European antimicrobial resistance surveillance as part of a community strategy

This thesis describes the set up of a European antimicrobial resistance surveillance system (EARSS) and its contribution to the Community strategy against antimicrobial resistance. EARSS is set up as an international network of national surveillance systems, collecting comparable and validated antimicrobial resistance data for public health purposes. The objectives, infrastructure and data management aspects of the surveillance system were defined by consensus of leading microbiologists and epidemiologists in Europe. At the kick-off meeting the community-acquired pathogen S. pneumoniae and the hospitalacquired pathogen S. aureus were chosen as most relevant pathogens to start surveillance for in EARSS. During the same meeting the EARSS protocol for susceptibility testing was developed, aiming to standardise data collection to allow for comparison of susceptibility data among participants. To minimise sample bias, it was decided to report only the first isolate of S. pneumoniae from blood and cerebrospinal fluid and the first S. aureus isolate from blood. This European initiative acted as a catalyst for national surveillance systems.