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Related Experiment Video

Updated: May 11, 2026

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

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

Published on: March 3, 2023

Development of the antimicrobial resistance burden score through a modified eDelphi.

William J Waldock¹, Mark Gilchrist^2,3, Frances Davies^2,3

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

Npj Antimicrobials and Resistance

|March 3, 2026

Summary

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.

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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.