Our flagship study, the Clinically-Oriented Antimicrobial Resistance Surveillance Network for Healthcare Associated Infections (ACORN–HAI) is a large-scale, multicentre protocol that builds upon the WHO Global Antimicrobial Resistance and Use Surveillance System. It aims to estimate syndromic and pathogen outcomes, as well as associated health economic costs. We specifically focus on healthcare-associated bloodstream infections and ventilator-associated pneumonia.

Surveillance of antimicrobial resistance is crucial for guiding antibiotic prescribing, infection prevention and control strategies, and the development of new antibiotics. However, most existing surveillance system focus on isolates and lack comprehensive patient-based clinical data. Furthermore, these systems are not widely implemented, particularly in low- and middle-income countries.

Our main objective is to establish an efficient antimicrobial resistance surveillance system that targets hospitalised patients of all ages with clinically compatible healthcare-associated bacterial infection syndromes and who have been prescribed parenteral antibiotics. Diagnostic stewardship activities will be implemented to optimise practices related to microbiology culture specimen collection. During enrolment and a 28-day follow-up period, basic patient characteristics, clinician diagnosis, empiric treatment, infection severity, and risk factors for healthcare-associated infections are recorded.

ACORN–HAI is a comprehensive approach to antimicrobial resistance surveillance that emphasises practical implementation and focuses on improving local diagnostic practices and antibiotic prescribing through patient-centred data collection. These data can be rapidly shared with local physicians and infection prevention and control teams.

eLearning Platform

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Saw Swee Hock School of Public Health
National University of Singapore

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