Implementation Plan of Australia’s First National Antimicrobial Resistance Strategy 2015-2019

IMPLEMENTATION PLAN Australia’s First National Antimicrobial Resistance Strategy 2015–2019 November 2016 IMPLEMENTATION PLAN Australia’s First National Antimicrobial Resistance Strategy 2015–2019 November 2016 IMPLEMENTATION PLAN Australia’s First National Antimicrobial Resistance Strategy 2015–2019 Implementation Plan: Australia’s First National Antimicrobial Resistance Strategy 2015–2019 Publications approval number: 11726 Copyright Statements: Paper-based publications © Commonwealth of Australia 2016 This work is copyright. You may reproduce the whole or part of this work in unaltered form for your own personal use or, if you are part of an organisation, for internal use within your organisation, but only if you or your organisation do not use the reproduction for any commercial purpose and retain this copyright notice and all disclaimer notices as part of that reproduction. Apart from rights to use as permitted by the Copyright Act 1968 or allowed by this copyright notice, all other rights are reserved and you are not allowed to reproduce the whole or any part of this work in any way (electronic or otherwise) without first being given the specific written permission from the Commonwealth to do so. Requests and inquiries concerning reproduction and rights are to be sent to the Communication Branch, Department of Health, GPO Box 9848, Canberra ACT 2601, or via e-mail to copyright@health.gov.au. Internet sites © Commonwealth of Australia 2016 This work is copyright. You may download, display, print and reproduce the whole or part of this work in unaltered form for your own personal use or, if you are part of an organisation, for internal use within your organisation, but only if you or your organisation do not use the reproduction for any commercial purpose and retain this copyright notice and all disclaimer notices as part of that reproduction. Apart from rights to use as permitted by the Copyright Act 1968 or allowed by this copyright notice, all other rights are reserved and you are not allowed to reproduce the whole or any part of this work in any way (electronic or otherwise) without first being given the specific written permission from the Commonwealth to do so. Requests and inquiries concerning reproduction and rights are to be sent to the Communication Branch, Department of Health, GPO Box 9848, Canberra ACT 2601, or via e-mail to copyright@health.gov.au. Source for images throughout publication: iStock Photos Implementation Plan: Australia’s First National Antimicrobial Resistance Strategy 2015–2019 iii Foreword Antimicrobial resistance is widely recognised as an important and complex issue. The World Health Organization describes antimicrobial resistance as one of the biggest threats to global health today and cautions that without immediate action we are heading towards a post-antibiotic era in which common infectious diseases can once again kill. Australia’s response recognises that antimicrobial resistance is a One Health issue which requires a co-ordinated response in all sectors where antimicrobials are used, including in the human health, animal health, food and agriculture sectors. Since the release of Australia’s first National Antimicrobial Resistance Strategy 2015–2019 in June 2015, the Australian Government Department of Health and Department of Agriculture and Water Resources have undertaken a consultation process with a wide range of organisations across these sectors to canvass the range of activities being undertaken to minimise the development of antimicrobial resistance and ensure the continued availability of effective antimicrobials. This Implementation Plan outlines Focus Areas for activity, as well as specific actions being undertaken by the Australian Government, State and Territory Governments, non-government organisations, professional bodies and research organisations. The Plan incorporates activities being undertaken across various sectors to encourage and enable collaboration and information sharing. These activities contribute to the establishment of an evidence base and better target our efforts to address gaps and ensure appropriate policies and programs are in place to limit the development of antimicrobial resistance. The Australian Government would like to thank stakeholder groups that have come together to support and provide input into this Implementation Plan, and for their continued support to progress implementation and reporting of these activities. Implementation Plan: Australia’s First National Antimicrobial Resistance Strategy 2015–2019 v Table of Contents Foreword iii Background 1 Purpose and scope 2 Governance 3 Roles and responsibilities 4 Reporting and monitoring 5 Objective 1: Increase awareness and understanding of AMR, its implications, and actions to combat it through effective communication, education and training. 6 Objective 2: Implement effective antimicrobial stewardship practices across human health and animal care settings to ensure the appropriate and judicious prescribing, dispensing and administering of antimicrobials. 8 Objective 3: Develop nationally coordinated One Health surveillance of AMR and antimicrobial usage. 