{
  "abstract": "Introduction Antimicrobial resistance (AMR) is an escalating global health threat and WHO priority. Patients with chronic respiratory disease are vulnerable to AMR due to recurrent infection and colonisation with high priority pathogens. Most epidemiological data on AMR is retrospective and single centre, limiting estimations regarding prevalence, burden and impact. To tackle this problem, we have set up a prospective, global registry into AMR as part of the European Respiratory Society Clinical Research Collaboration on Antimicrobial Resistance in Lung Disease. Here we present an outline of the study protocol and pilot phase results.Methods The registry is a prospective, international, multi-centre, observational study. The study design and process is shown in figure 1. Data will be captured across two-week periods biannually for five years. Primary endpoint: determine the prevalence of AMR in specific high-priority respiratory pathogens. Secondary endpoints: describe the geographical variation and susceptibility patterns of high-priority AMR pathogens, and determine any risk factors for AMR in chronic respiratory disease.Results A pilot phase was recently completed. 11 centres spanning 8 countries and 4 continents participated, contributing data for 396 patients. The most common disease groups were bronchiectasis (109/396), chronic obstructive pulmonary disease (95/396) and cystic fibrosis (92/396). 208/396 (53%) patients had at least one positive bacterial sample and 33/396 (8%) had at least one positive fungal sample in the preceding 12 months. The most common bacterial pathogen was Pseudomonas aeruginosa (61/208 (29%)), followed by Staphylococcus aureus (46/208 (22%) and Klebsiella pneumoniae (32/208 (15%)). 41/208 (20%) grew more than one species. Resistance profiles were available for 277 bacterial isolates. 55/277 (20%) showed mono-resistance and 123/277 (44%) showed resistance to >1 antibiotic. The most common reported resistance was Ciprofloxacin.Abstract P186 Figure 1A schematic of the study design for data collection and analysis for the PRESIDE registryConclusions This pilot phase demonstrated the feasibility of prospective multi-centre data capture around AMR. The main registry will launch in November 2025 and is currently anticipated to involve >100 centres worldwide. The registry will address critical knowledge gaps in AMR in chronic respiratory disease through an international and collaborative approach. It has the potential to inform global strategies for antimicrobial stewardship, infection prevention, and improve our management of AMR in chronic respiratory diseases.",
  "authors": [
    {
      "affiliations": [
        "Imperial College London, London, UK"
      ],
      "name": "K Pates"
    },
    {
      "affiliations": [
        "Fondazione IRCCS Ca, Milan, Italy"
      ],
      "name": "C Premuda"
    },
    {
      "affiliations": [
        "Liverpool Heart and Chest Hospital NHS Trust, Liverpool, UK",
        "University of Liverpool, Liverpool, UK"
      ],
      "name": "F Frost"
    },
    {
      "affiliations": [
        "Fondazione IRCCS Ca, Milan, Italy",
        "University of Milan, Milan, Italy"
      ],
      "name": "A Gramegna"
    },
    {
      "affiliations": [
        "University Medical Center Utrecht, Utrecht, Netherlands"
      ],
      "name": "M Ekkelenkamp"
    },
    {
      "affiliations": [
        "Universitätsmedizin, Berlin, Germany",
        "German Center for Child and Adolescent Health, Berlin, Germany"
      ],
      "name": "S Thee"
    },
    {
      "affiliations": [
        "Imperial College London, London, UK",
        "Royal Brompton and Harefield NHS Foundation Trust, London, UK"
      ],
      "name": "A Shah"
    }
  ],
  "title": "P186 Prospective study of antimicrobial RESIstance in chronic lung DIsease (PRESIDE) – a new global registry. Protocol and pilot phase results",
  "uid": "1831526d-7cff-53d9-b3fb-502e3f42b04d"
}