Comprehensive report on antibiotic resistance identifies challenges
A comprehensive national report on the spread of antimicrobial resistance in Australia has highlighted a number of specific types of bacteria as major emerging healthcare problems, with one type in particular causing resistance to last-resort antibiotics in just over half of hospital samples.
Despite some recent gains in efforts to encourage more careful use of antibiotics, the new report finds as much as 56% of samples of enterococci can be resistant to the antibiotic vancomycin – a level higher than in any European country.
The report, called Antimicrobial Use and Resistance in Australia 2017: Second Australian report on antimicrobial use and resistance in human health, also finds that a strain of methicillin-resistant Staphylococcus aureus (MRSA) has become the most common type of MRSA infection in the community, and is now a more common cause of bloodstream infections than hospital-associated strains of MRSA.
The report was launched at an event at Sydney's St Vincent's Hospital recently by the Australian Commission on Safety and Quality in Health Care. AURA 2017 provides a more comprehensive picture of antimicrobial resistance, which is a critical challenge to health systems in Australia and around the world.
The report contains valuable data on antimicrobial use in the community and hospitals, identifies key emerging issues for antimicrobial resistance, and gives a detailed overview of Australia's first National Alert System for Critical Antimicrobial Resistances (CARAlert). It finds that antibiotic use has been falling in Australian hospitals, a shift that will help to slow the spread of resistance. However, there are still concerning levels of inappropriate prescribing of antibiotics in hospitals and the community.
The report also highlights a number of areas for action to help reduce antimicrobial resistance. These include continued monitoring of the spread of resistant strains of Neisseria gonorrhoeae, the bacterium that causes gonorrhoea, to inform treatment guidelines for the condition. In the case of vancomycin-resistant enterococci, the report calls for strict adherence to infection control guidelines and effective cleaning and sterilisation in healthcare facilities.
Commission Senior Medical Advisor Professor John Turnidge said antimicrobial resistance was 'one of the most significant challenges for the delivery of safe, high-quality health services, and has a direct impact on patient care and patient outcomes'.
'AURA 2017 provides clinicians and health policy makers across Australia with the data and information needed to develop and better target strategies which will prevent and contain resistance, ultimately benefiting patients in our hospitals, and residents in the community and aged care homes,' Professor Turnidge said.
'Antibiotic resistance is greatly exacerbated through the overuse and misuse of antibiotics. Bacterial infections that were once able to be cured with antibiotics are becoming much harder to treat. In 2015, over 30 million prescriptions for antimicrobials were dispensed in the Australian community.'
The Australian Government Chief Medical Officer, Professor Brendan Murphy, highlighted the importance of the work of the Commission in establishing the AURA Surveillance System as an important element in support of Australia's First National Antimicrobial Resistance Strategy.
'The development of nationally coordinated surveillance of antimicrobial resistance and antimicrobial usage is a key objective of the strategy,' Professor Murphy said.
'AURA 2017 and the Commission's complementary range of reports on antimicrobial use and resistance are all providing valuable data to help clinicians and others to tackle this issue, and to help them and others see which strategies to combat antimicrobial resistance are working best.'