Australian passive AMR surveillance (APAS)
Australian Passive Antimicrobial Resistance Surveillance (APAS) is part of the AURA Surveillance System. APAS collects, analyses and reports on de-identified patient level antimicrobial resistance (AMR) data contributed by a number of public and private pathology services across Australia.
APAS provides 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.
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.
The Commission established APAS using the Queensland Health OrgTRx passive AMR surveillance system as the IT platform for the national system. 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 statewide level.
All APAS contributing laboratories outside of Queensland Health initially provided 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 77 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.
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 contributing laboratories 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
- Northern Sydney, Central Coast NSW, Hunter New England, Mid-North Coast, Northern NSW, South Western Sydney, South Eastern Sydney, Illawarra-Shoalhaven and Sydney Local Health Districts, and the Sydney Children’s Hospitals Network (Randwick), supported by NSW Health Pathology
- Mater Misericordiae Health Services, Brisbane
- SA Health, including all SA public hospitals supported by SA Pathology
- WA Health, including all WA public hospitals supported by PathWest Laboratory Medicine (Western Australia)
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 data has also been analysed and presented in three national AURA reports, including most recently AURA 2019: Third Australian report on antimicrobial use and resistance in human health
The following webinars have been developed to provide information on the Commission’s APAS system and additional training and support to APAS participants:
- Webinar 1 – Introduction to APAS and System Demonstration
- Webinar 2 – APAS – Introduction to APAS System (OrgTRx Platform) for New Users
- Webinar 3 – Advanced APAS System Training (OrgTRx Platform)
Other APAS training and support resources
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The following resources have been developed to provide additional training and support to APAS contributors: