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WHONET and BacLink Laboratory-based surveillance of infectious diseases and antimicrobial resistance

WHONET and BacLink Laboratory-based surveillance of infectious diseases and antimicrobial resistance. John Stelling, MD, MPH Brigham and Women’s Hospital, Boston WHO Collaborating Centre for Surveillance of Antimicrobial Resistance jstelling@rics.bwh.harvard.edu.

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WHONET and BacLink Laboratory-based surveillance of infectious diseases and antimicrobial resistance

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  1. WHONET and BacLinkLaboratory-based surveillance of infectious diseases and antimicrobial resistance John Stelling, MD, MPH Brigham and Women’s Hospital, Boston WHO Collaborating Centre for Surveillance of Antimicrobial Resistance jstelling@rics.bwh.harvard.edu

  2. The Complete Laboratory Information System • Clinical reporting • return results to clinicians • permanent record • Laboratory management system • preliminary and final results • guide technologists through needed laboratory tests • billing and financial accounting • Data analysis

  3. Uses of Microbiology Data • Laboratory quality improvement • Laboratory testing • Utilization of laboratory services by clinical staff • Infection control and outbreak preparedness • Identification of new and problem pathogens • Identification and investigation of outbreaks • Antimicrobial policy • Trends in infections and resistance • Characterization of cross-resistance • Development of treatment guidelines • Research • New resistance mechanisms • Risk factors for resistance • Evaluation of interventions

  4. WHONET: A Microbiology Data Management Tool • Enhance the use of locally-generated data • Antimicrobial policy, infection control • Laboratory quality assurance • Promote collaborations • National and international networks

  5. WHONET around the World • WHONET is currently used in over 90 countries, managing data from over 1300 laboratories. • Hospital and public health laboratories • Food and veterinary laboratories • Reference and research laboratories • Data collections • Routine laboratory data • Special surveys and research protocols

  6. WHONET Use in the World • African Regional Office of WHO (AFRO) • Algeria, Kenya, Namibia, South Africa, Tanzania, Zambia • Eastern Mediterranean Regional Office of WHO (EMRO) • Jordan, Kuwait, Lebanon, Libya, Morocco, Oman, Pakistan, Saudi Arabia, Tunisia • European Regional Office of WHO (EURO) • Austria, Belgium, Bulgaria, Croatia, Czech Republic, Denmark, Estonia, Finland, France, Georgia, Germany, Greece, Iceland, Ireland, Israel, Italy, Latvia, Luxembourg, Malta, Netherlands, Norway, Poland, Portugal, Romania, Russia, Slovakia, Slovenia, Spain, Sweden, Ukraine, United Kingdom • Pan-American Health Organization (PAHO) • Argentina, Bolivia, Brazil, Chile, Colombia, Costa Rica, Cuba, Dominican Republic, Ecuador, El Salvador, Guatemala, Mexico, Nicaragua, Panama, Paraguay, Peru, United States, Uruguay, Venezuela • South-East Asian Regional Office of WHO (SEARO) • India, Indonesia, Sri Lanka, Thailand • Western Pacific Regional Office of WHO (WPRO) • China, Hong Kong (China), Japan, Republic of Korea, Malaysia, Philippines, Singapore, Taiwan, Viet Nam

  7. WHONET Availability • Free of charge from WHO • www.who.int/drugresistance/whonetsoftware • The software includes 18 languages • English, Estonian, French, German, Italian, Latvian, Norwegian (two dialects), Polish, Portuguese, Spanish • Bulgarian, Greek, Russian • Chinese (Simplified), Indonesian, Japanese, Thai

  8. Isolate listing: List of patients with MRSA

  9. Isolate Summary:Number of patients with MRSA by location and month

  10. %RIS and histograms: Pseudomonas aeruginosa

  11. Scatterplot - Klebsiella pneumoniae Amikacin vs. Gentamicin

  12. Staphylococcus aureusTotal and by Resistance Profile

  13. BacTrack Expert SystemIsolate alerts

  14. Example WHONET Clusters *Dates are fictitious Confidential

  15. Acinetobacter baumannii Isolates Start date*: 6/1/05 End date*: 8/1/05 *Dates are fictitious

  16. Acinetobacter baumannii Clusters *Dates are fictitious Confidential

  17. Acinetobacter baumanniiSuspicious Susceptibility Pattern Start*: 6/1/05 End*: 7/28/05 *Dates are fictitious Non-susceptible to 7 antibiotics: Ampicillin, Cefotaxime, Ceftazidime, Levofloxacin, Nitrofurantoin, Gentamicin, Trimethoprim/Sulfamethoxazole

  18. BacLink 2Microbiology data conversion utility • Many laboratories in the world have already computerized their microbiology laboratory systems • This presents an obstacle and an opportunity

  19. Laboratory instruments Desktop softwares Laboratory systems Excel Access EpiInfo Mysis MEDITECH ADBakt MIC systems Disk diffusion readers BacLink Data conversion WHONET Data analysis

  20. Susceptibility Test Instruments Microdilution systems ATB Pasco Vitek Mast Scan Phoenix Wider MIC 2000 Sceptor Microscan Sensititre Disk diffusion readers Aura SirScan Biomic Videobac Mast Radius Wider Osiris

  21. Laboratory Information Systems and Other Formats • Laboratory Information Systems • ADBakt (Sweden) – MEDITECH Client/Server* • Cerner Classic – MEDITECH Magic • Cerner Millenium* – MYSIS* • MADS (Denmark) – Oman Laboratory Information System • Medicom – WinPath • Other formats • CDC ELR format* – NARMS (United States) • EARSS (European Union) – NORM (Norway) • JIAQA (Japan) – WHO-AFRO Bacteriology Lab (Africa) * = In development

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