A Clinically Oriented antimicrobial Resistance surveillance Network (ACORN): pilot implementation in three countries in Southeast Asia, 2019-2020

A Clinically Oriented Antimicrobial Resistance surveillance Network (ACORN) is a comprehensive platform that combines clinical data collection with diagnostic stewardship, microbiological data collection, and visualization of the linked clinical-microbiology dataset. The ACORN pilot was implemented in three Southeast Asian hospitals to collect clinical and microbiological data from patients with pneumonia, sepsis, or meningitis. The pilot showed that 28-day mortality was 8.7%, with third-generation cephalosporin resistance identified in 54.2% of E. coli and 38.7% of K. pneumoniae isolates. ACORN is now being scaled up in 15 hospitals in 9 low- and middle-income countries to determine the incidence, outcomes, and susceptibility of target pathogens among patients with infectious syndromes.