WHONET for automated real-time multilevel global microbial surveillance

描述（由申请人提供）：传染病和抗微生物药物耐药性的增长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微生物及其耐药基因，我们需要知道它们在哪里，要去哪里。世界各地数以千计的微生物实验室每天产生的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收集、整合和利用来自分散系统的数据。为了应对这一挑战，我们在世卫组织抗微生物药物耐药性监测合作中心的团队与世界卫生组织合作，20多年来开发和传播了世卫组织网络软件。世卫网络是支持基于电子实验室的抗菌素耐药性监测的领先免费公共卫生软件，并支持90多个国家和1300个医院、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、区域和全球）基于网络的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、分析和展示的安全多层web架构；2)支持网络的多层次分析，自动向医疗保健专业人员和国家当局发出对公共卫生具有重要意义的发现警报；3)在四个合作伙伴网络试点实施新平台；4)用于创建生产实现的实现指南。缺乏用于不兼容信息系统的数据转换工具已被证明是广泛数据共享的主要技术障碍，而我们在过去20年中开发的数据规范化实用程序已被证明对WHONET的成功扩展至关重要。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，以减少协作监视的障碍。自动化迭代多层次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。定量多药耐药模式和常规生化标记物的地理参考公共文库将允许微生物亚群的表型描述，提高世卫网络时空爆发检测算法的敏感性和特异性，并促进早期识别、跟踪和遏制以前未被识别的具有公共卫生或进化重要性的菌株。微生物在人类、医院、动物、大陆之间移动并进化。通过自动化、实时地动员和警惕大量尚未开发的资源——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于动员、共享和解释这些数据，以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.