Antimicrobial resistance

  • Antimicrobial resistance poses a major threat to health of individuals and populations worldwide
  • Antimicrobials are not only essential for the treatment of community-associated infections such as pneumonia and meningitis but also healthcare-associated infections
  • These infections are commonly caused by bacteria or fungi
    • Antibiotics kill or inhibit the growth of bacteria
    • Antifungals kill or inhibit the growth of fungi
  • In a healthcare setting, medical procedures such as the insertion of intravascular or urinary catheters, intubation or surgery break the body’s natural barriers to infection and allow pathogens direct access to sites such as the bloodstream, urinary tract, lung or abdominal cavity. Patients with healthcare-associated infections require prolonged care in hospitals, serving as a source of cross-infection to other patients
  • The emergence and widespread occurrence of multidrug-resistant bacteria and fungi threatens the ability of antimicrobials to act against these bacteria and fungi
  • New resistance mechanisms in bacteria and fungi are emerging and spreading across the world. Some bacteria are naturally resistant to antibiotics and other develop resistance through genetic changes. Misuse, overuse and inappropriate use of antibiotics accelerates this process.


Surveillance for AMR

  • Surveillance is a key component of the strategy to combat antimicrobial resistance
  • The Centre leads the national effort to conduct surveillance for AMR infections through establishment of a national diagnostic laboratory surveillance network
  • Several approaches are currently used for laboratory-based surveillance
    • National or sentinel surveys: bacterial and fungal isolates cultured from patients with bloodstream infections are submitted to CHARM’s reference laboratories for identification, antimicrobial susceptibility testing and genotyping
    • Enhanced surveillance: detailed clinical information is collected from patients admitted to sentinel hospitals who meet the surveillance case definitions
    • Electronic surveillance: data from public- and private-sector diagnostic laboratory information systems are compiled annually and reported as tables and resistance maps
  • The Centre was named a World Health Organization Coordinating Centre for AMR in 2017
  • CHARM is also a National Coordinating Centre for the WHO Global Antimicrobial Resistance Surveillance System (GLASS)
  • Senior members of the Centre represent NICD on the Ministerial Advisory Committee (MAC) for AMR and the WHO Strategic and Technical Advisory Group (STAG) for AMR


Outbreak investigation and response

  • The Centre uses several methods, including surveillance, to detect outbreaks of healthcare-associated infections
  • A team of trained epidemiologists within the Centre investigates and responds to such outbreaks