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 hospitals.

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 infections.