Whole-genome sequencing as part of national and international surveillance programmes for antimicrobial resistance: a roadmap

The global spread of antimicrobial resistance (AMR) and lack of novel alternative treatments have been declared a global public health emergency by WHO. The greatest impact of AMR is experienced in resource-poor settings, because of lack of access to alternative antibiotics and because the prevalenc...

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Main Authors: Iruka N Okeke, Ben Taylor, Celia Carlos, Marietta Lagrada, Polle K. Macaranas, Agnettah M. Olorosa, June Gayeta, Melissa Ana Masim, Elmer M. Herrera, David M Aanensen, Khalil Abudahab, Monica Abrudan, Silvia Argimon, Harry Harste, Mihir Kekre, Ali Molloy, Dawn Muddyman, Anneke Schmider, Anthony Underwood, María del Pilar Donado Godoy, Johan Fabian Bernal Morales, Alejandra Arevalo, Maria Fernanda Valencia Guerrero, Erik Cristopher Dustin Osma Castro, Anderson O. Oaikhena, Ayorinde Oluwatobiloba Afolayan, Jolaade J Ajiboye, Ravikumar K. L., Geetha Nagaraj, Varun Shammana, Vandana Govindan, Akshata Prabhu, Darmavaram Sravani, Shincy M. R., Rajitha G. V., Carolin Vegvari, John Stelling
Format: Article
Language:English
Published: BMJ Publishing Group 2020-11-01
Series:BMJ Global Health
Online Access:https://gh.bmj.com/content/5/11/e002244.full
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author Iruka N Okeke
Ben Taylor
Celia Carlos
Marietta Lagrada
Polle K. Macaranas
Agnettah M. Olorosa
June Gayeta
Melissa Ana Masim
Elmer M. Herrera
David M Aanensen
Khalil Abudahab
Monica Abrudan
Silvia Argimon
Harry Harste
Mihir Kekre
Ali Molloy
Dawn Muddyman
Anneke Schmider
Anthony Underwood
María del Pilar Donado Godoy
Johan Fabian Bernal Morales
Alejandra Arevalo
Maria Fernanda Valencia Guerrero
Erik Cristopher Dustin Osma Castro
Anderson O. Oaikhena
Ayorinde Oluwatobiloba Afolayan
Jolaade J Ajiboye
Ravikumar K. L.
Geetha Nagaraj
Varun Shammana
Vandana Govindan
Akshata Prabhu
Darmavaram Sravani
Shincy M. R.
Rajitha G. V.
Carolin Vegvari
John Stelling
author_facet Iruka N Okeke
Ben Taylor
Celia Carlos
Marietta Lagrada
Polle K. Macaranas
Agnettah M. Olorosa
June Gayeta
Melissa Ana Masim
Elmer M. Herrera
David M Aanensen
Khalil Abudahab
Monica Abrudan
Silvia Argimon
Harry Harste
Mihir Kekre
Ali Molloy
Dawn Muddyman
Anneke Schmider
Anthony Underwood
María del Pilar Donado Godoy
Johan Fabian Bernal Morales
Alejandra Arevalo
Maria Fernanda Valencia Guerrero
Erik Cristopher Dustin Osma Castro
Anderson O. Oaikhena
Ayorinde Oluwatobiloba Afolayan
Jolaade J Ajiboye
Ravikumar K. L.
Geetha Nagaraj
Varun Shammana
Vandana Govindan
Akshata Prabhu
Darmavaram Sravani
Shincy M. R.
Rajitha G. V.
Carolin Vegvari
John Stelling
author_sort Iruka N Okeke
collection DOAJ
description The global spread of antimicrobial resistance (AMR) and lack of novel alternative treatments have been declared a global public health emergency by WHO. The greatest impact of AMR is experienced in resource-poor settings, because of lack of access to alternative antibiotics and because the prevalence of multidrug-resistant bacterial strains may be higher in low-income and middle-income countries (LMICs). Intelligent surveillance of AMR infections is key to informed policy decisions and public health interventions to counter AMR. Molecular surveillance using whole-genome sequencing (WGS) can be a valuable addition to phenotypic surveillance of AMR. WGS provides insights into the genetic basis of resistance mechanisms, as well as pathogen evolution and population dynamics at different spatial and temporal scales. Due to its high cost and complexity, WGS is currently mainly carried out in high-income countries. However, given its potential to inform national and international action plans against AMR, establishing WGS as a surveillance tool in LMICs will be important in order to produce a truly global picture. Here, we describe a roadmap for incorporating WGS into existing AMR surveillance frameworks, including WHO Global Antimicrobial Resistance Surveillance System, informed by our ongoing, practical experiences developing WGS surveillance systems in national reference laboratories in Colombia, India, Nigeria and the Philippines. Challenges and barriers to WGS in LMICs will be discussed together with a roadmap to possible solutions.
