WHO integrated global surveillance on ESBL-producing E. coli using a “One Health” approach: implementation and opportunities

Overview

WHO and the Advisory Group on Integrated Surveillance on AMR (AGISAR) supported WHO to develop a standard protocol for integrated multisectoral surveillance. The model targets monitoring one indicator, the extended spectrum beta-lactamases- (ESBL) producing Escherichia coli across the human, animal and environmental sectors, the “Tricycle protocol”. This protocol includes standard methodologies in the human, food chain and environmental sectors to be implemented in low resource settings to facilitate the establishment of the integrated multisectoral surveillance on AMR. Countries can build from this simple approach a complete national surveillance system that involves other cross cutting pathogens, resistance mechanisms and expand the implementation in different cities and provinces in the country to get more evidence of the spread of the antimicrobial resistance in the different sectors and allow the implementation of interventions in a holistic way to contain AMR.