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Chapter 8. Surveillance


Summary: National and global surveillance, sometimes conducted over many years, reveals trends in antibiotic resistance that helps guide public policy. Surveillance is based on measurements of MIC with a large number of patient isolates. With a few pathogens, the phenotypic measures of MIC are gradually being replaced with genotypic (DNA) analyses, which require that resistance correlate strongly with particular mutations. Dosing strategies for gonorrhea, animal use of antibiotics, and hospital-to-hospital spread of resistant Enterococcus serve as examples where surveillance has revealed a need for changes in antibiotic use strategies.


The previous chapter discussed our immediate response to disease outbreaks and difficulties caused by antibiotic resistance. We now turn to surveillance, one of the long-term, global responses to resistance.


  

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