Key to antimicrobial stewardship success: Surveillance by diagnostic microbiology laboratories

The important role of laboratories in enhancing antimicrobial stewardship activities through improved diagnostics and provision of surveillance data is globally recognised. Consider the aim of an antimicrobial stewardship programme: ‘optimize clinical outcomes while minimizing the unintended consequences of antimicrobial use’. The clinical microbiology laboratory plays a critical role in achieving these aims through the provision of culture and susceptibility data that are both patient­specific (optimisation of clinical outcomes) and informative for surveillance activities that guide empirical antimicrobial selection (minimising unintended consequences of antimicrobial use). For this reason, the World Health Organization (WHO) included the strengthening of surveillance and laboratory capacity in its 2011 World Health Day six­point plan to combat antimicrobial resistance (AMR). South African laboratories in the public and private sectors have the means to provide surveillance data and, through a collaborative approach, the capacity to create antimicrobial resistance maps. In line with the WHO’s recommendations and under the auspices of the South African Society of Clinical Microbiology, efforts are currently underway to improve national AMR surveillance data for typical healthcare­ associated pathogens. The generation and provision of these data is, however, only half of the challenge. The analysis and interpretation thereof is equally important, as highlighted in this month’s SAMJ.