The DOH-ARSP implements an antimicrobial resistance surveillance on aerobic bacteria from clinical specimens. The surveillance collects culture and antimicrobial susceptibility data from its 24 sentinel sites and 2 gonorrhoeae surveillance sites. These sentinel sites participate in an external quality assessment scheme (EQAS) conducted by the reference laboratory to ensure quality of laboratory results. Periodic monitoring visits to sentinel sites are likewise done. All sentinel sites implement standard methods for culture and susceptibility testing based on the WHO Manual for the Laboratory Identification and Antimicrobial Susceptibility Testing of Bacterial Pathogens of Public Health Importance in the Developing World and updated Clinical Laboratory Standards Institute (CLSI) references for antibiotic susceptibility testing and quality control. Using a standard format, routine culture and antimicrobial susceptibility test results are sent monthly by the sentinel sites to the coordinating laboratory of the program – the Antimicrobial Resistance Surveillance Reference Laboratory (ARSRL) at the Research Institute for Tropical Medicine. Sentinel sites likewise send isolates with unusual antimicrobial susceptibility patterns to ARSRL for phenotypic and genotypic confirmatory testing.
The culture and antimicrobial susceptibility test results are encoded using a database software called WHONET. WHONET is a Windows-based database software developed by the WHO Collaborating Centre for Surveillance of Antimicrobial Resistance based at the Brigham and Women’s Hospital in Boston for the management and analysis of microbiology laboratory data with a special focus on the analysis of antimicrobial susceptibility test results. The ARSRL’s Data Management Unit manages the cleaning, analysis, storage and security of the program’s surveillance data.