Multi-site
Resistance map of your own network, not a country-level average
Public resistance maps are useful for policy and useless for prescribing. The map that changes a decision is the one drawn from the facilities you actually operate.
Short answer
A resistance map compares susceptibility across places. National and global maps, including the World Health Organization GLASS programme, exist to describe trends at policy scale. For a clinician the useful version is a comparison of the facilities in their own network, computed the same way at every site.
The comparison only means something if the method is identical
Two hospitals can report different Escherichia coli susceptibility to ciprofloxacin for reasons that have nothing to do with the organisms: one de-duplicated to first isolate per patient and the other did not, one used the current CLSI breakpoints and the other a version three years old, one counted intermediate results in the denominator and the other excluded them.
Running every site through the same rules, on the same breakpoint set, is what turns a set of local reports into a comparison. The rule receipt printed under each matrix is how you prove it was the same method.
What a network view is normally used for
- A regional system deciding whether one hospital needs a different empiric guideline from the rest
- A public health or reference laboratory network watching a resistant phenotype spread between sites
- A quality function comparing stewardship reporting across facilities on a like-for-like basis
- A research group that needs clean, rule-consistent exports rather than a dashboard
Small sites are where suppression matters most
A critical access hospital with a few hundred isolates a year will suppress most cells in any quarterly cut, and that is the correct behaviour. What a network view adds is the option to report the small site honestly and to pool it deliberately, with the pooling stated rather than assumed.
Related reading: how this compares to WHONET, tracking carbapenem resistance across sites. The four steps from susceptibility testing data to an antibiogram cover the method end to end.
Questions
On this page's topic
Is there an actual map with pins on it?
The comparison is a table and a set of matrices, because that is what supports a decision. Geography rarely explains the difference between two facilities in the same system; case mix and unit profile usually do.
How many facilities can I compare?
The Network plan covers up to twelve facilities. Above that is an Enterprise conversation, which usually also involves single sign-on and a scheduled ingest.
Can I contribute to a public surveillance programme with this?
Antimicrobe does not submit data anywhere on your behalf. It produces exports, and what you do with them is your decision.
More on antimicrobial resistance reporting
- UTI antibiotic resistance Urine is the highest volume specimen most laboratories process, which makes it the one sourc...
- carbapenem resistant organism Carbapenem resistance is the event that changes what a hospital can do next, and it is the l...
- empiric therapy Every empiric decision is a bet placed before the culture is back. The only honest way to im...
- antibiotic stewardship program A stewardship program lives or dies on whether it can answer questions quickly. Most of the...
- CLSI breakpoints A breakpoint revision can move a susceptibility rate by several points without one organism...
- WHONET WHONET is good software, it is free, and it is the global default for a reason. This page is...
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