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Isolation and Identification of Waterborne Antibiotic-Resistant Bacteria and Molecular Characterization of their Antibiotic Resistance Genes
08:58

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Published on: March 3, 2023

Development of the antimicrobial resistance burden score through a modified eDelphi

William J Waldock1, Mark Gilchrist2,3, Frances Davies2,3

  • 1Institute of Global Health Innovation, Imperial College London, London, UK. william.waldock17@imperial.ac.uk.

Npj Antimicrobials and Resistance
|March 3, 2026
PubMed

Insights

A new Antimicrobial Resistance (AMR) Burden Score was developed using expert consensus to better assess institutional AMR complexity. This score offers a structured framework for evaluating and managing AMR within healthcare settings.

Area of Science:

  • Infectious Diseases
  • Health Economics
  • Public Health Policy

Background:

  • Current antimicrobial resistance (AMR) surveillance methods are fragmented and do not fully capture the complexity of institutional AMR burden.
  • A comprehensive metric is needed to assess and manage AMR effectively at the institutional level.

Purpose of the Study:

  • To develop a novel AMR Burden Score using a modified eDelphi study with interdisciplinary experts.
  • To create a structured framework for assessing the complexity of AMR within healthcare institutions.

Main Methods:

  • A three-round modified eDelphi study involving 17 experts in Round 1 and 7 experts in Rounds 2 and 3.
  • Experts included clinicians, microbiologists, pharmacists, health economists, and public health specialists.
  • The study focused on achieving consensus for core indicators and weighting for the AMR Burden Score.

Main Results:

  • The AMR Burden Score consists of six weighted domains: Resistance (25%), Effectiveness (30%), Monitoring (30%), Adoption (5%), Processes (5%), and Systems (5%).
  • Strong consensus was reached on key indicators such as incidence of resistant infections, pathogen-specific resistance rates, and staff training programs.
  • The developed score provides a comprehensive approach to evaluating institutional AMR.

Conclusions:

  • The AMR Burden Score offers a structured and consensus-driven framework for institutional AMR assessment.
  • Implementation of the score requires context-specific adaptation and further validation to ensure its utility and accuracy.
  • This score can guide efforts to improve AMR surveillance and management in healthcare settings.

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