International implementation of ASIARS-net for AMR surveillance: Building on JANIS

OBJECTIVES: This study aimed to provide a narrative review of the history, characteristics, and progress of the ASIan Antimicrobial Resistance Surveillance Network (ASIARS-Net) system, an international web-based database system for antimicrobial resistance (AMR) surveillance. METHODS: ASIARS-Net was compared with other surveillance platforms, particularly WHONET, a globally used AMR surveillance software supported by the World Health Organization, in terms of usability, AMR data analysis and outputs, and data management and integration, to clarify their complementary roles. The comparison was conducted based on experiences in countries that have implemented ASIARS-Net, enabling each participating country or hospital group to maintain a confidential database, process surveillance datasets from WHONET or Excel files, and generate national summaries and facility-level feedback reports. RESULTS: In Thailand, WHONET data from 74 hospitals (840,000 specimens), along with Excel data from three additional hospitals, each processing over 20,000 isolates annually, were processed to produce tailored feedback reports and enable comparisons across hospitals. In Vietnam, the use of ASIARS-Net together with WHONET or Excel is independently coordinated by laboratories. In 2024, eight hospitals successfully uploaded data and generated feedback reports, covering more than 140,000 bacterial isolates. Moreover, a nationwide clinical laboratory reported more than 90,000 isolates collected during 2022-2024. These reports not only showed clear trends but also highlighted higher isolation and resistance rates of specific inpatient AMR pathogens in Vietnam than in Japan. CONCLUSIONS: The ASIARS-Net system is evolving into a globally relevant platform complementary to WHONET for AMR surveillance and research at various scales.