Global Antimicrobial Resistance and Use Surveillance System (GLASS)

Global Antimicrobial Resistance and Use Surveillance System (GLASS)

 

Antimicrobial resistance (AMR) represents a major threat to human health with significant global economic and security implications. In 2015, WHO Member States unanimously approved a Global Action Plan to tackle AMR (GAP-AMR). The goal of GAP-AMR is “to ensure, for as long as possible, continuity of successful treatment and prevention of infectious diseases with effective and safe medicines that are quality-assured, used in a responsible way, and accessible to all who need them”.

Surveillance is an essential tool to inform policies and infection prevention and control responses. Importantly, it is the cornerstone for assessing the spread of AMR and to inform and monitor the impact of local, national and global strategies. On 22 October 2015, WHO launched the Global Antimicrobial Resistance and Use Surveillance System (GLASS), the first global collaborative effort to standardize AMR surveillance. Endorsed by the Sixty-eighth World Health Assembly in resolution WHA68.7, GLASS was created to support the second objective of the GAP-AMR initiative to “strengthen knowledge through surveillance and research”, and to continue filling knowledge gaps, with the aim to inform strategies at all levels.

SCOPE

GLASS provides a standardized approach to the collection, analysis, interpretation and sharing of data by countries and seeks to actively support capacity building and monitor the status of existing and new national surveillance systems. Furthermore, GLASS promotes a shift from surveillance approaches based solely on laboratory data to a system that includes epidemiological, clinical, and population-level data. GLASS has been conceived to progressively incorporate data from surveillance of AMR in humans, such as monitoring of resistance and the use of antimicrobial medicines, including AMR in the food chain and in the environment.

STRUCTURE

The various types of AMR-related surveillance activities led by GLASS are grouped into a series of technical modules. These modules comprise surveillance activities built on routinely-available data (for example, patient samples collected for clinical purposes or national sales of antimicrobials) and focused activities targeted at generating information for specific purposes, based on the needs of countries and regions. GLASS is also engaged in the design and implementation of surveys and studies aimed at helping countries to achieve a better quality and representativeness of their data. Furthermore, GLASS provides support, including evidence-based guidelines and technical documents, to assist countries and regions to build capacity and take appropriate and timely corrective actions.

PARTNERSHIPS

GLASS works across all three levels of WHO – headquarters and regional and country offices – and is supported by the WHO AMR Surveillance and Quality Assessment Collaborating Centres Network (WHO AMR Surveillance CC Network). It enjoys strong commitment from participating countries and close collaboration with AMR regional networks such as the Central Asian and European Surveillance of Antimicrobial Resistance (CAESAR), the European Antimicrobial Resistance Surveillance Network (EARS-Net), the Latin American Network for Antimicrobial Resistance Surveillance (Rede Latinoamericana de Vigilancia de la Resistencia a los Antimicrobianos [ReLAVRA]), and the Western Pacific Regional Antimicrobial Consumption Surveillance System WPRACSS.


 

GLASS Data Visualization Dashboard

GLASS Surveillance Activities

The various types of AMR-related surveillance activities led by GLASS are grouped into technical modules (see figure opposite) 

ROUTINE SURVEILLANCE

GLASS-AMR provides a standardized approach to the collection, analysis and sharing of national AMR data in samples collected routinely for clinical purposes for a set of pathogens that cause common bacterial infections in human. GLASS-AMC provides a common and standardized set of methods for measuring and reporting antimicrobial consumption (AMC) at country, regional and global levels. Both technical modules collect data on the implementation of the respective national surveillance systems.

FOCUSED SURVEILLANCE

GLASS-EAR, the emerging AMR reporting (EAR) module, supports the timely detection, reporting, risk assessment and monitoring of emerging resistance. GLASS-FUNGI focuses on the surveillance of invasive fungal bloodstream infections caused by Candida spp.

SURVEYS AND STUDIES

EGASP offers an enhanced approach to sentinel gonorrhoea surveillance of men with urethral discharge and suspected urogenital infections. The One Health technical module offers an integrated multi-sector surveillance programme based on the extended-spectrum beta-lactamase (ESBL)-Escherichia coli (‘Tricycle’) project. PPS-AMU proposes a method for the conduct of point prevalence surveys (PPS) of antibiotic use (AMU) at the hospital level, and the BURDEN technical module presents studies estimating the public health impact of AMR



 

 

GLASS Reports

Global antimicrobial resistance and use surveillance system (‎GLASS)‎ report: 2022

The WHO Global Antimicrobial Resistance and Use Surveillance System (GLASS) was launched in 2015 to foster AMR surveillance and inform strategies to contain...

Global Antimicrobial Resistance and Use Surveillance System (GLASS) Report: 2021

Since its launch, GLASS has expanded in scope and coverage and as of May 2021, 109 countries and territories worldwide have enrolled in GLASS. A key new...

GLASS Report: Early Implementation 2020

The Global Antimicrobial Resistance and Use Surveillance System (GLASS) Report: Early Implementation 2020 is the third GLASS report. The aims of this report...

GLASS report: early implementation 2017-2018

The Global Antimicrobial Resistance Surveillance System (GLASS) Report: Early Implementation 2017-2018 is the second GLASS report and draws information...