10 Objective 4: Improve infection prevention and control measures across human health and animal care settings to help prevent infections and the spread of AMR. 12 Objective 5: Agree a national research agenda and promote investment in the discovery and development of new products and approaches to prevent, detect and contain AMR. 14 Objective 6: Strengthen international partnerships and collaboration on regional and global efforts to respond to AMR. 16 Objective 7: Establish and support clear governance arrangements at the local, jurisdictional, national and international levels to ensure leadership, engagement and accountability for actions to combat AMR. 18 Appendix A: Stocktake of activities 21 Acronyms and abbreviations 61 Implementation Plan: Australia’s First National Antimicrobial Resistance Strategy 2015–2019 1 Background In June 2015, the Australian Government released its first National Antimicrobial Resistance Strategy 2015–2019 (the Strategy). The Strategy is aligned with the World Health Organization’s Global Action Plan on Antimicrobial Resistance and sets the framework and direction for Australia’s national response to antimicrobial resistance (AMR). The Strategy recognises that AMR is a significant global health priority, largely driven by the global inappropriate use of antibiotics in human health, agriculture and animal husbandry. The Strategy supports a One Health approach by providing seven common objectives across human health, animal health and agricultural sectors which together support the overarching goal to minimise the development and spread of AMR and ensure the continued availability of effective antimicrobials: 1. Communication, education and training 2. Antimicrobial stewardship 3. Surveillance 4. Infection prevention and control 5. National research agenda 6. Strengthen international partnerships 7. Clear governance arrangements Translating the Strategy into action In November 2015, the Australian Government Department of Health and the Department of Agriculture and Water Resources jointly convened a National AMR Forum with representatives from the human health, animal health and agriculture sectors, as well as government representatives and researchers to inform the implementation of the Strategy under a One Health framework. The National Forum promoted discussion on key areas for action, as well as identified activities being undertaken across Australia to respond to the growing threat of AMR. Each objective under the Strategy is supported by Priority Areas for Action that outline high level areas in which attention is required. In order to provide greater direction on which immediate actions need to be undertaken, the Australian Government in consultation with stakeholders has identified Focus Areas, as well as developed a stocktake of activities currently underway (refer Appendix A). Vision  Goal  Objectives  Priority Areas for Action  Focus Areas  Activities The activities outlined in Appendix A of the Implementation Plan (the Plan) were informed through consultations with a variety of stakeholder groups. Given the breadth of activities nominated, those included in the Implementation Plan are limited to those that that can provide benefits at a national level and align with the Priority Areas for Action detailed under each Objective in the Strategy. A gap analysis will be undertaken to identify further actions required to address the Focus Areas under each Objective. 2 This Plan outlines Focus Areas, as well as specific actions being undertaken by the Australian Government, State and Territory Governments, non-government organisations, professional bodies and research organisations. The Plan incorporates activities being undertaken across various sectors to encourage and enable collaboration and information sharing. These activities contribute to the establishment of an evidence base, to better target our efforts, to address gaps and to ensure appropriate policies and programs are in place to limit the development of AMR. Aligning with the Strategy, the Plan focuses predominantly on bacterial resistance and the rapid development of resistance to antibiotics as an immediate priority. This Implementation Plan outlines Focus Areas for activity which the Australian Government believes will have the greatest contribution to assist in the achievement of the seven objectives identified in the Strategy. Implementation of activities against Focus Areas will take a staged approach over the period 2015–2019. Updates to the Plan may be undertaken in response to emerging issues and/or as new evidence becomes available. Updates to the activity tables at Appendix A will be undertaken on a biennial basis. Purpose and scope Implementation Plan: Australia’s First National Antimicrobial Resistance Strategy 2015–2019 3 The development of the Plan was overseen by the AMR Prevention and Containment (AMRPC) Steering Group, which is led by the Secretaries of the Department of Health and Department of Agriculture and Water Resources and includes the Australian Government Chief Medical and Veterinary Officers as members. The Australian Strategic and Technical Advisory Group (ASTAG) on AMR provided expert guidance during the development of the Plan. The Australian Government, through the AMRPC Steering Group, will oversee the delivery of the Implementation Plan and provide leadership and co-ordination on AMR. The AMRPC Steering Group will be responsible for monitoring the implementation of the Strategy and will review and report publically on progress on an annual basis. The ASTAG will provide high quality, well considered strategic, technical, scientific and clinical advice to the AMRPC Steering Group and will be engaged in monitoring the progress of activities under the Plan. The Department of Health and the Department of Agriculture and Water Resources will work together to support the AMRPC Steering Group, as well as liaise with stakeholders in their respective sectors to report against the activities articulated in Appendix A of the Implementation Plan. The achievement of One Health activities will require a concerted effort by both Departments. Governance 4 The goal of the Strategy is to minimise the development and spread of AMR and ensure the continued availability of effective antimicrobials. The Strategy recognises that undertaking action to achieve this goal requires Australian Government, State and Territory Governments, non-government organisations, professional bodies and research organisations to work together. Australian Government Individual Australian Government departments and agencies will be accountable for the achievement of activities outlined in Appendix A for which they are the lead. Their responsibilities will include monitoring progress and contributing to the development of an annual progress report. State and Territory Governments While the Strategy is the responsibility of the Australian Government, the work of the State and Territory Governments is integral to achieving the overall vision of the Strategy. Each State and Territory Government has its own initiatives that complement the Strategy’s vision. S ome state and territory activities are reflected in Appendix A. Individual State and Territory Governments will be accountable for the achievement of activities for which they are the lead organisation. Their responsibilities will include monitoring progress and contributing to the development of an annual progress report. Non-Government Sector The Government recognises the invaluable contribution made by the non-government sector including professional bodies and research organisations to address AMR in Australia. Many of these activities are captured in Appendix A. Individual organisations will be accountable for the achievement of activities for which they are the lead organisation. Their responsibilities will include monitoring progress and contributing to the development of an annual progress report. Roles and responsibilities Implementation Plan: Australia’s First National Antimicrobial Resistance Strategy 2015–2019 5 Reporting A report on progress of implementing the Strategy will be developed by the AMRPC Steering Group in consultation with the ASTAG. The first annual progress report is anticipated to be released in October 2017. This will include updates on the progress of individual activities as well as an analysis of remaining gaps and overall progress towards achieving actions under each of the key Focus Areas. Surveillance and monitoring The Antimicrobial Use and Resistance in Australia (AURA) Report released in June 2016 established a baseline for AMR and antibiotic use in human health. Initially, data collections will be focussed on establishing baseline measurements against which future targets can be set. A monitoring plan will be developed in consultation with ASTAG and the AMRPC Steering Group to identify indicators and set targets to monitor progress against the Objectives of the National AMR Strategy across human health, animal health and agriculture. Reporting and monitoring 6 Overview Effective communication, education and training is crucial to raise awareness and understanding amongst prescribers and dispensers across human and animal health, consumers and the general public about what can be done to combat AMR and the importance of taking action now. In order to increase awareness and understanding of AMR and appropriate antibiotic use, we need to better understand the behavioural drivers amongst consumers, including health professionals, veterinarians, farmers, animal owners and the general public. Activities in this Plan include initiatives that are already underway to determine where we need to focus our attention and resources to strengthen education, training and support initiatives. The Australian Government will develop a stakeholder engagement and communication plan and a One Health AMR website to better coordinate AMR-related activity, information and education resources both nationally and internationally, as well as facilitate collaboration and information sharing across sectors. Priority Areas for Action 1.1Strengthen consumer awareness initiatives to improve understanding of antimicrobial resistance and the importance of using antibiotics appropriately. FOCUS AREAS: • Identify and prioritise existing initiatives to improve consumer awareness and understanding about AMR and appropriate antibiotic use in all settings. • Investigate and promote new initiatives to introduce AMR information and key messages to new consumer groups. • Develop consistent and actionable consumer messages about AMR and appropriate antibiotic use for the One Health AMR website. • Strengthen ways to engage with media organisations to support reporting about AMR. • Identify and understand drivers of consumer decision making and antibiotic use and translate into resources for consumers. Objective 1: Increase awareness and understanding of AMR, its implications, and actions to combat it through effective communication, education and training. Implementation Plan: Australia’s First National Antimicrobial Resistance Strategy 2015–2019 7 1.2Increase support for human and animal health professionals in reinforcing key messages with patients and clients. FOCUS AREAS: • Improve the evidence base to better understand the behavioural drivers for antibiotic use and AMR in human and veterinary health. • Develop resources that promote and support appropriate antibiotic prescribing, particularly in primary health care and veterinary settings. • Enhance availability of resources to assist all health professionals, particularly GPs and veterinarians, to reinforce key messages with consumers about appropriate antibiotic use and actions that can be taken to reduce AMR. 1.3Strengthen communication and education initiatives for health professionals and health care team members. FOCUS AREAS: • Strengthen communication and education initiatives for human and animal health professionals. • Enhance the national coordination of, and participation in, Antibiotic Awareness Week to promote a greater understanding of AMR and the importance of responsible use of antibiotics across all sectors and the community. • Improve health professionals’ knowledge of antimicrobial stewardship (AMS) in accordance with relevant national standards. • Improve awareness and knowledge among veterinary practitioners about AMR and the need for judicious use of antibiotics in animals. • Ensure curriculum outcomes and competencies for AMR and AMS are emphasised and current in pre registration training for health and veterinary professionals. • Ensure that competencies for AMR and AMS are current and enforced in post registration training for health and veterinary professionals. 