Preface

The Survey of Antibiotic Resistance (SOAR) is a global antimicrobial resistance surveillance study of key respiratory pathogens that has been generating susceptibility data since 2002. The surveillance programme concentrates in particular on countries and regions for which little other susceptibility data is available. Such studies are critical to providing a greater understanding of the development of resistance over time at both a national and international level. This is the second such Supplement with articles providing new data for two major respiratory pathogens, Streptococcus pneumoniae and Haemophilus influenzae, collected between 2014 and 2016. In a major undertaking, over 2400 isolates were collected from 13 centres in 9 European countries and MICs were determined for 12 relevant antimicrobials. An overview of the Supplement allows insights into differing rates of antimicrobial resistance in different European countries. Such differences are often stark even when considering countries in close geographical proximity. An analysis of such comparative data has the potential to inform national policies on antibiotic stewardship that can decelerate the rise of antimicrobial resistance.

The rise of resistance has clear implications for the choice(s) of empirical therapy where this is deemed necessary (e.g. for community-acquired pneumonia). Detailed knowledge of the rates of antimicrobial resistance at local and national level is essential to inform such choices. A recurring theme in the articles in this Supplement is the difficulty in interpreting resistance data in the face of conflicting susceptibility breakpoints published by international organizations. This causes bewilderment for microbiologists, clinicians and the diagnostics industry and we wholly endorse their plea for further international harmonization of susceptibility breakpoints.

Given the international scale of the threat posed by antibiotic resistance, it is hoped this Supplement will be of relevance and interest to public health and clinical researchers around the world.

Transparency declarations

None to declare.