A critical component of AURA, and the largest, is the development of a national passive antimicrobial resistance (AMR) surveillance system – Australian Passive AMR Surveillance (APAS). This will occur through expansion of a significant existing system operated by Queensland Health, called OrgTRx. The objective of APAS is to provide analysis capability and reporting at the local, jurisdictional and national levels, enabling clinicians and policy-makers access to enhanced information, data and reports to inform appropriate public health action in response to AMR. APAS collects, analyses and reports on data on AMR from hospitals, aged care, community and private pathology services.
OrgTRx is a surveillance system using a data cube approach (Panorama software) that accepts extracts of surveillance data from participating laboratory information systems. It has been operational in Queensland Health since 2006 and all participating laboratories have access to the data cube for the preparation of regular reports and antibiograms to assist the antimicrobial stewardships teams in the hospitals that they serve. Users also have the capacity to perform ad-hoc queries.
In 2015, the Commission successfully completed a pilot to test use of OrgTRx outside Queensland as a platform for APAS. While participation in national passive AMR surveillance is voluntary, to date there has been very positive engagement across the sectors and across Australia. Since completion of the pilot, the development of APAS has significantly expanded, with the system now including over 20 million individual susceptibility results from 1 January 2015. These come from participating services from all states and the Australian Capital Territory, as well as some private sector laboratories.
The data captured via APAS is being used to report on AMR data in the form of:
Further expansion of APAS is under way. The Commission is continuing to work with states and territories and the private sector to enhance data representativeness and analytical value. Since May 2017, the Commission has also increased the breadth and depth of surveillance data by integrating historical data from 1 January 2005 to 31 December 2014 at a number of participating laboratories so as to enhance capacity for trend analysis and understanding of patterns in AMR in Australia. As a result of this work, a further 32 million susceptibility results have been added to the system.
In addition to these public services, Sullivan Nicolaides has been an important early contributor to this national surveillance through the provision of reports on resistance to complement data going directly into APAS.
As at 17 January 2018, participating services in APAS include:
The following resources have been developed to provide additional training and support to APAS participants: