WHONET for automated real-time multilevel global microbial surveillance

描述（由申请人提供）：传染病和对抗菌剂的耐药性对全球人类和动物福利构成威胁，并消耗有限的资源。为了控制和管理感染性微生物及其耐药基因，我们需要知道它们在哪里，它们要去哪里。全球数以千计的微生物实验室每天都会产生结果，这些结果可以进行跟踪和有针对性的控制干预，但医疗保健提供者和公共卫生机构很难从分散的系统中收集、整合和利用数据。为了应对这一挑战，我们世卫组织抗菌素耐药性监测合作中心的团队与世界卫生组织合作，开发和传播WHONET软件已有20多年。WHONET是领先的免费公共卫生软件，支持基于实验室的抗菌素耐药性电子监测，并支持90多个国家和1300家医院，公共卫生，食品和动物实验室的监测活动。该项目将通过创建一个多层次（地方、国家、区域、全球）的网络系统来改变这一举措，以支持对感染和抗菌素耐药性的自动化、实时协作监测。主要目标包括：1）用于数据管理、分析和呈现的安全多层网络架构; 2）启用网络的多层次分析，自动向医疗保健专业人员和国家当局发出具有公共卫生重要性的发现警报; 3）在四个合作伙伴网络中试点实施新平台;以及4）创建生产实施的实施指南。缺乏数据转换工具的不兼容的信息系统已被证明是主要的技术障碍，广泛的数据共享，我们的数据规范化工具，在过去的20年来，以解决这一挑战，已被证明是至关重要的WHONET的成功扩展。我们将把积累的专业知识和翻译资源转移到基于网络的解决方案中，以减少合作监督的障碍。自动迭代多级数据分析允许在任何时间、任何地点识别任何病原体的新威胁。地理参考公共图书馆的定量多药耐药模式和常规生化标志物将允许微生物亚群的表型划分，提高WHONET的时空爆发检测算法的灵敏度和特异性，并促进早期识别，跟踪和遏制以前未被识别的公共卫生或进化重要性菌株。微生物在人、医院、动物、大陆之间移动并进化。通过自动化、实时调动和警惕丰富但基本上尚未开发的资源--世界微生物实验室的累积努力--我们的目标是在公共部门开发免费的解决方案，可在全球范围内应用，以调动、共享和解释这些数据，指导及时有效的公共卫生行动。

DESCRIPTION (provided by applicant): Infectious diseases and resistance to antimicrobial agents grow as threats to human and animal welfare worldwide and drain limited resources. To contain and manage infecting microbes and their resistance genes, we need to know where they are and where they are going. Thousands of microbiology laboratories around the world generate results daily which could permit tracking and targeted control interventions, yet healthcare providers and public health agencies struggle to collect, integrate, and utilize data from fragmented systems. To address this challenge, our team at the WHO Collaborating Centre for Surveillance of Antimicrobial Resistance has developed and disseminated the WHONET software for over 20 years in collaboration with the World Health Organization. WHONET is the leading free public health software to support electronic laboratory-based surveillance of antimicrobial resistance, and supports surveillance activities in over 90 countries and 1300 hospital, public health, food, and animal laboratories. This project will transform this initiative through creation of a multilevel (local, national, regional, global) web- based system to support automated, real-time collaborative surveillance of infections and antimicrobial resistance. Key objectives include: 1) a secure multi-tiered web architecture for data management, analysis, and presentation; 2) web-enabled multilevel analytics with automated alerts to healthcare professionals and national authorities of findings of public health importance; 3) pilot implementation of the new platform in four partner networks; and 4) an implementation guide for creation of production implementations. The lack of data transformation tools for incompatible information systems has proved the primary technical obstacle to broad data sharing, and our data normalization utilities developed over the past 20 years to address this challenge have proved crucial to WHONET's successful expansion. We will transfer the accrued expertise and translation resources to web-based solutions to decrease barriers to collaborative surveillance. Automated iterative multilevel data analysis permits the identification of new threats in any pathogen in any location at any time. Geo-referenced public libraries of quantitative multidrug resistance patterns and routine biochemical markers will permit the phenotypic delineation of microbial subpopulations improving the sensitivity and specificity of WHONET's space-time outbreak detection algorithms and facilitating the early recognition, tracking, and containment of previously unrecognized strains of public health or evolutionary importance. Microbes move - between people, hospitals, animals, continents - and evolve. Through automated, real-time mobilization and vigilance of a rich yet largely untapped resource - the cumulative efforts of the world's microbiology laboratories - our goal is the development of free solutions in the public sector that can be applied worldwide to mobilize, share, and interpret these data to guide timely and effective public health action.