| What is the name of the antimicrobial resistance surveillance network coordinated by the National Centre for Disease Control? | National AMR surveillance network (NARS-Net) | Executive Summary The National AMR surveillance network (NARS-Net) under the National Programme on AMR Containment, coordinated by the National Centre for Disease Control (NCDC), has been expanded in a phased manner to include 50 laboratories in 33 states/UTs (as of March 2024). In 2017, NCDC was designated by the Ministry of Health and Family Welfare (MoHFW), Government of India as the National Coordinating Centre (NCC) for AMR surveillance and for submitting data to the WHO’s Global Antimicrobial Resistance Surveillance and Use System (GLASS)1. Antimicrobial Resistance data of selected WHO priority pathogen isolates generated by healthcare hospital laboratories adhering to the standard International/National procedures and part of various AMR surveillance programs in India has been collated and submitted to WHO-GLASS data calls since 2018. | 22 | definition | 1.000 | https://ncdc.mohfw.gov.in/uploads/pdf/amr32.pdf | Executive Summary The National AMR surveillance network (NARS-Net) under the National Programme on AMR Containment, coordinated by the National Centre for Disease Control (NCDC), has been expanded in a phased manner to include 50 laboratories in 33 states/UTs (as of March 2024). | 14 | page=14,block=1 | 0.700 | valid |
| Which software is used by NCDC to analyze surveillance data from NARS-Net sentinel sites? | WHONET, a microbiology data management open-source offline software | The surveillance data submitted by the NARS-Net sentinel sites is analyzed after validation at NCDC using WHONET, a microbiology data management open-source offline software. The annual National AMR surveillance report and the semi- annual bulletins prepared by NCDC are shared with national and state stakeholders and available in the public domain on the NCDC website. The network data is also submitted annually to the World Health Organization's Global AMR Surveillance and Use System (WHO-GLASS) since 2018 by NCDC, which has been notified by MoHFW as the National Coordinating Centre for AMR Surveillance in India. 2 Antimicrobial Resistance Collaborators. (2022). Global burden of bacterial antimicrobial resistance in 2019: a systematic analysis. The Lancet; 399(10325): P629-655. | 106 | definition | 1.000 | https://ncdc.mohfw.gov.in/uploads/pdf/amr32.pdf | The surveillance data submitted by the NARS-Net sentinel sites is analyzed after validation at NCDC using WHONET, a microbiology data management open-source offline software. | 17 | page=17,block=1 |
| What is Antimicrobial resistance (AMR)? | one of the top global public health and development threats | AMR is recognized as one of the top ten public health threats by the World Health Organization (WHO). Antimicrobial resistance (AMR) is one of the top global public health and development threats. It is estimated that bacterial AMR was directly responsible for 1.27 million global deaths in 2019 and contributed to 4.95 million deaths2 and this number is expected to go up if appropriate containment measures are not undertaken. | 136 | definition | 0.980 | https://ncdc.mohfw.gov.in/uploads/pdf/amr32.pdf | Antimicrobial resistance (AMR) is one of the top global public health and development threats. | 17 | page=17,block=1 | 0.850 | valid |
| What does CBDDR refer to? | Centre for Bacterial Diseases and Drug Resistance | Acronyms AMR Antimicrobial Resistance Amox-clav Amoxicillin/Clavulanic acid AST Antimicrobial Susceptibility Testing BMD Broth Microdilution CBDDR Centre for Bacterial Diseases and Drug Resistance CLSI Clinical & Laboratory Standards Institute CSV Comma Separated Value EQAS External Quality Assessment Scheme GLASS Global Antimicrobial Resistance and Use Surveillance System IPD Inpatient Department ICU Intensive Care Unit ID Identification IQC Internal Quality Control LIMS Laboratory Information Management System MRSA Methicillin-Resistant Staphylococcus aureus NARS-Net National Antimicrobial Resistance Surveillance Network NFGNB Non-fermenting Gram-negative bacilli NCDC National Centre for Disease Control NRL National Reference Laboratory OPD Outpatient Department OSBF Other Sterile Body Fluids PA Pus Aspirate R I S Resistant Intermediate Sensitive TMP-SMX Trimethoprim-Sulfamethoxazole SOP Standard Operating Procedure VBA Visual Basic Application VRE Vancomycin-Resistant Enterococcus species WHO World Health Organization | 147 | definition | 0.980 | https://ncdc.mohfw.gov.in/uploads/pdf/amr32.pdf | Acronyms AMR Antimicrobial Resistance Amox-clav Amoxicillin/Clavulanic acid AST Antimicrobial Susceptibility Testing BMD Broth Microdilution CBDDR Centre for Bacterial Diseases and Drug Resistance CLSI Clinical & Laboratory Standards Institute CSV Comma Separated Value EQAS External Quality Assessment Scheme GLASS Global Antimicrobial Resistance and Use Surveillance System IPD Inpatient Department ICU Intensive Care Unit ID Identification IQC Internal Quality Control LIMS Laboratory Information Management System MRSA Methicillin-Resistant Staphylococcus aureus NARS-Net National Antimicrobial |
