Ms. Brighid Carey1, Ms. Jan Bell1, Dr Jan Gralton1, Conjoint Associate Professor Carolyn Hullick1, Ms. Kim Stewart1
1Acsqhc, Sydney, Australia
Biography:
Brighid Carey is the Manager of Antimicrobial Use and Resistance in Australia (AURA) at the Australian Commission on Safety and Quality in Health Care. She has a background as a clinical pharmacist specialising in Antimicrobial Stewardship (AMS) and has studied Pharmacy Practice and Leadership and Management. Brighid received First Class honours for her study, Feasibility of Antimicrobial Stewardship in Small Rural Hospitals of the New England Tablelands Cluster. She is also the Advocacy and Communications Officer for the NSW Branch Committee for the Society of Hospital Pharmacists.
Abstract:
Introduction
Multidrug-resistant organisms (MROs), including vancomycin-resistant Enterococcus faecium (VRE), fluoroquinolone-resistant Escherichia coli and methicillin-resistant Staphylococcus aureus (MRSA), pose significant risks to patient safety.
Australian Passive AMR Surveillance (APAS) captures MRO data, which informs actions to address the prevention, control and treatment of antimicrobial-resistant infections.
Methods
APAS collects routine susceptibility testing data from integrated laboratory information systems via OrgTRx.
Results
Prevalence of VRE in Australia increased from 5.3% in 2006 to 42.5% in 2023. The vast majority of VRE was reported from hospitals, where rates are higher than the community (43.5% vs 24.4% in 2023). VRE varied amongst jurisdictions (2023: 12.8–69.4%). Trends were similar across remoteness areas.
Fluoroquinolone-resistant E. coli increased from 1.9% in 2006 to 13.4% in 2023. Rates were similar across settings but varied between jurisdictions (2023: 9–20.5%) and remoteness areas (2023: 8.3–19.4%). The highest levels were in the Northern Territory (NT) (2020: 29.1% peak) and very remote Australia (2023: 19.4%).
MRSA rates remained steady from 2006 to 2023 (range: 19.8–22.8%). Resistance was highest in aged care homes, the NT and remote and very remote Australia (2023: 22%, 36.4%, 31.5% and 33.5%, respectively).
Conclusions
Ongoing surveillance of antimicrobial resistance, compliance with Australian Guidelines for the Prevention and Control of Infection in Healthcare and implementation of antimicrobial stewardship are critical to control the upward trend in MROs across healthcare settings and local areas. This is particularly for vulnerable populations and where resistance rates are highest in aged care homes and across remote and very remote regions and northern Australia.