In the first year, partners focused on the literature search. Protocols for five systematic reviews (SRs) were developed and uploaded to the International Prospective Register of Systematic Reviews (PROSPERO): 1) frequency measures of healthcare-associated infections and antimicrobial resistance (AMR), 2) AMR-associated health outcomes, 3) AMR-associated economic outcomes, 4) existing mathematical models for AMR, and 5) obtaining individual-level data. Potential databases were identified, articles screened and extracted, and initial contact was made to request data access. Discussions were advanced on making both aggregated and individual-level data publicly available through the EPI-Net repository. The project management structure was established, the project website was launched, and the Scientific Advisory Committee (SAC) was set up.
In the second year, work concluded on all four systematic reviews, and manuscripts were submitted for publication. Aggregated data and visualizations of meta-analyses on the pathogen-specific impact of AMR were made publicly available via the EPI-Net platform:
https://epi-net.eu/primavera/about/(opens in new window). Data gaps were identified and discussed with partners to inform further actions. These gaps also guided work on a research prioritization agenda, for which a Delphi exercise was performed and a manuscript drafted. A theoretical model framework was advanced, with three case studies selected for the population models to be developed. Relevant data were identified, collected, and evaluated. More than 100 database owners were contacted, and the infrastructure to gather and share the data publicly was implemented, with the legal process to complete data-sharing agreements ongoing.
During the third year, five papers were published based on the systematic reviews and research conducted for model development. Work on the case studies was concluded, with two chosen to be advanced in subsequent project activities. A second search for additional patient-level data was performed, and third parties can now apply for access to individual-level patient data on the ECRAID-Base EPI-Net platform:
https://epi-net.eu/primavera/data-availability/(opens in new window). Work also began on cost-effectiveness analyses, as well as model evaluation and sustainability planning, with results expected to be reported over the following two years.
In the fourth year, two papers were published based on systematic reviews and model development research, and two additional manuscripts addressed future priorities for AMR research and challenges in data sharing. Efforts to gather anonymized individual-level patient data continued, resulting in the collection of 14,058 patient-level records from 19 of the 34 resistance–pathogen–infection groups, out of 196 eligible studies contacted. Three case studies—focusing on E. coli, S. aureus, and K. pneumoniae—were selected for programming language implementation and the development of a joint code repository. Work on cost-effectiveness analyses, model evaluation, and sustainability continued, with final results expected in the project’s last year.
To ensure continuous progress, the consortium held three annual meetings, four teleconferences with the SAC, and three workshops to advance model development. Dissemination activities included press releases and social media posts aligned with project milestones and outputs, which contributed to increasing project visibility and promoting the results to the broader scientific community.
