WHONET

1. WHONETinMICROBIOLOGY Dr.T.V.Rao MD

2. What is WHONET ? • WHONETis a free software developed by the WHO Collaborating Centre for Surveillance of Antimicrobial Resistance for laboratory-based surveillance of infectious diseases and antimicrobial resistance.

3. “If you cannot measure it, you cannot improve it” Lord Kelvin, 1824-1907

4. WHONET contains Complete Laboratory Information System • Clinical reporting • return results to clinicians • permanent record • Laboratory management system • preliminary and final results • guide technologists through needed laboratory tests • billing and financial accounting • Data analysis

5. Documentation • WHONET is a Windows-based database software developed for the management of microbiology laboratory data and the analysis of antimicrobial susceptibility test results.

6. All the Documented results are analyzed in WHONET • The heart of WHONET is a software package designed to collect the results of antibiotic resistance tests. Researchers / Microbiologists feed the results into a computer and look for trends

7. WHONET:is A Microbiology Data Management Tool • Enhance the use of locally-generated data • Antimicrobial policy, infection control • Laboratory quality assurance • Promote collaborations • National and International networks

8. WHONETCreates data from your Documentations

9. WHONETis used to support surveillance activities in the countries indicated  in Red.

10. WHONET A Global networking Programme • WHONET is currently used in over 90 countries, managing data from over 1300 laboratories. • Hospital and public health laboratories • Food and veterinary laboratories • Reference and research laboratories • Data collections • Routine laboratory data • Special surveys and research protocols

11. WHONETanalytical tools facilitate • The understanding of the local epidemiology of microbial populations; The selection of antimicrobial agents; The identification of hospital and community outbreaks; The recognition of quality assurance problems in laboratory testing.

12. WHONETRuns onall Major operating systems • The latest edition of WHONET runs on Microsoft Windows (98, 2000, XP, Vista, Windows 7) and through Windows emulators can be run successfully on Linux and Macintosh computers.

13. Software is Multilingual • The software is multilingual. Languages available at present include: Bulgarian, Chinese (simplified), English, Estonian, French, German, Greek, Indonesian, Italian, Japanese, Norwegian (Bokmål and Nynorsk), Portuguese, Russian, Spanish and Thai.

14. Why we should adopt to WHONET • The WHONETprogram puts each laboratory's data into a common code and file format at that laboratory, either by serving as or by translating from its own computer reporting system. It then enables each medical center to analyze its files in ways that help it monitor and manage resistance locally and to merge them with files of other centers for collaborative national or global surveillance of resistance.

15. Growing importance of WHONET • World over antimicrobial resistance is a major public health problem. The WHONET software program puts each laboratory data into a common code and file format, which can be merged for national or global collaboration of antimicrobial resistance surveillance

16. WHONET Puts the data in order • These tools enable any microbiology laboratory to put its test results into a database and conduct analyses to support local infection control and antibiotic use. Laboratories can also upload files created by WHONET, to feed into national or other multi-center surveillance networks and to inform drug policy.

17. Useful for routine reportingand Analyses the Data • WHONET is not a complete laboratory management system but can be used for simple clinical reporting of results. Software development has concentrated on data analysis, particularly of the results of antimicrobial susceptibility tests.

18. Epidemiological trends can predicted from Data • The analytic tools aid the selection of antimicrobial agents, the identification of hospital outbreaks, and the recognition of quality control problems in the laboratory. Review of antimicrobial results also permits characterization of resistance mechanisms and the epidemiology of resistant strains

19. Use and Misuse of Antibiotics has created Drug Resistance • Genes expressing resistance to each antimicrobial agent emerged after each agent became widely used. More than a hundred such genes now spread selectively through global networks of populations of bacteria in humans or animals treated with those agents. Information to monitor and manage this spread exists in the susceptibility test results of tens of thousands of laboratories around the world. The comparability of those results is uncertain, however, and their storage in paper files or in computer files with diverse codes and formats has made them inaccessible for analysis

20. Principal goals of the software are: • To enhance local use of laboratory data; and to promote national and international collaboration through theexchange of data.

21. The software consists of three sections. Section 1 • 1) Data Entry. In addition to the routine entry of susceptibility test results (disk diffusion, MIC, and/or E-test), this program permits printing, retrieval, and correction of clinical records as well as immediate feedback on test results. If data are converted from an existing laboratory system, for example with BACLINK, direct entry of data into WHONET is unnecessary.

22. Section 2 • 2) Data Analysis. Currently supported analyses include listings and summaries of isolates by user-defined criteria; tabulation of the percentages of resistant, intermediate, and susceptible isolates by species; zone diameter and MIC histograms; scatter plots of zone diameter versus zone diameter or MIC versus MIC; scatter plots of zone diameter versus MIC scatter plots and the calculation of zone diameter/MIC regression curves; listings and summaries of isolates by resistance profile; and automated screening of the data for unusual isolates.

23. Section 3 • Configuration Program. This program permits the user to enter and modify laboratory-specific information such as patient-care areas, antibiotics and interpretive breakpoints, language, and hardware.

24. WHONET analytical tools facilitate:the understanding of the local epidemiology • To understanding of the local epidemiology of microbial populations; the selection of antimicrobial agents; the identification of hospital and community outbreaks; and the recognition of quality assurance problems in laboratory testing.

25. WHONETcan handle Bacteria, Fungus, Parasite • WHONET can handle results from the testing of bacteria, fungi, and parasites. WHONET does not yet have Virological tests incorporated, but this is a priority area of programming in the upcoming year.

