Rapid assessment of antimicrobial resistance prevalence using a Lot Quality Assurance sampling approach.
OBJECTIVE
Increasing antimicrobial resistance (AMR) requires rapid surveillance tools, such as Lot Quality Assurance Sampling (LQAS).


METHODS
LQAS classifies AMR as high or low based on set parameters. We compared classifications with the underlying true AMR prevalence using data on 1335 Escherichia coli isolates from surveys of community-acquired urinary tract infection in women, by assessing operating curves, sensitivity and specificity.


RESULTS
Sensitivity and specificity of any set of LQAS parameters was above 99% and between 79 and 90%, respectively. Operating curves showed high concordance of the LQAS classification with true AMR prevalence estimates.


CONCLUSIONS
LQAS-based AMR surveillance is a feasible approach that provides timely and locally relevant estimates, and the necessary information to formulate and evaluate guidelines for empirical treatment.
Department of Global Health, Academic Medical Center, University of Amsterdam, Amsterdam Institute for Global Health & Development, Amsterdam, The Netherlands.
Frank
F
van Leth
Department of Medical Microbiology, Maastricht University, School of Public Health & Primary Care, Maastricht, The Netherlands.|Department of Sexual Health, Infectious Diseases & Environmental Health, Public Health Service South Limburg, Geleen, The Netherlands.
Casper
C
den Heijer
Department of Internal Medicine, Division of Infectious Diseases, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands.
Mariëlle
M
Beerepoot
Department of Medical Microbiology, Maastricht University, School of Public Health & Primary Care, Maastricht, The Netherlands.
Ellen
E
Stobberingh
Department of Internal Medicine, Division of Infectious Diseases, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands.
Suzanne
S
Geerlings
Department of Global Health, Academic Medical Center, University of Amsterdam, Amsterdam Institute for Global Health & Development, Amsterdam, The Netherlands.|Department of Medical Microbiology, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands.
Constance
C
Schultsz
D000890:Anti-Infective Agents / Q000494:pharmacology* / Q000627:therapeutic use; D024881:Drug Resistance, Bacterial; D004812:Epidemiologic Methods; D004926:Escherichia coli / Q000187:drug effects* / Q000302:isolation & purification; D004927:Escherichia coli Infections / Q000188:drug therapy / Q000453:epidemiology / Q000382:microbiology; D005260:Female; D006801:Humans; D055810:Lot Quality Assurance Sampling; D015995:Prevalence; D012680:Sensitivity and Specificity; D014552:Urinary Tract Infections / Q000188:drug therapy / Q000453:epidemiology / Q000382:microbiology
D000890:Anti-Infective Agents
Lot Quality Assurance Sampling; antimicrobial resistance; empirical treatment; urinary tract infection