GLASS report: early implementation 2016-2017

The Global Antimicrobial Resistance Surveillance System (GLASS) Report: Early Implementation 2016-17 draws information from GLASS enrolled countries...

GLASS Manual for Early Implementation

In May 2015, the Sixty-eighth World Health Assembly adopted the Global action plan on antimicrobial resistance, which reflects the global consensus...

 

 

GLASS IT Tools

GLASS IT Platform

GLASS IT TOOLS

The GLASS IT Platform is a web-based platform for global data sharing on AMR. It serves as a common environment for data submission for several technical modules (GLASS-AMR, GLASS-AMC, GLASS-FUNGI, EGASP) and supports the implementation of One Health AMR surveillance at national level. The GLASS IT Platform is also intended to facilitate future integrated analyses between AMC and AMR data at national, regional and global levels.

WHONET

GLASS IT TOOLS

WHONET is a free desktop Windows application for the management and analysis of microbiology laboratory data, with a particular focus on AMR surveillance, developed and supported by the WHO Collaborating Centre for Surveillance of Antimicrobial Resistance at the Brigham and Women's Hospital in Boston, Massachusetts (USA). WHONET is available in 28 languages and supports local, national, regional, and global surveillance efforts in more than 2300 hospital, public health, animal health and food laboratories in over 130 countries worldwide.

 

 

Laboratory Strenghthening

GLASS and WHO Collaborating Centres are working on building national laboratory capacities in countries through a range of activities. Laboratory-based diagnostic tests for AMR usually involve the laboratory identification of the infectious organism, its drug susceptibility, and sometimes serology testing and molecular analyses. Increased laboratory capacity and rapid, accurate diagnostic testing in countries  would significantly impact on global AMR surveillance and diagnostic stewardship. Diagnostic stewardship is defined as including the various stages of the diagnostic process in clinical microbiology and laboratory management.

GLASS and WHO Collaborating Centres will provide technical support to countries for the development and operation of national reference laboratories, such as external quality assurance, quality management, continuous training for the performance of AMR testing, as well as for the reporting and interpretation of AMR results. Several tools are listed below to support laboratory functions. Additional tools are currently under development by GLASS to support the strengthening of national reference laboratories in resource-limited settings.

 

health workers in a laboratory

 

 

 

 

GLASS Partnerships

CAESAR

CAESAR is a joint initiative of the WHO Regional Office for Europe, the European Society of Clinical Microbiology and Infectious Diseases (ESCMID), and the Dutch National Institute for Public Health and the Environment (RIVM). It consists of a network of national AMR surveillance systems coordinated by the European Centre for Disease Prevention and Control (ECDC) in Stockholm (Sweden) and includes all countries of the WHO European Region that are not part of EARS-Net.

Central Asian and Eastern European Surveillance of Antimicrobial Resistance network

EARS-Net

EARS-Net is the largest publicly-funded system for AMR surveillance in Europe. It is managed and coordinated by ECDC, supported by a coordination committee composed of experts selected from the appointed disease-specific contact points. EARS-Net is based on routine clinical antimicrobial susceptibility data from local and clinical laboratories reported to ECDC by appointed representatives from WHO Member States. Data originate from national AMR surveillance initiatives and/or laboratory networks. Only data from invasive isolates (blood and cerebrospinal fluid) are included.

European Antimicrobial Resistance Surveillance Network

ReLAVRA

In 1996, the Pan American Health Organization (PAHO)/WHO launched ReLAVRA, the Latin American Network for AMR Surveillance, which aims at reporting the magnitude and trends of AMR in the region using routine data from microbiology laboratories.

Red Latinoamericana de Vigilancia de la Resistencia a los Antimicrobianos

WPRACSS

WHO Regional Office for the Western Pacific (WPRO) launched the Western Pacific Regional Antimicrobial Surveillance System (WPRACSS) in 2020 to support its Member States in the implementation and further development of antimicrobial consumption and use monitoring at national level, in hospitals and the community, and to provide a regional platform for countries to understand their own consumption patterns to help guide action on stewardship and surveillance. WPRACSS aims to conduct AMC monitoring across the WPR with the aim of increasing multi-stakeholder accountability and strengthening stewardship of antimicrobials and improving health outcomes.

WHO Regional Office for the Western Pacific

EURO AMC Network

In collaboration with partners, the AMC Network was established in 2011 to assist non-EU countries and areas in setting up or strengthening surveillance at country/area level. Monitoring of consumption at country/area level helps provide centralized data to ensure that strategies to address antimicrobial consumption and resistance are effective. Efforts are closely coordinated with the ECDC so that data are comparable and can provide a pan-European overview of trends.

European Antimicrobial Medicines Consumption (AMC) Network

WHO AMR Surveillance CC Network

The mission of the AMR Surveillance CC Network is to assist WHO in supporting countries to build the capacity to develop and implement AMR surveillance.

WHO AMR Surveillance and Quality Assessment Collaborating Centres Network

 

 

GLASS 2020 Member State Consultation

GLASS 2020 Member State Consultation Event Page

GLASS 2020 Consultation banner

3rd High level technical consultation and meeting on surveillance of antimicrobial resistance and use for concerted actions
Online technical discussions: 22 October 2020 - 31 March 2021 +++ On-going discussions +++
Virtual Meeting: 26-29 April 2021


 

 

 

GLASS Related