1.4Develop a stakeholder engagement and communication plan to support whole-of-society awareness of, and participation in implementing the Strategy. FOCUS AREAS: • Develop a stakeholder engagement and communication plan to raise awareness of the actions that priority stakeholders can take to minimise the development and impacts of resistance. • Develop a One Health AMR website to ensure access to reliable sources of information on antibiotics and AMR thus facilitating the coordination of AMR related activities. • Promote Antibiotic Awareness Week to the community. 8 Overview Antimicrobial stewardship (AMS) is a key strategy in slowing the emergence of resistance. While AMS has become standard practice in hospital settings through the introduction of the National Health Care and Quality Services (NHCQS) Standards, more needs to be done to support stewardship in other settings. For the human health sector, the initial focus is to identify, test and implement stewardship interventions in general practice. In animal health and agriculture, greater attention needs to be given to support best practice antimicrobial use by veterinarians. Priority Areas for Action 2.1Ensure that tailored, evidence-based antibiotic prescribing guidelines are available for all sectors. FOCUS AREAS: • Ensure adequate access to Therapeutic Guidelines: Antibiotic to promote and support informed antibiotic prescribing across Australia. • Ensure adequate access to, and implementation of, current infection specific guidelines that support and enforce informed antibiotic prescribing across Australia. • Develop and enforce veterinary antibiotic prescribing guidelines for all classes of animals in Australia. • Ensure availability of evidence-based and best practice arrangements in AMS for the use of antibiotics in all classes of animals in Australia. 2.2Ensure the availability of evidence-based, best-practice and nationally consistent approaches to AMS across human health and animal care settings. FOCUS AREAS: • Evaluate existing AMS measures to determine which new initiatives are required in other sectors. • Build a strong evidence base to improve and promote AMS practices in human and animal health settings. • Identify patterns of antibiotic prescribing and provide feedback to prescribers to improve AMS. • Utilise Primary Health Networks to support and implement AMS in general practice. • Develop and implement setting-specific AMS frameworks for all classes of animals in Australia. • Ensure clinical software systems are optimised for AMS practices. • Develop and implement an AMS program for veterinary settings. Objective 2: Implement effective antimicrobial stewardship practices across human health and animal care settings to ensure the appropriate and judicious prescribing, dispensing and administering of antimicrobials. Implementation Plan: Australia’s First National Antimicrobial Resistance Strategy 2015–2019 9 2.3 Develop tailored, evidence-based resources to support the implementation of AMS programmes. FOCUS AREAS: • Promote use and further development of evidence-based resources to support AMS in human and animal settings where antibiotics are used. • Encourage jurisdictions to develop and implement state specific initiatives to support AMS in human and animal health settings. • Develop resources that support appropriate antibiotic use for surgical prophylaxis and consistency with national guidelines. • Identify the barriers and enablers to AMS, in areas such as Residential Aged Care Facilities and Indigenous Health Care Organisations, to inform the development of resources for use in those settings. 2.4 Review existing accreditation and quality assurance programmes to ensure they appropriately support and encourage compliance with best practice AMS approaches. FOCUS AREAS: • Identify and address the enablers and barriers to the implementation of national standards in human health settings. • Update accreditation standards to better support adherence to AMS in livestock production systems. • Investigate approaches to monitor compliance with best practice AMS. 2.5 Strengthen existing measures to better support appropriate and judicious use. FOCUS AREAS: • Promote the National Antimicrobial Prescribing Survey to measure appropriate antibiotic use. • Ensure appropriate authority and restriction arrangements are in place for prescribing antimicrobials. • Improve selection and targeted use of antibiotics in all classes of animals. • Ensure prescribing and dispensing practices are aligned with national prescribing guidelines for antibiotic use in human and animal health. • Review and enforce existing national regulations governing access to antibiotics to ensure they effectively support appropriate and judicious use. • Build audit and feedback processes into existing frameworks in human and animal settings. 