Saq065 amrau report Internal V11

National Surveillance and Reporting of Antimicrobial Resistance and Antibiotic Usage for Human Health in Australia (Project AMRAU)

June 2013

Antimicrobial Resistance Standing Committee

© Commonwealth of Australia 2013

ISBN 987–1-921983–47–4 June 2013

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Citation

Shaban RZ, Cruickshank M, Christiansen K & the Antimicrobial Resistance Standing Committee (2013). National Surveillance and Reporting of Antimicrobial Resistance and Antibiotic Usage for Human Health in Australia. Antimicrobial Resistance Standing Committee, Australian Heath Protection Principal Committee: Canberra.

Inquiries regarding this publication should be directed to:

Chair, Antimicrobial Resistance Standing Committee

Australian Heath Protection Principal Committee

c/Australian Commission on Safety and Quality in Health Care

GPO Box 5480 Sydney NSW 2001

Email: [e-mail]

Acknowledgements

Professor Ramon Z. Shaban (Centre for Health Practice Innovation, Griffith Health Institute, Griffith University), Dr Marilyn Cruickshank and Dr Keryn Christiansen (Emeritus Consultant, Royal Perth Hospital) convey their sincerest thanks to:

Dr Marilyn Cruickshank, Chair of the Antimicrobial Resistance Standing Committee, for her oversight of this publication.

Members of the Antimicrobial Resistance Standing Committee for their contribution to developing this publication.

Mr Geoff Simon, Mr Peter D. Coxeter and Ms Kerri Gillespie for their preparatory assistance.
Disclaimer

This document is a review of the available evidence with respect to the science and systems for the surveillance and reporting of antimicrobial resistance and antibiotic usage. It is designed to provide information based on the best evidence available at the time of publication to assist in decision making. The science of antimicrobial resistance and antibiotic usage and the practices of surveillance and reporting are rapidly evolving. The authors, members of the Antimicrobial Resistance Standing Committee and the Australian Commission on Safety and Quality in Health Care give no warranty that the information contained in this document and any online updates available on the Commission’s website or elsewhere is correct or complete, and shall not be liable for any loss

whatsoever whether due to negligence or otherwise arising from the use of or reliance on this document.

Table of contents

Table of contents 3

Figures and tables 4

Acronyms and abbreviations 7

Preface 8

Recommendations 11

Executive Summary 12

1. Surveillance and reporting of antimicrobial resistance and antibiotic usage in Australia 16

1.1 Antimicrobial resistance and antibiotic usage – a global threat to human health 16

1.2 Microbes, antimicrobials and antibiotics 17

1.3 The problem of antimicrobial resistance 19

1.4 Reversing trends in antimicrobial resistance 24

1.5 Antimicrobial resistance and Australia 29

1.6 Antimicrobial Resistance Standing Committee 31

1.7 National Surveillance and Reporting of Antimicrobial Resistance and Antibiotic Usage for Human Health in Australia – scope and specific questions 32

2. The global context: existing programs and activities 35

2.1 An overview of global surveillance and reporting systems 35

2.2 Key characteristics of existing systems 53

3. Options and models for the Australian context 76

3.1 Objectives of international antimicrobial resistance surveillance systems 76

3.2 Case studies – existing programs of most relevance to the Australian context 77

3.3 Critical elements contributing to the success of existing systems 131

4. National coordination in Australia: systems, enablers and barriers 133

4.1 Setting the scene – a recent history 133

4.2 Australia’s recent history 139

4.3 Fundamentals to national coordination 140

4.4 Strategic options and assumptions for national coordination 145

4.5 Enabler and barrier analysis 147

5. Australia’s repsonse – a national coordinating centre 156

5.1 The proposal 156

5.2 Overview of the status of program components 161

6. Appendices 164

Appendix 1: Study design and methods 164

Appendix 2: Global program and activity analysis 168

7.References 202