Monitoring and surveillance of antimicrobial resistance in microorganisms associated with aquatic animals.

The World Organisation for Animal Health (OIE) Aquatic Animal Health Code recommends that programmes forthe monitoring and surveillance of antimicrobial resistance in microorganisms associated with aquatic animals be initiated by the appropriate authorities. This paper discusses the classes of bacteria to be studied in such programmes and the methods of sample collection to be employed. It also discusses the susceptibility test protocols appropriate for use in such programmes, the interpretive criteria that should be applied to the data they generate and the form in which the output of such programmes should be reported. The authors argue that it is essential that all monitoring and surveillance programmes should employ standardised and internationally harmonised susceptibility test methods to the greatest extent possible. With respect to bacteria capable of infecting aquatic animals, it is recommended that the set of consensus-based standards and guidelines published by the Clinical and Laboratory Standards Institute be adopted as the basis for international harmonisation of test protocols, as they are significantly more developed than any alternatives. It is further recommended that, for the purpose of evaluating antimicrobial resistance trends, such as emerging resistance, the data generated by these protocols should be interpreted by the application of epidemiological cut-off values. However, as yet, internationally agreed cut-off values have been produced for only one species. Thus, for many species, authorities will be obliged to set their own local and laboratory-specific cut-off values. It is recommended that laboratories use a statistical and standardised method of establishing such local cut-off values. Internationally harmonised standard test protocols and interpretive criteria have, to a large extent, been developed to monitor antimicrobial resistance in bacterial species capable of infecting humans. These methods can also be applied to microorganisms capable of infecting humans that are isolated from aquatic animals reared for human consumption or for sale as companion animals.