10 Overview Current gaps in surveillance coverage, jurisdictional differences in data collection, analysis and reporting, and the use of different diagnostic systems for undertaking susceptibility testing have resulted in a fragmented picture of AMR and usage in Australia. Nationally harmonised and coordinated surveillance is essential to understand the magnitude, distribution and impact of resistant organisms and antimicrobial usage, identify emerging resistance and trends, and determine associations between usage and resistance. The Strategy outlines objectives to guide the development of national surveillance programs across human health, animal health and animal and agriculture sectors. The AURA 2016: first Australian report on antimicrobial use and resistance in human health was released in June 2016 and these data will be used to identify and target action required to prevent the spread of AMR, including the review of existing policies and programmes to identify areas for improvement. Priority Areas for Action 3.1Establish the foundations for national One Health surveillance. FOCUS AREAS: • Continue the development of the national surveillance system for AMR and antimicrobial usage (AU) in human and animal health, which includes the coordination of existing discrete programmes and data collections. • Encourage cross-sector collaboration, integration and sharing of expertise to improve national One Health surveillance data across all jurisdictions. • Ensure laboratory capability and capacity where necessary to detect possible critical antimicrobial resistances. • Improve understanding of antimicrobial use in all sectors and applications in food production to inform policy decision-making. 3.2Agree the objectives of surveillance for each sector, ensuring they align with the overarching objectives for the national One Health surveillance system. FOCUS AREAS: • Define sector-specific objectives for surveillance and ensure they are operational, and that these are reviewed to ensure alignment with the overarching objectives of a national One Health surveillance system as outlined in the Strategy. Objective 3: Develop nationally coordinated One Health surveillance of AMR and antimicrobial usage. Implementation Plan: Australia’s First National Antimicrobial Resistance Strategy 2015–2019 11 3.3Develop lists of priority organisms and associated antimicrobials for national reporting. FOCUS AREAS: • Regularly review the current list of priority organisms and associated antimicrobials, and associated case definitions, for human and animal health surveillance. 3.4Agree and implement a uniform standard for laboratory testing methods for antibacterial susceptibility. FOCUS AREAS: • Promote national consistency in antimicrobial susceptibility testing and reporting in human and animal health to support improved data comparability at the national level. 3.5Improve human health surveillance. FOCUS AREAS: • Continue to improve existing human health AMR and AU surveillance data sources/programs which contribute to the national surveillance system. • Test and improve the alert system to monitor and provide real-time alerts for confirmed critical antimicrobial resistances. • Better coordinate surveillance and response to the emergence, and outbreaks, of multi-resistant organisms, particularly in community settings. • Improve surveillance in hospitals by simplifying and standardising the collection and reporting of antimicrobial use. • Explore capability for real-time aggregation, analysis and reporting of AMR and AU. • Better understand geographic patterns of antimicrobial dispensing in human health and target interventions accordingly. • Develop the use of genomic surveillance to better understand the spread of AMR. 3.6Improve animal health and agriculture surveillance. FOCUS AREAS: • Describe antimicrobial use and undertake AMR monitoring in livestock and companion animal industries and identify opportunities for improved monitoring. 3.7Investigate requirements for surveillance in food. FOCUS AREAS: • Analyse the relationship between environmental, animal, food and human isolates for emerging AMR organisms through the collection of surveillance data. • Improve understanding of the extent to which resistant bacteria are present in the food chain, the extent of transmission of resistant organisms, and the risk this may pose to human health. 12 Overview Infection prevention and control (IPC) is critical in the management of all infectious organisms, but particularly so in reducing the spread of resistant organisms where there may be limited or no antimicrobial treatments available. Preventing infection and its spread reduces the need for antibiotics and the opportunity for organisms to develop resistance and share resistance genes. Evidence-based IPC programmes are required across all sectors and settings, recognising that some settings pose a higher risk of infection than others. Over time, the availability of surveillance data, findings from research and the development of new technologies will inform new approaches and improvements in IPC. Priority Areas for Action 4.1Ensure the availability of evidence-based, best-practice and nationally consistent standards for IPC across human health and animal care settings. FOCUS AREAS: • Strengthen national evidence-based or best practice IPC standards for human health. • Develop national IPC standards for different animal sectors. • Facilitate access to, and dissemination of, national IPC guidelines for human and animal health through the One Health AMR website. 