A Switzerland wide surveillance system, to register and analyse all circulating
antibiotic resistant microorganisms will be set up in the next two years
(1). The methodology of the monitoring will provide the basis for research,
formulating prevention policy, and control.
A research team at the institute of infectious diseases at the university
of Bern together with a steering group is developing a monitoring system,
which includes 60% of hospital patients and 30% of practicing general practitioners
in Switzerland. Previous studies have been limited to specific pathogens,
patient groups, or regions.
Compared internationally, the levels of antibiotic resistance in Switzerland
are relatively low, although an increase has been observed in recent years.
Because resistance can spread quickly in a population, it is important to
intervene while resistance is relatively low.
A feasibility study was conducted as part of a one-year pilot project.
From more than 80 Swiss microbiology laboratories, the team selected 20
covering the highest number of patients in all areas of the country. The
laboratories agreed to send the anonymised results of the resistance tests
electronically to a central database, where they will be analysed. During
the pilot project the research team, which is led by Dr Kathrin Muehlemann,
also checked the comparability of the tests to be conducted at the participating
laboratories and found a software developer for the data management system.
The epidemiology of the different bacteria strains sheds light on trends
in the evolution of resistance, which could help in the development of new
antibiotics. The research team will also observe antibiotic use and compare
this with data on resistance development. Information on this relationship
will also be used by other countries such as Denmark, and by individual
The database will be completed by August 2005. During the final year of
the project it is planned to link the monitoring data to European databases
on antibiotic resistance (such as the European Antimicrobial Resistance
Surveillance System (EARSS, http://www.earss.rivm.nl/)
and antibiotic consumption (such as the European Surveillance of Antimicrobial
Consumption (ESAC). There are also plans to extend the surveillance to fungal