About this Guide

The ARS (Antibiotic Resistance Surveillance) infrastructure was created in 2008 enabling comprehensive pathogen and resistance surveillance, covering both inpatient and outpatient care. ARS is a laboratory-based surveillance system allowing for the continuous collection of routine data on pathogen detection and their susceptibility to antimicrobials for the entire spectrum of clinically relevant pathogens. Participants in ARS include laboratories that perform microbiological tests on samples from medical care facilities and doctor's practices or hospitals.

The main objectives of ARS at national and international level are:

  • Establishment of comprehensive and representative surveillance for pathogen detection and antibiotic resistance
  • Provision of reference data for the professional community
  • Provision of reports with pathogen and resistance statistics for participants
  • Provision of representative data for the European Antimicrobial Resistance Surveillance Network (EARS-NET) at the ECDC, and for the WHO's Global Antimicrobial Resistance and Use Surveillance System (GLASS)

The German Antimicrobial Resistance Strategy (DART 2030) mandates the reporting from ARS to DEMIS - the German Electronic Reporting and Information System - in accordance with Section 14 (2) IfSG.

The cooperation with DEMIS allows for participation in pathogen-specific sentinels via the interface. The chlamydia and measles sentinels are currently included in this FHIR interface. In addition to the mapping of microbiological diagnostics for chlamydia and measles, sentinel-specific variables and characteristics are defined in the form of pathogen-specific value sets.

For the collaboration with DEMIS, it is necessary to provide an interface definition in accordance with the FHIR standard, using nationally and internationally used terminologies for mapping microbiological data.

This implementation guide describes the data model, the FHIR resources used and the coding systems for mapping microbiological diagnostics for data transmission to ARS, taking into account the chlamydia and measles sentinel via DEMIS. In addition to the resources designed for ARS, this guideline contains basic considerations for handling coding systems as well as examples.

When designing the resources, the principle of interoperability with national (e.g. laboratory report, mioLaboratory Report) and international (e.g. EU-Laboratory Report) specifications was upheld.


Target group

This guide is aimed at:

  • Software manufacturers of laboratory and hospital applications implementing the ARS-FHIR interface in their systems.
  • Laboratory and hospital staff who implement the mapping of existing pathogen identification and resistance testing to FHIR resources using the provided value-sets from various coding systems.

Structure of the implementation guide

This guide includes:

  • Structural specifications in the form of FHIR profiles for all FHIR resources relevant for ARS (see Structure definitions and extensions section)
  • Semantic specifications in the form of rules for handling the coding systems and ValueSets (see Terminologies section and Semantics section)
  • Specifications for lifecycle management
  • Specifications for creating patient pseudonyms
  • Specifications for using identifiers for organizations