Investigating the feasibility and potential of combining industry AMR monitoring systems: a comparison with WHO GLASS
Authors: Rahbé Eve , Kovacevic Aleksandra , Opatowski Lulla , Leclerc Quentin J. 
Published: March 2024

AbstractBackgroundEfforts to estimate the global burden of antimicrobial resistance (AMR) have highlighted gaps in existing surveillance systems. Data gathered from hospital networks globally by pharmaceutical industries to monitor antibiotic efficacy in different bacteria represent an additional source to track the temporal evolution of AMR. Here, we analysed available industry monitoring systems to assess to which extent combining them could help fill the gaps in our current understanding of AMR levels and trends.MethodsWe analysed six industry monitoring systems (ATLAS, GEARS, SIDERO-WT, KEYSTONE, DREAM, and SOAR) obtained from the Vivli platform and reviewed their respective isolates collection and analysis protocols. Using the R software, we designed a pipeline to harmonise and combine these into a single dataset. We assessed the reliability of resistance estimates from these sources by comparing the combined dataset to the publicly available subset of WHO GLASS for shared bacteria-antibiotic-country-year combinations.ResultsCombined, the industry monitoring systems cover 18 years (4 years for GLASS), 85 countries (71), 412 bacterial species (8), and 75 antibiotics (25). Although all industry systems followed a similar centralised testing approach, the criteria for isolate collection were unclear (patients selection, associated sampling periods…). ForE.coli,K. pneumoniaeandS. aureus, at least 65% of comparable resistance proportions were within 0.1 of the corresponding estimate in GLASS. We did not identify systemic bias towards resistance in industry systems compared to GLASS.ConclusionsCombining industry monitoring systems can substantially strengthen our knowledge of global AMR burden across bacterial species and countries. High agreement values for available comparisons with GLASS suggest that data for other bacteria-antibiotic-country-year combinations only present in industry systems could complement GLASS, particularly for Priority Pathogens currently not covered. This valuable information on resistance levels could help clinicians and stakeholders prioritize testing and select appropriate antibiotics in settings with limited surveillance data.Plain language summaryAntimicrobial resistance (AMR) is a growing problem worldwide, but we don’t always have enough information to fully understand its extent and how it’s changing over time. In this study, we looked at data collected by pharmaceutical companies from hospitals around the world to see how well antibiotics are working against different bacteria. We wanted to see if combining these data sources could help us fill in gaps in global AMR surveillance. We reviewed the methods of six different systems that collect this data and developed an approach to combine them. Then, we compared this combined data to publicly available GLASS data from the WHO to check if it was reliable. We found that the data from the pharmaceutical companies covered more years, countries, bacterial species, and antibiotics than GLASS. Even though the way the data was collected by the companies wasn’t always clear, we saw that the resistance estimates were similar to those from GLASS for some common bacteria likeE.coli,K. pneumoniae, andS. aureus. Overall, combining data from these different sources could improve our understanding of AMR worldwide, especially in places where surveillance is currently limited, and for Priority Pathogens not covered by GLASS.