EU protocol for harmonised monitoring of antimicrobial resistance in human Salmonella and Campylobacter isolates

This protocol for harmonised monitoring of antimicrobial resistance (AMR) in Salmonella and Campylobacter from human isolates aims to increase the quality and comparability of AMR data collected at the EU level from different Member States. As such, it is primarily targeted to the National Public Health Reference Laboratories to guide the susceptibility testing needed for EU surveillance and the reporting to ECDC. It also provides guidance on how to improve the comparison of results with the AMR monitoring performed in isolates from animals and food products. The protocol was developed by ECDC in close co-operation with representatives of the Food- and Waterborne Diseases and Zoonoses (FWD) network and supports the implementation of the Commission Action Plan on antimicrobial resistance. Surveillance objectives for monitoring of antimicrobial resistance in human clinical isolates of Salmonella and Campylobacter at the EU level were agreed within the FWD network. Based on these, a priority list was set of antimicrobial agents to monitor for surveillance purposes. The list comprises ten antimicrobial substances for Salmonella and three for Campylobacter. For laboratory measurement of antimicrobial activity the European Committee on Antimicrobial Susceptibility Testing (EUCAST) method is recommended. Additional detail is given regarding methods for detection and confirmation of two specific resistance phenotypes of particular concern – extended-spectrum beta-lactamase (ESBL) producers and carbapenemase producers. Member States are encouraged to submit results of susceptibility testing as ‘quantitative’ values (minimum inhibitory concentration in mg/L or zone diameter in mm) to facilitate comparison of data over time, and to allow comparison with quantitative AMR data from animal and food isolates that takes account of ecological cut-off values for the relevant bacterial species. It is also possible to continue reporting of the interpretation of the susceptibility testing i.e. susceptible, intermediate or resistant, either separately with the case-based data or together with the isolate-based quantitative values. The reporting of interpreted values through the case-based data will however be phased out in the coming years