Antimicrobial resistance (AMR) is a threat to public health. To protect ourselves against AMR, we need to know how often and where these multi-resistant microorganisms occur and if there are any trends to identify. The Netherlands Medical Microbiological Laboratories (MMLs) exchange relevant data with the National Institute for Public Health and Environment (RIVM). RIVM systematically collects and analyses this data to gain insight into the spread of infections. The information outcome is presented to healthcare providers to help them prevent infections. To start prevention at an early stage, sharing information should be faster, better and unambiguous. That is why we need common language.

With the project Common Language for AMR  (Eenheid van Taal in antibioticaresistentie in Dutch), the Dutch Society for Medical Microbiology (NVMM), the National Institute for ICT in Healthcare (Nictiz) and RIVM are aiming to improve and accelerate the exchange of data on antimicrobial resistance. We do this in partnership with the Association for Medical Microbiological Laboratories (VMML) and Cooperating Medical Laboratories and Diagnostic Centres in the Netherlands (SAN).

Common Language AMR in the Netherlands

Common Language for antimicrobial resistance is a Dutch project for substantive and technical standards and structures in digital data exchange. It ensures that all information and data has the same meaning for all stakeholders (healthcare providers, patients, researchers and public health administrators).  

Dutch Lab Code Set: Common Language

The Dutch Lab code set is a subset based on the international coding systems Logical Observation Identifiers Names and Codes (LOINC) and Systematic Nomenclature of Medicine – Clinical Terms (SNOMED CT). The Dutch Lab code set contains laboratory codes for body material, antibiotics, laboratory tests and microorganisms. By applying Common Language in labcodes, lab requests and results can be exchanged unambiguously between MMLs, healthcare providers, researchers and epidemiologists of public health institutions in the Netherlands. The laboratory code set was used for the first time to exchange information on antimicrobial resistance. Together with a standard for the exchange of digital health information (HL7), this method for real-time data delivery has increased the quality, simplicity and flexibility of AMR surveillance.

When laboratories have implemented Common Language for AMR, there are more opportunities for broader use of the Dutch Labcodeset and digital data exchange in healthcare, for example between MMLs and general practitioners, hospitals and other healthcare providers. It provides the possibility to easily exchange laboratory diagnostics requests and reports, through secure channels in the Netherlands.

The Healthcare Information Council has recognised the Dutch Lab Code Set as an undisputed building block for information exchange in the healthcare system.

Common Language is the new working method for the future.

Common Language for AMR is essential. You really need it to gain proper insight, so that you can take the right measures.

Marc Bonten, University Medical Center (UMC) Utrecht (pilot phase participant, Common Language for AMR project)

Common Language AMR international

AMR is a global health problem. WHO has declared AMR one of humanity's top 10 global public health threats. Without effective antimicrobials, the success of modern medicine in treating infections, including during major surgery and cancer chemotherapy, would be at increased risk*. Country borders do not bind resistant microorganisms; it requires a united multisectoral approach. International cooperation and exchange of data, to provide insight into the spread, is crucial to contain this spread.

The importance of common language in this exchange is evident; by using international coding systems and exchange standards for secure data delivery, the information can be analysed quickly and unambiguously.

For participants of the GLASS-AMR from the World Health Organization (WHO), Unity of Language simplifies data collection, and therefore data can be delivered almost realtime.

*Source WHO factsheet on antimicrobial resistance.

Benefits of Common Language

There are two pathways within the Common Language for AMR project: Lab2lab and Lab2publichealth.


  • Improved electronic data exchange between labs
  • More efficient working methods
  • Better collaboration

MMLs use a Lab2lab connection to exchange messages with each other. This allows them, for example, to submit requests for methicillin-resistant Staphylococcus aureus (MRSA Methicillin-resistant Staphylococcus aureus (Methicillin-resistant Staphylococcus aureus)) and carbapenemase-producing Enterobacteriaceae (CPE) classification tests to RIVM’s laboratory. Partner MMLs use the Dutch Lab Code Set and a Lab2lab connection to exchange messages. Data no longer have to be entered manually. This makes cooperation between the MMLs and with RIVM very easy.


  • Improved electronic exchange between laboratories and RIVM systems
  • Less error prone
  • Faster insight into AMR occurrence
  • More rapid implementation of measures

With Lab2publichealth, the results of antimicrobial sensitivity tests are automatically sent to RIVM every day. This reduces the chance of errors and facilitates faster data feedback. Changes in epidemiology can then be identified earlier, so that healthcare professionals and policymakers (at the local, regional and national level) can take timely measures to prevent further spread.

All Medical Microbiological Laboratories should use this Lab Code Set. It really makes communication between labs easier. With the Netherlands Lab Code Set, you will be ready for the future!

Leo Smeets, medical microbiologist at Reinier Haga (leader in the introduction of Common Language for AMR)