4.2Review existing accreditation and quality assurance programmes to ensure they appropriately support and encourage compliance with best practice IPC measures. FOCUS AREAS: • Update general practice accreditation standards to better support best practice IPC in human health and consider additional mechanisms to support and monitor compliance in this setting. • Identify and address the enablers and barriers to the implementation of national standards in all acute and non-acute settings, including hospitals, general practice and residential aged care settings. • Strengthen the capability of accreditation and quality assurance programmes to better support the implementation of national IPC guidelines in animal industries. • Enhance the national hand hygiene approach to reduce healthcare associated infections and AMR. 4.3Develop additional initiatives and resources to strengthen IPC in all human health care settings. FOCUS AREAS: • Adapt and extend existing IPC resources and initiatives to non-acute human health settings, in particular general practice, community health and residential and aged care settings. Objective 4: Improve infection prevention and control measures across human health and animal care settings to help prevent infections and the spread of AMR. Implementation Plan: Australia’s First National Antimicrobial Resistance Strategy 2015–2019 13 • Strengthen consumer, health professional and other key stakeholder awareness of the importance of IPC in reducing AMR, in particular in general practice, community health and residential and aged care settings. • Develop national resources in response to novel and emerging IPC and AMR needs, as necessary, for health care settings including acute care settings. • Foster efforts to establish comprehensive and integrated national surveillance of healthcare-associated infections, including for resistant and non-resistant organisms, to inform IPC policy and guidelines. • Establish a repository of key IPC resources and links on the One Health AMR website. 4.4Further develop initiatives and resources to strengthen IPC in the livestock industry. FOCUS AREAS: • Increase key stakeholder engagement within the livestock industry regarding understanding of, and access to, IPC strategies to improve the health of livestock and reduce antimicrobial based treatment interventions. • Develop guidance to enhance whole-of farm management of biosecurity risks. • Develop IPC program and management resources suitable for livestock and other animal industries to assist producers and livestock workers. 4.5Further develop resources to strengthen IPC in veterinary practice. FOCUS AREAS: • Implement and educate on national IPC guidelines for veterinary practices, their clients and other animal care settings. • Establish a repository of veterinary IPC resources on the One Health AMR website. • Consider strategies to increase IPC awareness among veterinarians and their clients. 4.6Encourage continued increases in vaccination rates to prevent infections. FOCUS AREAS: • Enhance existing promotional campaigns and strategies to strengthen uptake of vaccination in both the human health and animal sectors. • Implement new campaigns and strategies that demonstrate how immunisation against vaccine preventable diseases reduces antimicrobial use in both human and animal health sectors. • Foster the development of new therapeutics to increase the uptake of vaccination and reduce antimicrobial use. 14 Overview A strong research and development agenda is needed to advance the discovery of new therapies and diagnostic technologies to better prevent infectious disease, treat resistant infections and support the development, refinement and implementation of evidence-based practices to limit the emergence and spread of AMR. Limited systematic coordination of research effort has contributed to gaps in our understanding of how AMR develops and spreads and how best to prevent and contain it. There is a wide range of research activities already underway, both nationally and internationally, and further work is required to better coordinate our research efforts to avoid duplication of effort, determine gaps, identify priorities, and inform future policy. Priority Areas for Action 5.1Identify current gaps and agree national research and development priorities. FOCUS AREAS: • Map research and development needs against current efforts to determine gaps in the evidence base. • Identify where the greatest impacts can be achieved in AMR research and development. • Develop an agreed list of research and development priorities. • Determine surveillance needs and AMR prevalence, and improve knowledge about antimicrobial resistance genes to understand their significance and impact on animal and human health. 5.2Coordinate national research activities and the sharing of information. FOCUS AREAS: • Develop a national mechanism for improved collaboration and information and data sharing to promote efficient use of resources and minimise duplication of effort within and between all sectors (One Health), including the Australian Government, State and Territory Governments, non-government organisations, professional bodies and research organisations. 5.3Explore opportunities to increase support for research and development, including incentives for greater private sector investment. FOCUS AREAS: • Investigate how AMR-related research and development is funded, including examination of how relationships with private investors and the pharmaceutical industry can be developed or enhanced. Objective 5: Agree a national research agenda and promote investment in the discovery and development of new products and approaches to prevent, detect and contain AMR. Implementation Plan: Australia’s First National Antimicrobial Resistance Strategy 2015–2019 15 • Explore opportunities to increase cross disciplinary initiatives on AMR research. • Investigate opportunities to increase support for national AMR research and development priorities. • Increase support for priority and neglected research areas, such as companion animal research. 