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spelling doaj-art-12f16ef37082479992ce3b87ec90699d2024-12-11T09:00:07ZengBMJ Publishing GroupBMJ Global Health2059-79082020-11-0151110.1136/bmjgh-2019-002244Whole-genome sequencing as part of national and international surveillance programmes for antimicrobial resistance: a roadmapIruka N Okeke0Ben Taylor1Celia CarlosMarietta LagradaPolle K. MacaranasAgnettah M. OlorosaJune GayetaMelissa Ana MasimElmer M. HerreraDavid M Aanensen2Khalil AbudahabMonica AbrudanSilvia ArgimonHarry HarsteMihir KekreAli MolloyDawn MuddymanAnneke SchmiderAnthony UnderwoodMaría del Pilar Donado GodoyJohan Fabian Bernal MoralesAlejandra ArevaloMaria Fernanda Valencia GuerreroErik Cristopher Dustin Osma CastroAnderson O. OaikhenaAyorinde Oluwatobiloba AfolayanJolaade J AjiboyeRavikumar K. L.Geetha NagarajVarun ShammanaVandana GovindanAkshata PrabhuDarmavaram SravaniShincy M. R.Rajitha G. V.Carolin Vegvari3John Stelling4Department of Pharmaceutical Microbiology, University of Ibadan, Ibadan, NigeriaKeele University Faculty of Medicine & Health Sciences, Keele, Staffordshire, UKCentre for Genomic Pathogen Surveillance, Wellcome Genome Campus, Cambridge, UKDepartment of Infectious Disease Epidemiology, Imperial College London, London, UKDepartment of Medicine, Brigham and Women’s Hospital, Boston, Massachusetts, USAThe global spread of antimicrobial resistance (AMR) and lack of novel alternative treatments have been declared a global public health emergency by WHO. The greatest impact of AMR is experienced in resource-poor settings, because of lack of access to alternative antibiotics and because the prevalence of multidrug-resistant bacterial strains may be higher in low-income and middle-income countries (LMICs). Intelligent surveillance of AMR infections is key to informed policy decisions and public health interventions to counter AMR. Molecular surveillance using whole-genome sequencing (WGS) can be a valuable addition to phenotypic surveillance of AMR. WGS provides insights into the genetic basis of resistance mechanisms, as well as pathogen evolution and population dynamics at different spatial and temporal scales. Due to its high cost and complexity, WGS is currently mainly carried out in high-income countries. However, given its potential to inform national and international action plans against AMR, establishing WGS as a surveillance tool in LMICs will be important in order to produce a truly global picture. Here, we describe a roadmap for incorporating WGS into existing AMR surveillance frameworks, including WHO Global Antimicrobial Resistance Surveillance System, informed by our ongoing, practical experiences developing WGS surveillance systems in national reference laboratories in Colombia, India, Nigeria and the Philippines. Challenges and barriers to WGS in LMICs will be discussed together with a roadmap to possible solutions.https://gh.bmj.com/content/5/11/e002244.full
spellingShingle Iruka N Okeke
Ben Taylor
Celia Carlos
Marietta Lagrada
Polle K. Macaranas
Agnettah M. Olorosa
June Gayeta
Melissa Ana Masim
Elmer M. Herrera
David M Aanensen
Khalil Abudahab
Monica Abrudan
Silvia Argimon
Harry Harste
Mihir Kekre
Ali Molloy
Dawn Muddyman
Anneke Schmider
Anthony Underwood
María del Pilar Donado Godoy
Johan Fabian Bernal Morales
Alejandra Arevalo
Maria Fernanda Valencia Guerrero
Erik Cristopher Dustin Osma Castro
Anderson O. Oaikhena
Ayorinde Oluwatobiloba Afolayan
Jolaade J Ajiboye
Ravikumar K. L.
Geetha Nagaraj
Varun Shammana
Vandana Govindan
Akshata Prabhu
Darmavaram Sravani
Shincy M. R.
Rajitha G. V.
Carolin Vegvari
John Stelling
Whole-genome sequencing as part of national and international surveillance programmes for antimicrobial resistance: a roadmap
BMJ Global Health
title Whole-genome sequencing as part of national and international surveillance programmes for antimicrobial resistance: a roadmap
title_full Whole-genome sequencing as part of national and international surveillance programmes for antimicrobial resistance: a roadmap
title_fullStr Whole-genome sequencing as part of national and international surveillance programmes for antimicrobial resistance: a roadmap
title_full_unstemmed Whole-genome sequencing as part of national and international surveillance programmes for antimicrobial resistance: a roadmap
title_short Whole-genome sequencing as part of national and international surveillance programmes for antimicrobial resistance: a roadmap
title_sort whole genome sequencing as part of national and international surveillance programmes for antimicrobial resistance a roadmap
url https://gh.bmj.com/content/5/11/e002244.full
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