Molecular Methods for Antimicrobial Resistance (AMR) Diagnostics to Enhance the Global Antimicrobial Resistance Surveillance System (GLASS). Geneva: World Health Organization; 2019
(2019; 64 pages)


Antimicrobial resistance (AMR) is a serious threat to global public health. In 2015, WHO launched the Global Antimicrobial Resistance Surveillance System (GLASS) in order to standardize the collection of data on AMR in Member States, for planning, prevention and intervention programmes. Reports to GLASS currently rely on detection of phenotypic resistance, which requires bacteria to be cultured and tested for growth in the presence of antimicrobial agents. In future, GLASS may incorporate the results of molecular testing for AMR detection by appropriate methods. Molecular diagnostic methods can be used at the same time as phenotypic testing to yield additional information, such as the exact gene or mutation underlying a resistance phenotype. This information can be used to interpret AMR profiles at surveillance sites and better understand the global occurrence of certain resistance mechanisms.

Different laboratory settings have different requirements for molecular methods for AMR diagnostics. This technical note addresses three generic laboratory settings with different capacity for molecular AMR testing: those with no prior experience in molecular AMR surveillance; newly established national reference laboratories (NRLs) with some experience in molecular methods; and fully established NRLs with experience in molecular AMR surveillance. Molecular diagnostic methods are graded according to their complexity of use, setup cost and cost per tested specimen. This technical note provides guidance to people involved at various levels of AMR surveillance in choosing the most appropriate molecular AMR test for their setting, including clinical and reference laboratories. The document also provides a review of available methods and how they could be used in national surveillance.

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