Antimicrobial resistance is a significant global health priority that threatens to take modern medical and veterinary practice back to the pre-antibiotic era. In Australia’s “First National Antimicrobial Resistance Strategy” released by the Australian Government in June 2015, the development of a nationally coordinated one health surveillance program on antimicrobial resistance was identified as a key objective.
The Australian Group for Antimicrobial Resistance (AGAR) plays a unique role in the surveillance of antimicrobial resistance in Australia. It has a broad laboratory membership representing the major teaching hospitals in all capital cities and in several regional hospitals. Established in 1986 and consisting of 32 laboratories, AGAR is operated by the Australian Society for Antimicrobials and is funded by the Australian Commission on Safety and Quality in Health Care. Over the last thirty years AGAR has conducted major national surveys of resistance in Staphylococcus aureus, which have documented the spread of different clones of methicillin-resistant Staphylococcus aureus in Australian hospitals, Enterococcus, Enterobacteriacae, Streptococcus pneumoniae and Haemophilus influenza.
Initially a snapshot-based surveillance program, in 2013 AGAR commenced three ongoing sepsis programs: the Australian Staphylococcus Sepsis Outcome Program (ASSOP), the Australian Enterococcus Sepsis Outcome Program (AESOP), and the Australian Gram Negative Sepsis Outcome Program (GnSOP). The programs are continuous and include the molecular characterisation of isolates performed by the two AGAR reference laboratories located at Murdoch University (ASSOP and AESOP) and University of Adelaide (GnSOP). As the sepsis programs are similar to those performed by the European Antimicrobial Resistance Surveillance Network (EARS-Net), comparison of Australia’s antimicrobial resistance prevalence with many European countries can be made
(http://ecdc.europa.eu/en/activities/surveillance/EARS-Net/Pages/index.aspx).
The surveillance programs performed by AGAR have provided Australia a unique perspective on emerging patterns of resistance in key pathogens. The use of an active surveillance strategy with standard methodology for collection and examination of clinically significant isolates has produced data accurately reflecting the changing prevalence of antimicrobial resistance in Australia’s major hospitals as well as the community.