5.4Explore opportunities to support the translation of promising research findings into new products, policies and approaches. • The Focus Area has been sufficiently identified above via the Priority Area for Action. 16 Overview International collaboration on AMR is integral to ensure the efforts of individual countries is maximised. Australia will continue to actively engage with other countries, particularly in the Asia–Pacific region, and multilateral organisations through strategic policy support, regulatory action and coordinated initiatives. Priority Areas for Action 6.1Active engagement with multilateral organisations and relevant forums to contribute to regional and global action on antimicrobial resistance. FOCUS AREAS: • Participate in and contribute to the implementation of the World Health Organization (WHO) Global Action Plan on AMR. • Participate in WHO, World Organisation for Animal Health (OIE), Food and Agriculture Organization of the United Nations (FAO), Codex and other international fora. • Engage with global partners on AMR through high level international forums, such as the United Nations General Assembly, G20, G7 and the Asia–Pacific Economic Cooperation (APEC). • Develop public and animal health curricula on AMR for use in developing countries, with a One Health emphasis. 6.2Lead regional initiatives to increase capacity to respond to antimicrobial resistance. FOCUS AREAS: • Assist in the development of AMR strategies, tools and resources in the Asia and Pacific region. • Support building and upskilling of capacity for diagnosis, reporting and response to AMR pathogens in particular in the Asia Pacific region. • Support malaria and tuberculosis control efforts in the Asia and Pacific region. • Support food safety initiatives in the region, recognising the importance of cross border trade and zoonotic disease. • Contribute to the current knowledge and understanding of AMR in livestock in the region. Objective 6: Strengthen international partnerships and collaboration on regional and global efforts to respond to AMR. Implementation Plan: Australia’s First National Antimicrobial Resistance Strategy 2015–2019 17 6.3Learn from international best practice. FOCUS AREAS: • Engage with benchmarking countries to inform the local implementation of best practice in human and animal health surveillance, with a One Health approach. • Establish international collaborations to inform national evidence based research and activity/ies. 6.4Participate in international surveillance initiatives. FOCUS AREAS: • Contribute to global AMR and antibiotic use surveillance activities and AU monitoring activities. • Enhance cross-border capacity to track emergence and spread of resistance internationally, with support for genomic based diagnostic capacity in the region. 6.5Establish closer ties with international collaborations to link Australia’s national research agenda with what is happening internationally. FOCUS AREAS: • Build relationships with international partners and identify international collaborative research and development priorities across all technology levels. • Liaise with international health and animal research funding agencies to ensure better co-ordination of research funding efforts. • Investigate options to collaborate and share information across international research networks. 18 Overview Achievement of the Strategy objectives requires a coordinated effort from a wide range of implementation partners. Clear lines of responsibility and accountability at the international, national, jurisdictional and local levels are needed to support progress. Australia will continue to support relevant multilateral organisations such as the World Health Organization (WHO), World Organisation for Animal Health (OIE) and Food and Agriculture Organization of the United Nations (FAO) to foster a global approach of responsibility and accountability on combatting AMR. Priority Areas for Action 7.1Identify, establish and maintain linkages between implementation partners across all sectors. FOCUS AREAS: • Continue to work with stakeholders throughout implementation of the National AMR Strategy. • Establish linkages to support and promote collaboration with and between experts from across human health, animal health and agriculture. • Establish systems to ensure consistent and uniform messages about AMR are disseminated. • Encourage government and non government stakeholders who use or depend upon antimicrobials to ensure their governance structures and management systems provide clear accountability and plans for minimising AMR. 7.2Work with stakeholders to develop an Implementation Plan for the Strategy. FOCUS AREAS: • Bring together stakeholders to jointly develop an Implementation Plan that will detail specific actions under the Strategy and support improved coordination of effort and accountability for outcomes. 