| What does CLSI stand for? | Clinical & Laboratory Standards Institute | Acronyms AMR Antimicrobial Resistance Amox-clav Amoxicillin/Clavulanic acid AST Antimicrobial Susceptibility Testing BMD Broth Microdilution CBDDR Centre for Bacterial Diseases and Drug Resistance CLSI Clinical & Laboratory Standards Institute CSV Comma Separated Value EQAS External Quality Assessment Scheme GLASS Global Antimicrobial Resistance and Use Surveillance System IPD Inpatient Department ICU Intensive Care Unit ID Identification IQC Internal Quality Control LIMS Laboratory Information Management System MRSA Methicillin-Resistant Staphylococcus aureus NARS-Net National Antimicrobial Resistance Surveillance Network NFGNB Non-fermenting Gram-negative bacilli NCDC National Centre for Disease Control NRL National Reference Laboratory OPD Outpatient Department OSBF Other Sterile Body Fluids PA Pus Aspirate R I S Resistant Intermediate Sensitive TMP-SMX Trimethoprim-Sulfamethoxazole SOP Standard Operating Procedure VBA Visual Basic Application VRE Vancomycin-Resistant Enterococcus species WHO World Health Organization | 202 | definition | 0.980 | https://ncdc.mohfw.gov.in/uploads/pdf/amr32.pdf | Acronyms AMR Antimicrobial Resistance Amox-clav Amoxicillin/Clavulanic acid AST Antimicrobial Susceptibility Testing BMD Broth Microdilution CBDDR Centre for Bacterial Diseases and Drug Resistance CLSI Clinical & Laboratory Standards Institute CSV Comma Separated Value EQAS External Quality Assessment Scheme GLASS Global Antimicrobial Resistance and Use Surveillance System IPD Inpatient Department ICU Intensive Care Unit ID Identification IQC Internal Quality Control LIMS Laboratory Information Management System MRSA Methicillin-Resistant Staphylococcus aureus NARS-Net National Antimicrobial |
| What does GLASS stand for? | Global Antimicrobial Resistance and Use Surveillance System | Acronyms AMR Antimicrobial Resistance Amox-clav Amoxicillin/Clavulanic acid AST Antimicrobial Susceptibility Testing BMD Broth Microdilution CBDDR Centre for Bacterial Diseases and Drug Resistance CLSI Clinical & Laboratory Standards Institute CSV Comma Separated Value EQAS External Quality Assessment Scheme GLASS Global Antimicrobial Resistance and Use Surveillance System IPD Inpatient Department ICU Intensive Care Unit ID Identification IQC Internal Quality Control LIMS Laboratory Information Management System MRSA Methicillin-Resistant Staphylococcus aureus NARS-Net National Antimicrobial Resistance Surveillance Network NFGNB Non-fermenting Gram-negative bacilli NCDC National Centre for Disease Control NRL National Reference Laboratory OPD Outpatient Department OSBF Other Sterile Body Fluids PA Pus Aspirate R I S Resistant Intermediate Sensitive TMP-SMX Trimethoprim-Sulfamethoxazole SOP Standard Operating Procedure VBA Visual Basic Application VRE Vancomycin-Resistant Enterococcus species WHO World Health Organization | 316 | definition | 0.980 | https://ncdc.mohfw.gov.in/uploads/pdf/amr32.pdf | Acronyms AMR Antimicrobial Resistance Amox-clav Amoxicillin/Clavulanic acid AST Antimicrobial Susceptibility Testing BMD Broth Microdilution CBDDR Centre for Bacterial Diseases and Drug Resistance CLSI Clinical & Laboratory Standards Institute CSV Comma Separated Value EQAS External Quality Assessment Scheme GLASS Global Antimicrobial Resistance and Use Surveillance System IPD Inpatient Department ICU Intensive Care Unit ID Identification IQC Internal Quality Control LIMS Laboratory Information Management System MRSA Methicillin-Resistant Staphylococcus aureus NARS-Net National Antimicrobial |
