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. 2020 Jun 1;11:2719. doi: 10.1038/s41467-020-16322-5

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© The Author(s) 2020

Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons license, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons license and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this license, visit http://creativecommons.org/licenses/by/4.0/.

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Fig. 1 — a ARSP workflow and enhanced detection of high-risk clones by WGS. Isolates collected by sentinel sites are tested for susceptibility to antibiotics (open squares: susceptible, solid squares: resistant). The data are stored as resistance profiles in WHONET and summaries of resistance trends are shared yearly with surveillance stakeholders. WGS of bacterial isolates and interpretation with web applications like Microreact and Pathogenwatch provide information on genetic relatedness (strains), known AMR determinants (mechanisms), and the mobile genetic elements (MGE, vehicles) for their dissemination, thus allowing us to detect high-risk clones. b Detail of trends in antimicrobial resistance in the Philippines. Yearly resistance rates for key bug–drug combinations based on phenotypic data collected by sentinel sites. EBC Enterobacteriaceae (K. pneumoniae, E. coli, Salmonella enterica), PAE P. aeruginosa, ABA A. baumannii (Acinetobacter spp. before the year 2000), SAL Salmonella enterica, SAU S. aureus, ESBL extended-spectrum beta-lactamase production suspected, or non-susceptible to the following antibiotics IPM imipenem, CIP ciprofloxacin, OXA oxacillin, WGS box: period covered by the retrospective sequencing survey.