WHOnet Preparation and Antibiogram Interpretation

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WHOnet Preparation and Antibiogram Interpretation

Andaru Dahesihdewi, Dr. dr. MKes, SpPK-K


KSM/Departemen Patologi Klinik dan Kedokteran Laboratorium RSUP Dr Sardjito/FKKMK UGM Yogyakarta

WHOnet is a database software for the management of microbiology laboratory test


result. The principal goals of the software are to enhance local use of laboratory data and to
promote collaboration through the exchange of data between centers. The software was
developed for the management of routine laboratory result, for research and for data analysis
of antimicrobial susceptibility. WHOnet analytical tools can facilitate the selection of
antimicrobial agents, the surveillance and identification of antimicrobial resistance.
Preparation of data analysis by WHOnet are began with BacLink configuration. BacLink 2
is a software complimentary to WHOnet for data importing from existing microbiology
laboratory information system or automated susceptibility test instruments. Both software are
available free of charge from the WHO. The two principal components of BacLink 2 are file
format configuration and running the conversion. File format configuration consists principally
in describing the structure and the codes used in the data file. File format configuration only
needs to be accomplished once and can modified at a future date if we introduce change into
our data files. After we have configured BacLink, we are ready to convert the data files into
WHOnet structure (or alternatively Excel, Access, dBASE or text format). We can convert data
files on a periodic basis - monthly, yearly - if we want add to the database prospectively.
The WHOnet data analysis of antimicrobial susceptibility microbe is important to
develop the surveillance in particular region. Hospital surveillance of antimicrobial resistance is
the main activity of antimicrobial stewardship program. Some requirements for the
representative data set analysis consists of the specimen validity, the relevancy of the pathogen
which is first isolate recovered from particular specimen in specific period of infection and the
number of isolates tested of each antimicrobial in one period analysis which minimal is 30.
Based on PMK 8 2015, hospital antibiogram is minimally developed yearly. Developing
antibiogram might be general or stratified analysis according to the capacities available. More
simple detail analysis might be donefor limited data and resources. Description of susceptibility

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pattern could be based on specimen type, wards, pathogen type, clinical status, etc. In general,
specimen type could be categorized as sterile sourced (blood, cerebrospinal fluid, pleural or
pericardial fluid, etc) and non-sterile sourced ; pathogen type could be categorized based on
Gram staining (Gram +ve or -ve) ; wards could be categorized as adult, paediatric, intensive,
emergency or out patients. Multidrug resistance pathogens are recommended described
antimicrobial susceptibility pattern particularly.
This local continuous representative antibiogram will become based of antimicrobial usage
guideline in the hospital. Based on the local antibiogram, antibiotics in hospital might be
categorized as restricted or not restricted for controlling their risk of resistance. This
antibiogram have also the roles to evaluate the resistance trend by the time.

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