TY  - JOUR
AU  - Iera, Jessica
AU  - Isonne, Claudia
AU  - Seghieri, Chiara
AU  - Tavoschi, Lara
AU  - Ceparano, Mariateresa
AU  - Sciurti, Antonio
AU  - D'Alisera, Alessia
AU  - Sane Schepisi, Monica
AU  - Migliara, Giuseppe
AU  - Marzuillo, Carolina
AU  - Villari, Paolo
AU  - D'Ancona, Fortunato
AU  - Baccolini, Valentina
PY  - 2025
DA  - 2025/1/15
TI  - Availability and Key Characteristics of National Early Warning Systems for Emerging Profiles of Antimicrobial Resistance in High-Income Countries: Systematic Review
JO  - JMIR Public Health Surveill
SP  - e57457
VL  - 11
KW  - early warning system
KW  - surveillance
KW  - emerging AMR
KW  - high-income countries
KW  - antimicrobial resistance
AB  - Background: The World Health Organization (WHO) recently advocated an urgent need for implementing national surveillance systems for the timely detection and reporting of emerging antimicrobial resistance (AMR). However, public information on the existing national early warning systems (EWSs) is often incomplete, and a comprehensive overview on this topic is currently lacking. Objective: This review aimed to map the availability of EWSs for emerging AMR in high-income countries and describe their main characteristics. Methods: A systematic review was performed on bibliographic databases, and a targeted search was conducted on national websites. Any article, report, or web page describing national EWSs in high-income countries was eligible for inclusion. EWSs were identified considering the emerging AMR-reporting WHO framework. Results: We identified 7 national EWSs from 72 high-income countries: 2 in the East Asia and Pacific Region (Australia and Japan), 3 in Europe and Central Asia (France, Sweden, and the United Kingdom), and 2 in North America (the United States and Canada). The systems were established quite recently; in most cases, they covered both community and hospital settings, but their main characteristics varied widely across countries in terms of the organization and microorganisms under surveillance, with also different definitions of emerging AMR and alert functioning. A formal system assessment was available only in Australia. Conclusions: A broader implementation and investment of national surveillance systems for the early detection of emerging AMR are still needed to establish EWSs in countries and regions lacking such capabilities. More standardized data collection and reporting are also advisable to improve cooperation on a global scale. Further research is required to provide an in-depth analysis of EWSs, as this study is limited to publicly available data in high-income countries. 
SN  - 2369-2960
UR  - https://publichealth.jmir.org/2025/1/e57457
UR  - https://doi.org/10.2196/57457
DO  - 10.2196/57457
ID  - info:doi/10.2196/57457
ER  -