Antimicrobial drug resistance is a growing global threat to health security. Drugs that were previously efficacious to treat infectious diseases are now rapidly losing their effectiveness due to a combination of overuse and misuse of antimicrobial drugs in both people and animals. Some of the most effective drugs to treat malaria, tuberculosis and gonorrhea are now useless in some parts of the world and common community acquired bacterial infections are also becoming more difficult to treat.
Antimicrobial susceptibility testing is therefore becoming more and more essential to guide the treatment of many types of infectious diseases. The usual method for characterizing antibiotic resistance is to detect phenotype resistance by measuring bacterial growth in the presence of the antibiotic being tested. This method is highly sensitive but is not suitable for local health care centres due to the cost and complexity. The long incubation time is also an obstacle for widespread use in developing countries.
Newer approaches such as PCR (e.g. GeneXpert for TB) are now being introduced in developing countries but still in a limited fashion. In addition to PCR-based techniques, novel approaches such as those based on microfluidics, microarrays, mass spectroscopy and whole genome sequencing also offer the potential for rapid detection of antimicrobial drug resistance. However, the applicability of these techniques in Low- and Middle-Income countries (LMICs) remains to be demonstrated.
In order to stimulate the development of and access to affordable and appropriate technologies for antimicrobial susceptibility testing (particularly at the point-of-care (PoC)), WHO is convening a consultation of experts on rapid methods for antimicrobial susceptibility testing in LMICs.
Aims and Challenges
· Review the status of antimicrobial susceptibility testing (AST) in LMICs
· Review current AST methods
· Review new methods and their potential for use in LMICs
· Develop a road map to stimulate the development of and access to suitable tools for AST in LMICs (with a focus on PoC tools)
· A better definition of the needs and barriers.
· A report on current technologies used and the potential of newer technologies in the pipeline.
· A road map to stimulate the development of and access to suitable tools for AST in LMICs with milestones, timeline, deliverable, potential partners and funding sources.