26. Picks up Antibiograms and analyses • The heart of WHONET is a software package designed to collect the results of antibiotic resistance tests. Researchers feed the results into a computer and look for trends.

27. Individual Microbial Infections can be analyzed at regular intervals

28. Analyses the isolates by month and location (MRSA)

29. Histograms can be created for Individual Microbes

30. Scatterplot created for two different AntibioticAmikacin vs. Gentamicin

31. Data Created from Various countreis can be Compared and analyzed

32. Emerging resistant pattern of Drug resistance can be identified early and compared with different locations in Hospital

33. All antibiotic profiles at a click

34. Uses of Microbiology Data • Laboratory quality improvement • Laboratory testing • Utilization of laboratory services by clinical staff • Infection control and outbreak preparedness • Identification of new and problem pathogens • Identification and investigation of outbreaks

35. Uses of Microbiology Data • Antimicrobial policy • Trends in infections and resistance • Characterization of cross-resistance • Development of treatment guidelines • Research • New resistance mechanisms • Risk factors for resistance • Evaluation of interventions

36. With on line linking We can feed our results to WHO surveillance system • With the establishment of the Division of Emerging and other Communicable Diseases Surveillance and Control, WHO will strengthen national and international capacity in surveillance, prevention and control of communicable diseases, in particular those that represent new, emerging and re-emerging public health problems.

37. Experience with WHONET suggests • The WHONET experience suggests that solid drug resistance data can be collected and analyzed in resource-constrained settings, using core microbiology, if local laboratories are given appropriate support. Strengthening these laboratories is therefore a potentially cost-effective contribution to both treating drug resistant disease and preventing its further spread.

38. WHOthanks the individuals globally and helps the Laboratories • WHO is grateful to the many individuals around the world who contributed translations of the software. If you would like to assist with additional translations, please contact the WHO Collaborating Centre in Boston.

39. Down load WHONET through Hyperlink below Click here to download the software and manuals

40. You can back link the data you already have • Many laboratories in the world already have computer systems for the recording of laboratory test results. WHONET comes with the free BacLink data conversion utility to facilitate the transfer of data from existing laboratory information systems into WHONET in order to avoid the need for double data entry. BacLink, also developed by the WHO Collaborating Centre in Boston, is included and installed as part of the standard WHONET package.

41. Laboratory instruments Desktop softwares Laboratory systems Excel Access EpiInfo Mysis MEDITECH ADBakt MIC systems Disk diffusion readers BacLink Data conversion WHONET Data analysis

42. Baclink can transfer data into WHONET from: • Common commercial database and spreadsheet software; commercial susceptibility test instruments for MIC broth micro dilution and disk diffusion readers hospital and laboratory information systems through text files

43. WHONETconnects to the World through WWW • These tools enable any microbiology laboratory to put its test results into a database and conduct analyses to support local infection control and antibiotic use. Laboratories can also upload files created by WHONET, to feed into national or other multi-centre surveillance networks and to inform drug policy. Such surveillance programs are now in place in many countries.

44. WHONETUse in the World • African Regional Office of WHO (AFRO) • Algeria, Kenya, Namibia, South Africa, Tanzania, Zambia • Eastern Mediterranean Regional Office of WHO (EMRO) • Jordan, Kuwait, Lebanon, Libya, Morocco, Oman, Pakistan, Saudi Arabia, Tunisia • European Regional Office of WHO (EURO) • Austria, Belgium, Bulgaria, Croatia, Czech Republic, Denmark, Estonia, Finland, France, Georgia, Germany, Greece, Iceland, Ireland, Israel, Italy, Latvia, Luxembourg, Malta, Netherlands, Norway, Poland, Portugal, Romania, Russia, Slovakia, Slovenia, Spain, Sweden, Ukraine, United Kingdom • Pan-American Health Organization (PAHO) • Argentina, Bolivia, Brazil, Chile, Colombia, Costa Rica, Cuba, Dominican Republic, Ecuador, El Salvador, Guatemala, Mexico, Nicaragua, Panama, Paraguay, Peru, United States, Uruguay, Venezuela • South-East Asian Regional Office of WHO (SEARO) • India, Indonesia, Sri Lanka, Thailand • Western Pacific Regional Office of WHO (WPRO) • China, Hong Kong (China), Japan, Republic of Korea, Malaysia, Philippines, Singapore, Taiwan, Viet Nam

45. Reducing the Antimicrobial resitance is a great contribution to Medical Profession • The WHONET experience suggests that solid drug resistance data can be collected and analyzed in resource-constrained settings, using core microbiology, if local laboratories are given appropriate support. Strengthening these laboratories is therefore a potentially cost-effective contribution to both treating drug resistant disease and preventing its further spread.

46. Long Term Goals of WHONET usage • The long term goals of these activities are to strengthen the capacities of WHO member countries to detect and contain the emergence of major multi-drug resistant bacteria and to improve standardization of interpretation of antibiotic resistance data throughout the world. This in turn will be supportive to all those involved in antimicrobial drug research and development and for WHO to advocate for it.

47. World Antibiotic Resistance Network • WHO has also started another program, WARN (the World Antibiotic Resistance Network), to help gather and analyze the data generated by the folks who use WHONET.

48. WHONETserves Major challenges in Drug Resistance • Create Laboratory facilities for accurate diagnosis and susceptibility testing Disseminate information on local and regional prevalence of resistance Establish antibiotic policies, treatment guidelines, and infection control policies, with mechanisms for feedback and review.

49. WHONETDocumentation at Sri Deva Raj Urs Medical College, KolarINDIA

50. Created by Dr.T.V.Rao MDfor “e” learning Programme Email doctortvrao@gmail.com