The Integrated Antimicrobial Resistance (AMR) Surveillance Manual provides a national framework for the implementation of integrated antimicrobial resistance surveillance in Malaysia using a One Health approach. Developed under the Strategic Action Plan for Antimicrobial Resistance (My-AP AMR), the manual aims to harmonize surveillance activities across human health, animal health, food, aquaculture and fisheries sectors. The manual establishes objectives, methodologies, sampling procedures, laboratory methods, data management requirements, reporting mechanisms, and coordination arrangements for monitoring antimicrobial resistance (AMR), antimicrobial consumption (AMC), and antimicrobial usage (AMU). The manual establishes surveillance systems for antimicrobial resistance in human health and antimicrobial consumption in humans. For human health, it provides procedures for monitoring Escherichia coli and Salmonella isolates from hospitals and selected primary healthcare facilities, including specimen collection, antimicrobial susceptibility testing, data collection, data analysis, and reporting through WHONET and national public health institutions. For antimicrobial consumption surveillance, the manual outlines methods for collecting procurement and sales data from public and private healthcare sectors, calculating defined daily doses (DDD), analysing antimicrobial consumption patterns, and comparing consumption trends with antimicrobial resistance data. For animal health, the manual establishes active and passive surveillance of antimicrobial resistance in poultry, pigs, dairy cattle, slaughterhouses, and animal-based products. It identifies target organisms, sampling locations, laboratory procedures, antimicrobial susceptibility testing methods, and reporting arrangements coordinated through the Department of Veterinary Services. The manual further introduces antimicrobial usage monitoring for livestock, focusing on poultry and pigs, using data collected from farms, feed importation, medicated feed, antimicrobial wholesalers, and veterinary authorities. It provides procedures for data aggregation, analysis, and reporting using population correction unit (PCU) methodology and annual reporting mechanisms. The manual also establishes antimicrobial resistance surveillance in aquaculture, fisheries, and food. In aquaculture and fisheries, surveillance covers fish, shrimp, shellfish, aquaculture farms, shellfish culture areas, and fisheries monitoring programmes, with data generated through active surveillance, diagnostic investigations, and research activities. In the food sector, the manual provides procedures for sampling raw fish, poultry, pork, beef, and mutton from retail markets, laboratory testing for Salmonella and Escherichia coli, data collection, trend analysis, and annual reporting. Across all sectors, the manual provides standardized approaches for data collection and reporting, laboratory analysis, monitoring of antimicrobial resistance trends, and submission of results to the National Antimicrobial Resistance Committee (NARC) through designated technical working groups and sectoral authorities.
ماليزيا · 2019-01-01