aureus to antimicrobial drugs, and to assess the surveillance and infection control programs in INSPEAR centers.
A proficiency testing study was performed to investigate the ability of INSPEAR centers to detect clinically important resistance phenotypes, to assist centers in establishing reliable methods to detect particular resistances, to validate data from hospital laboratories participating in INSPEAR, and to ensure consistent quality testing in INSPEAR clinical laboratories.
The need to be aware of global sentinel events is leading to an important function of the program: the periodic publication of what INSPEAR members determine by consensus to be important types of antimicrobial resistance heretofore undescribed or of great public health importance (Table 1).
The new regional emergence of resistance in an INSPEAR facility may warrant a coordinated response from local or international INSPEAR members to prevent the resistant strains from becoming endemic.
When an emerging event is suspected at an INSPEAR center, the national or regional coordinator should be alerted and microbiologic confirmation performed at the local, national, or regional level when possible, or with additional INSPEAR resources (Figure).
INSPEAR response may include immediate, specific responses, such as microbiologic support (e.g., confirmation of resistance, studying the mechanism of resistance, molecular typing to determine clonality) or on-site epidemiologic and infection control support (e.g., assistance with outbreak investigation, intervention studies, control measures) (Table 3).