Carbapenemase-producing Enterobacterales (CPE), either alone or in combination with ribosomal methyltransferases, has been the most frequently reported CAR to CARAlert.
The majority of CARs have been reported from the three most populous states – New South Wales, Victoria and Queensland.
The IMP-type carbapenemase (mainly IMP-4) is now endemic on the eastern seaboard of Australia in several species of Enterobacterales, particularly Enterobacter cloacae complex. This means that it is difficult to eliminate, and rigorous control measures are essential. There is no evidence that other carbapenemases have become established in Australia to date.
The number of CPE reported, and the endemicity of IMP-type carbapenemase, highlight the importance of implementing actions outlined within the Commission’s Recommendations for the control of carbapenemase-producing Enterobacterales: A guide for acute health facilities.
The frequency of reporting of azithromycin-nonsusceptible Neisseria gonorrhoeae has occurred in the context of a significant increase in notifications of N. gonorrhoeae and there have been sporadic cases of ceftriaxone-nonsusceptible or azithromycin-nonsusceptible (high-level resistance) N. gonorrhoeae.
There was a large increase in the number of reports of multidrug-resistant (MDR) Shigella in 2019. Infections caused by Shigella species are generally food-borne or sexually transmitted and are notifiable nationally. In 2019, New South Wales and Victoria reported increases in MDR Shigella amongst men who have sex with men. In response to the increase, both states issued public health alerts and implemented changes to management recommendations for shigellosis as part of their prevention and control strategies.
The majority of CARs reported from aged care homes since 2019 were daptomycin-nonsusceptible Staphylococcus aureus. Skin and soft tissue infections are commonly caused by S. aureus, which may be spread by contact with contaminated surfaces and hands of healthcare workers, visitors and residents. In group living environments, S. aureus may also be inadvertently spread by sharing personal items such as bed linen, towels or clothing. There is a risk of transmission of this CAR within aged care homes, and in hospitals due to the frequent movement of aged care home residents between these two settings.
CARAlert data undergo regular epidemiological analysis; statistical methods for evaluating temporal and spatial trends will be implemented as the data collection matures.