Evidence map›Paper›PMID 33268385›Full record

ReviewBMJ global health2020

Leapfrogging laboratories: the promise and pitfalls of high-tech solutions for antimicrobial resistance surveillance in low-income settings.

Iruka N Okeke, Nicholas Feasey, Julian Parkhill, Paul Turner, Direk Limmathurotsakul, Pantelis Georgiou, Alison Holmes, Sharon J Peacock

Open access · goldAbstract readReview
In one paragraph

Review in BMJ global health, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 34 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
34citing papers in PubMed, 2 pooled it
6.8field-weighted citation impact, top 2% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

34 citing papers in PubMed, 2 syntheses or guidelines pooled it, 82 citations in OpenAlex.

  1. Pooled it
  2. Pooled it
  3. Comprehensive Phenotypic Characterization of ClinicalInternational journal of molecular sciences · 2026
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  18. Capturing Data on Antimicrobial Resistance Patterns and Trends in Use in Regions of Asia (CAPTURA).Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2023
    Article
  19. Review
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors at 6 institutions in 5 countries.

Iruka N OkekeDepartment of Pharmaceutical Microbiology, University of Ibadan, Ibadan, Nigeria iruka.n.okeke@gmail.com.ORCID 0000-0002-1694-7587
Nicholas FeaseyThe Malawi Liverpool Wellcome Trust Clinical Research Programme, Blantyre, Malawi.
Julian ParkhillDepartment of Veterinary Medicine, University of Cambridge, Cambridge, UK.
Paul TurnerCambodia Oxford Medical Research Unit, Angkor Hospital for Children, Siem Reap, Cambodia.ORCID 0000-0002-1013-7815
Direk LimmathurotsakulMahidol Oxford Tropical Medicine Research Unit, Bangkok, Thailand.ORCID 0000-0001-7240-5320
Pantelis GeorgiouDepartment of Electrical and Electronic Engineering, Imperial College London, London, UK.
Alison HolmesNational Centre for Infection Prevention and Management, Faculty of Medicine, Imperial College London, London, UK.
Sharon J PeacockDepartment of Medicine, University of Cambridge, Cambridge, UK.
Imperial College London · GBUniversity of Cambridge · GBAngkor Hospital for Children · KHMahidol Oxford Tropical Medicine Research Unit · THUniversity of Ibadan · NGUniversity of Liverpool · GB

Funding

Medical Research Council MR/L00464X/1Wellcome Trust
6 · The paper itself

Abstract

The scope and trajectory of today's escalating antimicrobial resistance (AMR) crisis is inadequately captured by existing surveillance systems, particularly those of lower income settings. AMR surveillance systems typically collate data from routine culture and susceptibility testing performed in diagnostic bacteriology laboratories to support healthcare. Limited access to high quality culture and susceptibility testing results in the dearth of AMR surveillance data, typical of many parts of the world where the infectious disease burden and antimicrobial need are high. Culture and susceptibility testing by traditional techniques is also slow, which limits its value in infection management. Here, we outline hurdles to effective resistance surveillance in many low-income settings and encourage an open attitude towards new and evolving technologies that, if adopted, could close resistance surveillance gaps. Emerging advancements in point-of-care testing, laboratory detection of resistance through or without culture, and in data handling, have the potential to generate resistance data from previously unrepresented locales while simultaneously supporting healthcare. Among them are microfluidic, nucleic acid amplification technology and next-generation sequencing approaches. Other low tech or as yet unidentified innovations could also rapidly accelerate AMR surveillance. Parallel advances in data handling further promise to significantly improve AMR surveillance, and new frameworks that can capture, collate and use alternate data formats may need to be developed. We outline the promise and limitations of such technologies, their potential to leapfrog surveillance over currently available, conventional technologies in use today and early steps that health systems could take towards preparing to adopt them.

Indexed as

Drug Resistance, BacterialLaboratoriesAnti-Bacterial AgentsHumansAnti-Bacterial Agentsdiseasedisorderepidemiologyhealth systemsmedical microbiologyor injuryother diagnostic or toolother infection

Identifiers

PMID33268385
PMCPMC7712442
OpenAlexW3109070984

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.