Background: Antimicrobial Resistance (AMR) is a significant public health threat in many countries around the world, endangering the control of infections and infectious disease. AMR related illness has been responsible for annual global mortality of 700,000. Besides health outcomes, they bear an adverse impact on economic development. However, the lack of comprehensive global AMR surveillance data and an over-reliance on an indicator-based surveillance system has limited the early detection of emerging AMR threats and trends. Methods: The EpiWATCH outbreak database has been used to retrieve AMR outbreak reports between August 2016-March 2020 using keywords such as 'resistance', 'resistant', 'superbug', 'bugs', 'MRSA' and 'VRE'. Cases were grouped according to geolocation and time to conduct a descriptive epidemiologic analysis of the outbreak. Results: A total of 60 reports of outbreaks involving 18,275 cases of AMR were identified from 14 countries between August 2016 and March 2020. Over half of the reports were from the United States of America. The most common reported pathogen was MRSA, followed by drug-resistant Salmonella which includes Salmonella Typhi and non-Typhi Salmonella serovars. The majority of the infections were caused by gram-negative bacteria. Drug-resistant Klebsiella, Acinetobacter and New Delhi Metallo-β-lactamase-1 (NDM-1) Carbapenemase-producing Enterobacteriaceae acquired in hospitals were associated with reported mortality. Schools and universities were atrisk locations in the community for Methicillin-resistant Staphylococcus Aureus (MRSA) outbreaks and in hospital settings, the neonatal units were at risk. EpiWATCH identified reports of AMR for pathogens not captured by the WHO AMR surveillance system, GLASS. Conclusion: EpiWATCH identified reported AMR outbreaks quickly compared to an indicator-based surveillance system. It detected outbreaks by pathogens, including some not monitored by the World Health Organization. Also, it identified information on both colonised and infected cases. Thus, open source data from EpiWATCH can complement an indicator-based surveillance system for strengthening AMR surveillance.

A review on the use of non-pharmaceutical interventions (NPI) was conducted in long-term care facilities. The use of personal protective equipment, isolation and re-testing of COVID-19 were protective against the infection. Facilities which implemented NPIs prior to the outbreak had fewer COVID-19 outbreaks, odds ratio=0.70. Re-testing of asymptomatic people during outbreaks is crucial.