ACSQHC
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Australian Commission on Safety and Quality in Health Care
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AGAR
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Australian Group on Antimicrobial Resistance
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AHPPC
|
Australian Health Protection Principal Committee
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AMR
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antimicrobial resistance
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AMRSC
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Antimicrobial Resistance Standing Committee
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ANSORP
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Asian Network for Surveillance of Resistant Pathogens
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ATC
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Anatomical Therapeutic Chemical
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CDC
|
Centers for Disease Control and Prevention
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CHRISP
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Centre for Healthcare Related Infection Surveillance and Prevention
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DANMAP
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Danish Integrated Antimicrobial Resistance Monitoring and Research Programme
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DoD
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US Department of Defense
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EAGAR
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Expert Advisory Group on Antimicrobial Resistance
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EARS-Net
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European Antimicrobial Resistance Surveillance Network
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ECDC
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European Centre for Disease Prevention and Control
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ESAC-Net
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European Surveillance of Antimicrobial Consumption Network
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ESBL
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extended-spectrum beta-lactamase
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HAI
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healthcare-associated infection
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ICU
|
intensive care unit
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JETACAR
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Joint Expert Technical Advisory Committee on Antibiotic Resistance
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LIS
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laboratory information system
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MRSA
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methicillin-resistant Staphylococcus aureus
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NARMS
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National Antimicrobial Resistance Monitoring System
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NAUSP
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National Antimicrobial Utilisation Surveillance Program
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ReLAVRA
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Red Latinoamericana de Vigilancia de la Resistencia a los Antimicrobianos (Latin American Network for Antimicrobial Resistance Surveillance)
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STRAMA
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Swedish Strategic Programme for the Rational Use of Antibiotic Agents and Surveillance of Resistance
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TESSy
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The European Surveillance System
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UK
|
United Kingdom
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US
|
United States
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VRE
|
vancomycin-resistant enterococci
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WHO
|
World Health Organization
| Preface
Antimicrobial resistance has been recognised as a global health priority by the World Health Organization. Australian governments have also taken significant action in establishing two committees to oversee national initiatives to prevent and contain antimicrobial resistance in Australia.
In February 2013 the Department of Health and Ageing and the Department of Agriculture, Fisheries and Forestry formed the Australian Antimicrobial Resistance Prevention and Containment Steering Group bringing together the secretaries of each Department, the Commonwealth Chief Veterinary Officer and the Chief Medical Officer. The Steering Group will provide governance and leadership on antibiotic resistance and oversee the development and implementation of a coherent framework for current and future work related to antimicrobial resistance.
In April 2012, the Australian Health Protection Principal Committee, and subsequently Australian Health Ministers Advisory Council endorsed the formation of the Antimicrobial Resistance Standing Committee (AMRSC). The standing committee was formed to oversee antimicrobial resistance in Australia, provide expert advice and recommend national priorities on issues relating to antimicrobial resistance.
Membership of AMRSC brings together representatives from the Commonwealth government and its agencies in human, animal and agricultural contexts, clinical experts and professional colleges.
The report – National Surveillance and Reporting of Antimicrobial Resistance and Antibiotic Usage for Human Health in Australia – was commissioned in response to a gap analysis undertaken by a multidisciplinary taskforce convened by the Australian Commission on Safety and Quality in Health Care in 2011. The gap analysis clearly demonstrated that there are a number of activities developed by the state and territory jurisdictions as part of their primary responsibility for managing infection control and some nationally coordinated surveillance activities funded by the Commonwealth. The Australian Commission on Safety and Quality in Health Care, in collaboration with Commonwealth agencies and professional organisations, is coordinating a national healthcare associated infection prevention program creating a mandatory national accreditation scheme which means over 1500 hospitals and health services will be taking active steps to address antibiotic resistance, standardising surveillance definitions, establishing a national hand hygiene initiative and antimicrobial stewardship programs, and providing education for clinicians.
However, the gap analysis also demonstrated a national surveillance system to determine how many patients were infected with resistant bacteria, how many died or had complications as a result of their infection, or an alert system to notify clinicians and policy makers of emerging and re-emerging highly resistant bacteria was now required as a matter of national importance.
Effective surveillance is the cornerstone of efforts to control antimicrobial resistance. At the local level, the data are used to formulate recommendations for rational antibiotic use, to develop standard treatment guidelines, and for ensuring that healthcare providers comply with recommendations. At a national level, data on resistance and use can inform policy decisions such as development or revision of essential medicines lists, and identification of priorities for public health action to reduce the impact of antimicrobial resistance, such as education campaigns or regulatory measures. Conversely, lack of surveillance can lead to misdirected and inefficient policies, wasting of limited resources, inappropriate therapy and ultimately human suffering and death through the inability to provide an effective drug to patients in need.
The report examines international antimicrobial resistance surveillance models, current activities undertaken by Australian surveillance units; activities undertaken by the Australian Group on Antimicrobial Resistance, and the National Antimicrobial Utilisation Program, and examines how reports from routine diagnostic laboratories might provide a source of data to contain antimicrobial resistance.
While acknowledging the importance of antimicrobial resistance and antibiotic use in veterinary and agricultural practice, the scope of this report is limited to bacteria in the context of human health.
The report is consistent with Australia’s Communicable Disease Control Framework, and proposes options applicable to the Australian context for short, medium and longer terms actions. The recommendations centre on national coordination using a ‘One Health’ framework linking together data on resistance and antibiotic use from humans, animals and agriculture to provide a national picture of AMR to guide action on preserving the effectiveness of antimicrobial agents.
Marilyn Cruickshank RN, PhD, FACN
Chair
Antimicrobial Resistance Standing Committee
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