Australian passive AMR surveillance (APAS)
The AURA Surveillance System includes Australian passive AMR surveillance (APAS) which collects, analyses and reports on de-identified patient level AMR data contributed by 10 public and private pathology services across Australia. These laboratories detect AMR in isolates referred for testing from public and private hospitals, aged care homes and community settings
APAS was established by the Commission in 2015, with the support of Queensland Health providing access to its OrgTRx IT system, to develop a national passive AMR surveillance system. The objective of APAS is to provide analytical capability and reporting of resistance at the local, jurisdictional and national levels, enabling clinicians and policymakers access to enhanced information, data and reports to inform appropriate action in response to AMR.
Initially, data were captured from 1 January 2015 from all contributing laboratories; historical data have now been incorporated from four of those laboratories. The APAS system now includes in excess of 70 million individual susceptibility results from 2005 to 2020 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.
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 statewide level.
The Commission is continuing to work with states and territories and the private sector to enhance the system’s data representativeness and analytical value.
Participants in the APAS
APAS contributors include:
- Pathology Queensland and the Queensland Health Communicable Diseases Branch (includes all public hospitals in Queensland)
- The Canberra Hospital supported by ACT Pathology
- Monash Health, Victoria
- Royal Hobart Hospital, Tasmania
- NSW Health Pathology laboratories that provide services to Hunter New England, Mid North Coast, Northern NSW, South Western Sydney, South Eastern Sydney, Illawarra Shoalhaven and Sydney Local Health Districts
- Mater Misericordiae Health Services, Brisbane
- SA Pathology, which provides services to all SA Health public hospitals
- PathWest Laboratory Services, which provides services to all WA Health public hospitals.
This report highlights concerning results for three types of significant resistances in Australia:
- Methicillin resistance in Staphylococcus aureus (MRSA)
- Fluoroquinolone non-susceptibility in Escherichia coli
- Vancomycin non-susceptibility in Enterococcus faecium
APAS – OrgTRX training and support resources
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The following resources have been developed to provide additional training and support to APAS participants: