Towards Developing an International Environmental AMR Surveilance Strategy

在更广泛的环境中以及在更广泛的环境中充分了解抗菌素耐药性的发展和传播，这是一个迫切和日益增长的需要。然而，目前对抗菌素耐药性的环境方面的研究主要局限于个别机构或学术实验室。各国政府和国际机构（欧盟、联合国、世卫组织）已经认识到，我们必须建立有效的环境监测系统，以识别和监测我们的水域、土壤、空气和野生动物中的抗菌素耐药性，从而进一步了解自然环境在抗菌素耐药性的出现和传播中所起的作用，以及人类/动物来源的抗菌素/耐药微生物如何进入环境导致抗菌素耐药性。“同一个健康”方针促进了人类、兽医和食品部门的统一监测，并使用共同的结果指标来监测抗菌素耐药性和抗菌素使用情况：一些联合国家报告公布了关键指标细菌和关键抗生素的抗菌素耐药性趋势（例如英国“同一个健康”报告、DANMAP和苏格兰“同一个健康”抗菌素使用和耐药性报告（SONAAR））。然而，到目前为止，对于环境部门的衡量指标还没有明确的共识。该网络旨在确定可靠的、可衡量的环境抗菌素耐药性监测指标和方法，方法是：在多部门“同一个健康”方针的背景下，利用和转让临床和动物抗菌素耐药性指标和方法的现有知识。我们将把主要研究人员与环境、人类卫生和兽医部门以及具有广泛经济背景的国家的决策者和监管机构聚集在一起。我们的目标是达成一套标准化的目标和可重复、可获取的方法，以便以协调的方式产生比较数据。然后，我们将在向各国政府和国际机构提供的建议和简报中列出我们的调查结果。

There is an urgent and increasing need to fully understand the development and transmission of AMR both into and within the wider environment. However, at present research into environmental aspects of AMR has been largely confined to individual institutions or academic laboratories. National governments and international bodies (EU, UN, WHO) have recognised that we must establish effective environmental surveillance systems to identify and monitor AMR in our waters, soils air and wildlife in order to increase understanding of the natural environment's role in emergence and spread of AMR and how the introduction of antimicrobials / resistant microorganisms from human / animal sources into the environment contribute to AMR. A One Health approach promotes harmonised surveillance across human, veterinary and food sectors and the use of common outcome indicators to monitor AMR and antimicrobial use: several joint national reports publish AMR trends for key indicator bacteria and key antibiotics (for example UK One Health report, DANMAP and Scottish One Health Antimicrobial Usage and Antimicrobial Resistance Report (SONAAR). However, there is no clear consensus so far regarding which indicators to measure for the environmental sector. This network aims to identify robust, measurable surveillance indicators and methodologies for environmental AMR by: building on and transferring existing knowledge from clinical and animal AMR indicators and methodologies in the context of a multi-sectoral, One Health approach. We will bring together key researchers with policy makers and regulators across the environmental, human health and veterinary sectors and from countries with a wide range of economic settings. We aim to arrive at a standardised set of targets and reproducible, accessible methodologies allowing comparative data to be generated in a coordinated manner. We will then set out our findings in advice and briefings to governments and international bodies.