Resistance varies widely with geographical location, type of community and level of health facility. There-fore local surveillance data should be used to guide clinical management and update clinical guidelines, educate prescribers and guide infection control policies. Data should distinguish between hospital nosocomial and community-acquired infections and should exclude duplicate isolates from the same patient.

A national antimicrobial surveillance system should consist of:

• national reference microbiology laboratory facilities to coordinate epidemiologically sound surveillance of AMR in common pathogens in the community, hospitals and other health care facilities;

•a network of laboratories, all with adequate internal and external quality assurance, that regularly collect and report relevant resistance data and provide quality microbiological diagnostic services.