Australian Passive AMR Surveillance (APAS)
Australian Passive AMR Surveillance (APAS) is a key AURA Surveillance System program conducted by the Commission. APAS collects, analyses and reports on de-identified patient-level AMR data contributed voluntarily by 11 public and private pathology services across Australia, several of which capture state-wide public patient data via their laboratory information systems.
As at July 2021, APAS captures over 80 million susceptibility results, providing the largest volume of resistance surveillance data to AURA. These data provide access to geographical and organism related trends in resistance and inform local, state and national AMR response strategies. National APAS data analyses have most recently been published in AURA 2021: Fourth Australian report on antimicrobial use and resistance in human health.
APAS was established by the Commission in 2015, by engaging with states, territories, and the private sector in strategic locations across the country to capture resistance data from public and private hospitals, aged care homes and community settings. The Commission has established agreements with these providers and is responsible for the analysis, interpretation, and publication of all APAS data. The Commission also consults with APAS participants (who maintain ownership of their data) to gain any necessary local or state/territory information to inform understanding of AMR patterns arising from the data.
APAS was established with the support of Queensland Health, which enabled access to the OrgTRx system as the supporting information technology infrastructure. All participating APAS laboratories have access to their own data within the system for the preparation of regular local reports and antibiograms to support the antimicrobial stewardship and infection prevention efforts of the health services they serve. APAS does not hold patient-identified data.
The data captured through APAS is used to report on AMR data in the form of:
- Longitudinal datasets for specified organism-antimicrobial combinations
- Cumulative antibiograms showing rates of resistance for a range of organisms from a specified specimen type within a time period
- Tabulations showing the resistance profiles of organism strains isolated during a time period
- Reporting for individual units within hospitals or health services, or at a state-wide level.
All APAS contributing laboratories outside of Queensland Health initially provided their data from 1 January 2015 for capture in APAS; once integrated with APAS, data are submitted on a monthly basis. Subsequent to the initial data captured from 1 January 2015 from all sites, in 2017, the Commission increased the breadth and depth of data by integrating historical data from a number of participating laboratories, from 1 January 2005, so as to further enhance capacity for trend analysis and understanding of patterns in AMR in Australia. The APAS system now includes in excess of 80 million individual susceptibility results from all states and the Australian Capital Territory, along with a number of private sector laboratories.
Sullivan Nicolaides Pathology has also been an important contributor to national passive surveillance through the provision of reports on resistance in isolates referred by hospitals, aged care homes, community and general practices in Queensland and Northern NSW for many years.
A key objective of the Commission is to continue to work with states and territories and the private sector to expand APAS to enhance the system’s data representativeness and analytical value.
Participants in the APAS
APAS contributing laboratories include:
- ACT Pathology (all public and some private Australian Capital Territory health services)
- Pathology Queensland (all Queensland Health public hospitals and health services)
- Monash Health, Victoria
- Royal Hobart Hospital and Launceston General Hospital, Tasmania – combined data from these two contributing laboratories capture the majority of public patient data for Tasmania
- Three NSW Health Pathology laboratory services providing services to:
- Sydney and South Western Sydney Local Health Districts (LHDs)
- South Eastern Sydney and Illawarra Shoalhaven LHDs (including the Sydney Children’s Hospitals Network - Randwick)
- Hunter New England, Mid North Coast and Northern NSW LHDs
- Mater Pathology Queensland (Queensland public and private patients)
- SA Pathology (public health catchments for South Australia)
- PathWest Laboratory Medicine, WA (all Western Australian public hospitals)
Alfred Health, Melbourne is currently being integrated with APAS - once complete, inclusion of this service’s data will provide a significant boost to APAS’s coverage of Victoria.