AMR Surveillance in India

AMR Surveillance in Indian states

Since 2018, HISP India has been actively working in the field of Antimicrobial Resistance (AMR) surveillance, focusing on the digitization of microbiology laboratories in tertiary public medical colleges in Himachal Pradesh, Bihar and Varanasi. This work aims to enhance AMR testing by enabling the digital surveillance of antimicrobial sensitivity and resistance patterns, supporting clinical care, and assisting partner institutions in developing facility-specific Antimicrobial Stewardship Policies (ASP).

AMR surveillance in Animals

AMR surveillance in animals is crucial for monitoring antimicrobial resistance in livestock, poultry, and companion animals, as they can serve as reservoirs for resistant pathogens. From a veterinary perspective, surveillance focuses on tracking resistance patterns in animals visiting veterinary hospitals, assessing antibiotic usage, and identifying potential transmission pathways between animals, humans, and the environment. This data helps inform responsible antimicrobial use (AMU) practices, develop targeted intervention strategies, and support One Health initiatives to combat AMR at the human-animal-environment interface.

AMR Surveillance in Humans

HISP India has developed a robust digital Antimicrobial Resistance (AMR) Surveillance System using the free and open-source DHIS2 platform. This system represents a major advancement in infectious disease control and healthcare data management. In Varanasi, where healthcare facilities are primarily dedicated to cancer research, the system has been customized to meet specific institutional needs.

The AMR surveillance system empowers microbiology lab technicians to enter patient data efficiently while enabling real-time analysis of susceptibility percentages and antibiograms through interactive dashboards. It also categorizes resistance patterns and genes across various organism groups, classifying them into Multi-Drug Resistant (MDR), Extensively Drug Resistant (XDR), and Pan-Drug Resistant (PDR) categories.

Key features include:

  • Syndrome-based and sample-type analysis: Data is structured around different syndromes and sample types (diagnostic vs. surveillance), providing a comprehensive view of resistance trends.
  • Advanced filtering options: Users can analyze data based on location, department, and sample type, enhancing usability for epidemiological insights.
  • Curated reports: These reports help correlate risk factors with specific syndromes, aiding decision-making for infection control strategies.

To enhance interoperability, Varanasi’s healthcare facilities, which operate proprietary software systems, have successfully integrated their existing patient data repositories with the AMR surveillance system. This integration enables automated data import, ensuring seamless aggregation of clinical events. The system facilitates in-depth analysis and visualization through interactive dashboards, featuring comprehensive data tables and visual charts.

By strengthening microbiology labs and improving data-driven decision-making, HISP India’s AMR surveillance system contributes to enhanced patient care, informed antibiotic stewardship policies, and improved responses to antimicrobial resistance trends.

Partners

Team

Gitika Arora

Head - Health Systems

Neha Chadha

Sr. Project Officer – DHIS2

Akshita Pundir

Sr. Project Officer - DHIS2

Subhash Thakur

Sr. Project Coordinator - AMR

Rashmi Surial

Research Assistant

Publications

#TitlePublicationYearUrl
1Social and cultural determinants of antibiotics prescriptions: analysis from a public community health centre in North IndiaFrontiers in Pharmacology2024View
2Systems thinking based approaches to engage with health inequities shaping Antimicrobial Resistance in low and lower-middle-income countriesJournal of Infection and Public Health2023View
4Assessing feasibility of point-of-care Antibiotics Susceptibility Testing technologies for mitigating access gaps for peripheral communities 2023View
3Digital Monitoring of Antibiotic Resistance (ABR) in Low- and Middle-Income Countries: A Narrative Literature ReviewScandinavian Conference on Health Informatics2022View
5Strengthening digital monitoring of antibiotic resistance in low-resource settingsJournal of Global Health2022View
6Designing an Antibiotics Resistance (ABR) monitoring system to strengthen the evidence base for facilitating responsible antibiotics prescription by physicians: A case study from IndiaICIS 20222022View
7Routinizing practices and stabilizing institutional work: A case of digital monitoring of Antibiotic Resistance (ABR) in IndiaCommunications of the Association for Information Systems2022View
8Designing for Scale: Strengthening Surveillance of Antimicrobial Resistance in Low Resource SettingsIFIP Joint Working Conference on the Future of Digital Work: The Challenge of Inequality (IFIPJWC)2022View

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