Towards Developing an International Environmental AMR Surveilance Strategy

迫切需要充分了解AMR的发展和在更广泛环境中的传播。然而，目前对AMR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、土壤、空气和野生动物中的AMR，以便更好地了解自然环境在AMR的出现和传播中所起的作用，以及从人/动物来源引入的抗菌剂/抗药性微生物如何有助于AMR。一个健康的方法促进人类、兽医和食品部门的协调监测，并使用共同的结果指标来监测AMR和抗菌剂的使用：几个联合的国家报告公布了关键指示细菌和关键抗生素的AMR趋势(例如，英国One Health报告、DANMAP和苏格兰One Health的抗菌素使用和抗菌素耐药性报告(SONAAR)。然而，关于衡量环境部门的哪些指标，到目前为止还没有明确的共识。该网络旨在通过以下方式确定强有力的、可衡量的环境AMR监测指标和方法：以临床和动物AMR指标和方法为基础，并在多部门、一个卫生方法的背景下转让现有知识。我们将召集关键研究人员与环境、人类健康和兽医部门的政策制定者和监管机构以及来自经济背景广泛的国家的关键研究人员汇聚一堂。我们的目标是达成一套标准化的目标和可重复使用的方法，以便以协调的方式生成比较数据。然后，我们将在向各国政府和国际机构提供咨询意见和简报中阐述我们的调查结果。

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.