| What system does India submit its antimicrobial resistance data to under the NCDC's coordination? | WHO’s Global Antimicrobial Resistance Surveillance and Use System (GLASS) | Executive Summary The National AMR surveillance network (NARS-Net) under the National Programme on AMR Containment, coordinated by the National Centre for Disease Control (NCDC), has been expanded in a phased manner to include 50 laboratories in 33 states/UTs (as of March 2024). In 2017, NCDC was designated by the Ministry of Health and Family Welfare (MoHFW), Government of India as the National Coordinating Centre (NCC) for AMR surveillance and for submitting data to the WHO’s Global Antimicrobial Resistance Surveillance and Use System (GLASS)1. Antimicrobial Resistance data of selected WHO priority pathogen isolates generated by healthcare hospital laboratories adhering to the standard International/National procedures and part of various AMR surveillance programs in India has been collated and submitted to WHO-GLASS data calls since 2018. | 477 | relationship | 0.970 | https://ncdc.mohfw.gov.in/uploads/pdf/amr32.pdf | In 2017, NCDC was designated by the Ministry of Health and Family Welfare (MoHFW), Government of India as the National Coordinating Centre (NCC) for AMR surveillance and for submitting data to the WHO’s Global Antimicrobial Resistance Surveillance and Use System (GLASS)1. |
| What urgent need is highlighted due to the limited availability of new antimicrobial agents? | investment for antibiotic research and development | These pathogens include S. aureus, E. coli, Klebsiella species, Salmonella Typhi/ParaTyphi, and Acinetobacter baumanii. The antimicrobial resistance surveillance in India over the last 6 years has shown gradually increasing resistance to both first-line and second-line antibiotics. This issue is further exacerbated by the limited availability of new antimicrobial agents, underscoring the urgent need for investment for antibiotic research and development. In addition to focusing on research, it is crucial to implement infection prevention and control (IPC) and Antimicrobial Stewardship (AMS) programs to prevent and control AMR. In summary, the AMR surveillance results from NARS-NET emphasize the importance of taking concerted action to strengthen implementation of facility-level, state, and national infection prevention and control programs and antimicrobial stewardship practices. | 407 | relationship | 0.970 | https://ncdc.mohfw.gov.in/uploads/pdf/amr32.pdf | This issue is further exacerbated by the limited availability of new antimicrobial agents, underscoring the urgent need for investment for antibiotic research and development. |
| Where are AMR isolates designated as Alerts submitted for confirmation and testing? | AMR-national reference laboratory (NRL) located at the Centre for Bacterial Disease and Drug Resistance (CBDDR), NCDC | To ensure quality of data, AMR isolates designated as Alerts under the programme if isolated at the programme sites, such as vancomycin-resistant S. aureus and colistin-resistant Gram-negative bacteria, are mandated to be submitted to the AMR-national reference laboratory (NRL) located at the Centre for Bacterial Disease and Drug Resistance (CBDDR), NCDC for confirmation of identification and antimicrobial susceptibility testing (AST). The virtual capacity-building program “Extension for Community Healthcare Outcome (ECHO)” initiated in 2020, over and above the continuous hands-on training on bacteriology testing methods and data management using WHONET, has also impacted the quality of data. Trainings on colistin agar dilution and broth microdilution methods, both at the NRL at NCDC and onsite during site visits, have contributed to an increase in the number of | 239 | relationship | 0.970 | https://ncdc.mohfw.gov.in/uploads/pdf/amr32.pdf | aureus and colistin-resistant Gram-negative bacteria, are mandated to be submitted to the AMR-national reference laboratory (NRL) located at the Centre for Bacterial Disease and Drug Resistance (CBDDR), NCDC for confirmation of identification and antimicrobial susceptibility testing (AST). |
| Which carbapenem showed the highest resistance in Klebsiella spp. urine isolates? | ertapenem (42%, CI: 40.2- 43.2) | Klebsiella species In the current data reporting period, 32,915 Klebsiella species isolates were reported of which 30,922 were from unique patients. The isolation rate of Klebsiella spp. in data reported by the sentinel sites was highest from urine (47%) followed by pus aspirate (28%), blood (19%) and OSBF (5.5%) (Table 4). Among the urine isolates, one-third of the isolates tested against aminoglycosides namely amikacin (36%, CI: 35 – 36.8) were found to be resistant; while 47% (CI: 46.6 - 48.3) resistance was observed to nitrofurantoin (Table 9). Seven of every 10 isolates of Klebsiella spp. from urine were found to be resistant to third generation cephalosporins. With respect to carbapenem resistance in urine isolates, resistance to ertapenem (42%, CI: 40.2- 43.2) was highest. | 746 | relationship | 0.970 | https://ncdc.mohfw.gov.in/uploads/pdf/amr32.pdf | With respect to carbapenem resistance in urine isolates, resistance to ertapenem (42%, CI: 40.2- 43.2) was highest. | 40 | page=40,block=1 | 0.700 | valid |