2021-06-06-世界卫生组织-GLASS-AMR_Manual_–_Feedback_from_countries_–_Sergey_Eremin_9页_1mb

GLASS-AMR Manual Summary

Core Content

The GLASS-AMR manual is a document developed by the World Health Organization (WHO) to update and improve the methods and metrics for antimicrobial resistance (AMR) and use surveillance in humans. It is part of a broader package of tools aimed at supporting the implementation of GLASS 2.0, the Global Antimicrobial Resistance and Use Surveillance System. The manual provides guidance to countries on how to effectively apply the GLASS-AMR methodology and is intended for national focal points, public health professionals, and health authorities responsible for AMR surveillance.

Main Objectives

• To describe the objectives and methodology of GLASS-AMR.
• To offer guidance for countries on implementing the GLASS-AMR approach.
• To support the development of national AMR surveillance systems through practical tools and metrics.
• To align with the One Health approach, which integrates human, animal, and environmental health.

Key Points from Feedback

Q1: Does the draft Manual provide sufficient guidance on the methods and metrics?

• Yes: Many countries found the manual to be comprehensive and useful for understanding the methods and metrics.
• No: Some felt the guidance was insufficient, especially for countries with limited resources or experience.

Q2: Is the GLASS-AMR methodology presented in a clear manner?

• Yes: The methodology was generally well-structured and easy to follow.
• No: Some countries suggested that the clarity could be improved, particularly in explaining complex components of the system.

Q3: Does the draft Manual provide useful tools for putting the GLASS-AMR approach into practice?

• Yes: Countries appreciated the practical tools and guidance provided.
• No: Some found the tools not sufficiently developed or not aligned with their national needs.

Q4: Is the inclusion of new specimen types, pathogens, and antimicrobials appropriate?

• Yes: Many countries supported the inclusion of new specimen types, pathogens, and drug combinations.
• No: Some expressed concerns about the challenges posed by the extended list, especially for countries with limited resources or capacity. One suggested focusing on standardization and harmonization of surveillance for specific infections like bloodstream infections and UTIs.

Q5: Is the draft GLASS-AMR Manual 2.0 useful for enhancing national AMR surveillance systems?

• Yes: Several countries found the manual to be useful in improving their national surveillance systems.
• No: Others were not convinced by the rationale and called for further discussions with stakeholders.

Q6: Can countries start submitting anonymized individual data in the next stage of GLASS implementation?

• Yes: Many countries are already submitting individual data to international networks or are collecting it nationally.
• No: Some countries highlighted limitations in their laboratory systems and lack of human and IT resources, which would hinder their ability to submit individual data.

Q7: What elements are key for categorizing AMR data regarding quality and representativeness?

• Countries emphasized the importance of data quality indicators such as completeness, timeliness, and accuracy.
• Representativeness was considered crucial, including geographic, demographic, and clinical diversity.
• Standardization and harmonization of data collection methods were also highlighted as key elements.

Q8: Additional Comments

• 25 countries provided positive feedback, including useful comments, questions, and suggested edits.
• Several countries conducted comprehensive reviews of the document.
• A more detailed overview of the feedback will be included in the final report, to be distributed after the consultation meeting in April 2021.

Summary of Country Responses

Conclusion

The GLASS-AMR manual has received a mix of positive and constructive feedback from 63 countries. While many appreciate its comprehensive guidance and practical tools, some have raised concerns about the complexity of the methodology and the feasibility of implementing new specimen types and pathogens. The manual is seen as a valuable resource for improving national AMR surveillance systems, but further refinements and stakeholder engagement are recommended to ensure its effectiveness across all levels of resource availability.