Community need
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Antimicrobial resistance, or AMR, is a significant problem to humanity. It occurs when microorganisms including viruses, bacteria, fungi, and parasites mutate over time and do not respond to medicines making it difficult or impossible to treat diseases. One way to prevent this is to have correct data related to AMR in order to evaluate the different situations and to adequately address the main causes which are overuse or misuse of antimicrobial agents.
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Currently, in Thailand, it is quite difficult to collect and report AMR-related data such as number of patient cases with antimicrobial resistance, particular bacterial infections which need to be reported, medications used to treat infections, or medications having encountered problems of antimicrobial resistance. The health care system does not have a universal format or a platform where data can be managed and reported easily at a local healthcare facility. Local hospitals are not empowered to do this on site. As a result, physicians and decision makers at local hospitals have no access to useful data, in a timely fashion, to help make optimal decisions on usage or on the adoption of policies targeting problems related to AMR or use of antimicrobial agents.
Research response
Think global and act local is the motto of a research team led by Dr. Direk Limmathurotsakul, as the principal investigator, and his colleagues at the Microbiology Department, MORU. In 2019, they introduced a translational research project creating an automated tool to produce reports of AMR using local AMR data for local hospitals and by local hospitals themselves. User-friendly features of the project output, which is an offline application, included easy data transformation, simple data output formats, and data security. Data collection systems currently in use in hospitals can be automatically imported to the application called
" AutoMated tool for Antimicrobial resistance Surveillance System (AMASS) "
AMASS can take the different formats of data such as data names of sex or gender, data values of M/F or 0/1, data date of dd-mm-yy or dd-mm-yyyy, which are used differently across hospitals, automatically analyze and transform the data into an-easy-to-understand reports in PDF and CSV within one double click. AMASS reports do not contain any patient sensitive information or identification. So, AMASS reports and summary data within the reports can be pooled and shown across settings e.g. a regionally, countrywide, or globally.
Outcomes
AMASS progressed from phase 1 in 2019 reporting AMR to phase 2 in 2020 reporting AMR plus notifiable bacterial diseases. Presently, AMASS phase 3 is ongoing with an addition of cluster analysis and its phase 4 is forthcoming with an addition of antimicrobial prescription data usage for better care focusing on outbreaks and antibiotic use, respectively. The research team received grants from several sources including Mahidol-Oxford Translational Innovation Partnership (MOTIP) and the Wellcome Data for Science and Health.
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The research impact of this project extends into several aspects, starting from reports of precise data about antimicrobial resistance and reports of notifiable bacterial diseases accomplished at participating hospitals. Collaborations were established with local hospitals, the Department of Disease Control, and the Ministry of Public Health in Thailand, and WHONET (The microbiology laboratory database software) and ACORN (A Clinically Oriented antimicrobial Resistance Network) outside the country. Training for PhD students in the course of this research project and dissemination of knowledge were achieved. AMASS used the automated platform to improve the health care data analysis which could improve the decision-making process of healthcare professionals and policy makers. Then, the practice of antimicrobials agent use and infection prevention control can be done more effectively and, eventually, this can reduce antimicrobial resistance and improve patients’ well-being.
MOTIP helped support the AMASS project during phase 2 by providing seed funding to the research team, in year 2020. Dr. Direk stated that the funding made it possible for the project to progress from Phase 1. Small grants are particularly helpful for early projects to move along toward their ultimate goals.
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Further information about AMASS, please visit www.amass.website.
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More information related to support for translational research projects, contact motip@tropmedres.ac.