National Alert System for Critical Antimicrobial Resistances (CARAlert)
AURA
CARAlert collects data on nationally agreed priority organisms with critical resistances to last-line antimicrobial agents. CARAlert provides timely information and advice to support clinicians, policy makers and system managers respond to antimicrobial resistance (AMR) in Australia.
About CARAlert
CARAlert was established by the Commission in 2016, with funding from the Department of Health and Aged Care. CARAlert is part of the AURA Surveillance System. It collects and reports on data on critical antimicrobial resistances (CARs) – these are resistance mechanisms or profiles that are known to present a serious threat to the effectiveness of last-line antimicrobial agents.
Monitoring and providing regular reports on CARs in Australia helps to inform actions that prevent and control AMR. CARAlert also provides state and territory public health services with access to confirmed CAR results.
The CARs that are reported to CARAlert are outlined in the table below.
| Species | Critical resistance |
|---|---|
| Acinetobacter baumannii complex | Carbapenemase-producing |
| Candida auris | |
| Enterobacterales | Carbapenemase-producing, and/or ribosomal methyltransferase-producing |
| Transmissible colistin resistance | |
| Enterococcus species | Linezolid-resistant |
| Mycobacterium tuberculosis | Multidrug-resistant – resistant to at least rifampicin and isoniazid |
| Neisseria gonorrhoeae | Ceftriaxone- or azithromycin-nonsusceptible |
| Gentamicin-resistant | |
| Neisseria meningiditis | Ciprofloxacin-nonsusceptible |
| Salmonella species | Ceftriaxone-nonsusceptible |
| Shigella species | Multidrug-resistant |
| Staphylococcus aureus complex* | Vancomycin- or linezolid-nonsusceptible |
| Streptococcus pyogenes | Penicillin-reduced susceptibility |
| Pseudomonas aeruginosa | Carbapenemase-producing |
* For CARAlert, S. aureus complex includes S. argenteus and S. schweitzeri
In 2022, the Commission conducted a review of CARAlert to assess whether currently reported CARs continue to be priorities, and to identify any additional CARs for inclusion.
Following consultation with states, territories and a range of clinical experts, from 1 January 2023:
- Ciprofloxacin-nonsusceptible N. meningiditis was added to CARAlert
- Gentamicin-resistant N. gonorrhoeae was added to CARAlert
- Reporting of daptomycin-nonsusceptible S. aureus was suspended and will be considered for reintroduction when more reliable phenotypic testing methods are available.
CARAlert reports and resources
- Bimonthly CARAlert data updates
Bimonthly reports summarising data submitted to the CARAlert system
- CARAlert reports
Annual reports for the CARAlert system
- CARAlert resources
User guides and other resources for the CARAlert system
- CARAlert frequently asked questions
Answers to some of the most frequently asked questions about the CARAlert system