial sample is included. As a prospective study, individual isolate-level data and antimicrobial susceptibility information on pathogens were collected routinely from the bacteriology laboratory and compiled with clinical information retrieved from face-to-face interviews with the patient and completed using medical records where necessary. Analysis of the local ecology, resistance rates and antibiotic prescription patterns were collected.
BACKGROUND: This protocol obtained ethical approval from the Malagasy Ethical Committee n°07-MSANP/SG/AGMED/CNPV/CERBM on 24 January 2023. Findings generated were shared with national health stakeholders, microbiologists, members of the RESAMAD network and the Malagasy academic society of infectious diseases.
METHODS: A prospective, observational, hospital-based study was carried out for data collection using a standardised data collection tool, called TSARA deployed in 2023 in 10 hospitals in Madagascar participating in the national Malagasy laboratory network (Réseau des Laboratoires à Madagascar (RESAMAD)). Any hospitalised patient where the clinician decided to take a bacterial sample is included. As a prospective study, individual isolate-level data and antimicrobial susceptibility information on pathogens were collected routinely from the bacteriology laboratory and compiled with clinical information retrieved from face-to-face interviews with the patient and completed using medical records where necessary. Analysis of the local ecology, resistance rates and antibiotic prescription patterns were collected.
BACKGROUND: This protocol obtained ethical approval from the Malagasy Ethical Committee n°07-MSANP/SG/AGMED/CNPV/CERBM on 24 January 2023. Findings generated were shared with national health stakeholders, microbiologists, members of the RESAMAD network and the Malagasy academic society of infectious diseases.
摘要：
背景：抗菌素耐药性（AMR）已成为重大的公共卫生威胁。没有任何干预,据估计，到2050年，AMR每年将导致1000万人死亡，这主要影响低收入/中等收入国家。AMR具有系统性的负面观点，会影响整个医疗保健系统，甚至影响患者的个人结果。针对这个问题,世卫组织敦促各国提供抗菌药物管理计划（ASP）。医院的ASP是AMR国家行动计划的重要组成部分，并显示出能显著降低AMR，特别是在马达加斯加等低收入国家。作为ASP的一部分，AMR监测提供了指导医疗实践所需的基本信息。在梅里埃基金会的支持下，我们开发了一种AMR监视工具-对抗生素的实际监视技术（TSARA）。TSARA结合了细菌学和临床信息，以更好地了解马达加斯加AMR的范围和影响，没有这样的监视工具。
方法：前瞻性，观察,使用标准化的数据收集工具进行基于医院的数据收集研究，称为TSARA，于2023年在马达加斯加的10家医院中部署，这些医院参与了马达加斯加国家实验室网络（马达加斯加实验室（RESAMAD））。包括临床医生决定采取细菌样品的任何住院患者。作为一项前瞻性研究，我们从细菌学实验室常规收集个体分离株水平的数据和关于病原体的抗菌药物敏感性信息,并根据从患者面对面访谈中获得的临床信息进行汇编,必要时使用医疗记录完成.对当地生态的分析，收集耐药率和抗生素处方模式。
背景：该方案于2023年1月24日获得了马达加斯加伦理委员会n°07-MSANP/SG/AGMED/CNPV/CERBM的伦理批准。产生的调查结果与国家卫生利益攸关方分享，微生物学家,RESAMAD网络和马达加斯加传染病学会的成员。
方法：前瞻性，观察,使用标准化的数据收集工具进行基于医院的数据收集研究，称为TSARA，于2023年在马达加斯加的10家医院中部署，这些医院参与了马达加斯加国家实验室网络（马达加斯加实验室（RESAMAD））。包括临床医生决定采取细菌样品的任何住院患者。作为一项前瞻性研究，我们从细菌学实验室常规收集个体分离株水平的数据和关于病原体的抗菌药物敏感性信息,并根据从患者面对面访谈中获得的临床信息进行汇编,必要时使用医疗记录完成.对当地生态的分析，收集耐药率和抗生素处方模式。
背景：该方案于2023年1月24日获得了马达加斯加伦理委员会n°07-MSANP/SG/AGMED/CNPV/CERBM的伦理批准。产生的调查结果与国家卫生利益攸关方分享，微生物学家,RESAMAD网络和马达加斯加传染病学会的成员。