7.3Establish baseline measures to inform monitoring and evaluation of the Strategy. FOCUS AREAS: • Use data to establish a benchmark against which key actions under the Strategy can be measured. • Publish national reports on AMR and antibiotic usage in human and animal health and agriculture. Objective 7: Establish and support clear governance arrangements at the local, jurisdictional, national and international levels to ensure leadership, engagement and accountability for actions to combat AMR. Implementation Plan: Australia’s First National Antimicrobial Resistance Strategy 2015–2019 19 7.4Review regulation (legislated and other) relevant to antimicrobial resistance and antibiotic usage. FOCUS AREAS: • Review current systems of regulation in Australia relevant to AMR and antibiotic usage to identify gaps and opportunities to more effectively limit the emergence of resistance. Implementation Plan: Australia’s First National Antimicrobial Resistance Strategy 2015–2019 21 This stocktake of activities attempts to capture the huge effort and financial contribution being undertaken by a wide range of organisations and sectors. Whilst some activities may contribute towards the achievement of more than one Objective they have been listed under the Objective and Priority Area for Action to which they are expected to make the greatest contribution. Activities that are supported by Australian Government funding are denoted by an asterisk in the tables. Table definitions SECTOR Each activity has been attributed to the relevant sector which it most relates to: One Health, human health, animal health or agriculture, which are defined as follows: • The One Health concept recognises that human, animal and ecosystem health are inextricably linked, and achieving optimal health outcomes for people and animals requires joint effort of the human health, veterinary health, and environmental health communities. • Human Health relates to initiatives aimed at improving our use of antibiotics in various settings including primary health care, secondary care, aged care as well as promoting informed use by consumers. • Animal Health and Agriculture relates to initiatives aimed at improving animal health, welfare, biosecurity, and production outcomes associated with the threat of AMR. ACTIVITY/IES The activities under each Priority Area for Action cover a range of areas including research projects, pilot programmes, surveillance and communication activities, as well as the production of resources. Some activities are concerned with adapting and extending existing initiatives and programs, some focus on identifying gaps where action is yet to be undertaken, and others provide a necessary foundation for later work. Activities included in the Implementation Plan are expected to be undertaken within existing resources and do not commit Governments to additional funding. LEAD ORGANISATION The Implementation Plan identifies the lead organisation that will be responsible and accountable for progressing individual activities. This includes monitoring progress and contributing to the development of an annual report to be co-ordinated by the Department of Health and the Department of Agriculture and Water Resources. TIMEFRAMES FOR COMPLETION Timeframes for key milestones for each activity have been provided by the lead organisation and will inform reporting against progress. APPENDIX A: STOCKTAKE OF ACTIVITIES 22 O B JE C T IV E 1 : C O M M U N IC A T IO N , E D U C A T IO N A N D T R A IN IN G P R IO R IT Y A R E A F O R A C T IO N 1 .1 : S tr e n g th e n c o n su m e r a w a re n e ss i n it ia ti v e s to i m p ro v e u n d e rs ta n d in g o f a n ti m ic ro b ia l re si st a n c e a n d t h e i m p o rt a n c e o f u si n g a n ti b io ti c s a p p ro p ri a te ly . H u m a n H e a lt h 1. 1. 1 C o lla b o ra te w it h N PS M ed ic in eW is e an d a g ed c ar e b o d ie s to p ro vi d e a su it e o f i n fo rm at io n o n A M S an d A M R fo r c o n su m er s ac ce ss ib le v ia t h e N at io n al C en tr e fo r A M S w eb si te . N at io n al C en tr e fo r A n ti m ic ro b ia l St ew ar d sh ip * 20 16 o n w ar d s 1. 1. 2 La u n ch t h e ‘Jo in t h e Fi g h t’ A n ti b io ti c R es is ta n ce C o m m u n it y C am p ai g n u si n g s o ci al m ed ia a n d d ig it al a d ve rt is in g to re in fo rc e ke y m es sa g es to e n co u ra g e co n su m er s to t ak e re sp o n si b ili ty to h el p fi g h t an ti b io ti c re si st an ce . N PS M ed ic in eW is e* 20 12 –1 7 1. 1. 3 R ev ie w a n d u p d at e co n su m er in fo rm at io n o n h ea lt h d ir ec t.g o v. au a n d m ya g ed ca re .g o v. au a b o u t an ti b io ti cs a n d a n ti m ic ro b ia l r es is ta n ce . A u st ra lia n G ov er n m en t D ep ar tm en t of H ea lt h , H ea lt h d ire ct A u st ra lia L td * Ju n e 20 16 1. 1. 4 U n d er ta ke a p ilo t p ro g ra m to te st h ea lt h m ed ia (t h ro u g h te le vi si o n , p am p h le ts ) i n G P o ffi ce s to in fo rm a n d /o r r em in d p at ie n ts a t p o in t o f ca re o f A M R is su es a n d t h e ap p ro p ri at e u se o f a n ti b io ti cs p ri n ci p le s. A u st ra lia n G o ve rn m en t D ep ar tm en t o f H ea lt h w it h N PS M ed ic in eW is e an d T o n ic H ea lt h M ed ia * 20 16 A n im a l H e a lt h a n d A g ri c u lt u re 1. 1. 5 D ev el o p a n A M R lin k w it h in t h e A C T Ve te ri n ar y Su rg eo n s w eb si te fo r c o m m u n it y an d V et er in ar y Su rg eo n a cc es s to in fo rm at io n o n t h e N at io na l A nt im ic ro bi al R es is ta nc e St ra te gy 2 01 5– 20 19 . A C T Ve te ri n ar y Su rg eo n s B o ar d M ar ch 2 01 6 1. 1. 6 D ev el o p a fa ct s h ee t an d w eb si te w it h in fo rm at io n fo r V ic to ri an ve te ri n ar ia n s, v et er in ar y st u d en ts , a n im al h ea lt h p ar a p ro fe ss io n al s, fa rm er s an d v et er in ar y st aff o n r is ks a ss o ci at ed w it h A M R. V ic to ri an D ep ar tm en t o f E co n o m ic D ev el o p m en t, Jo b s, T ra n sp o rt a n d R es o u rc es Ju n e 20 17 1. 1. 7 D is se m in at e A M R in fo rm at io n t h ro u g h t h e D ED JT R ex te rn al w eb si te , co m m u n ic at e w it h p ro d u ce rs a t fie ld d ay s, li n k to fr o m t h e Ve t B o ar d w eb si te , c o m m u n ic at e in te rn al ly w it h A n im al H ea lt h s ta ff , an d c o m m u n ic at e to s tu d en ts t h ro u g h t h e U n iv er si ty o f M el b o u rn e Ve te ri n ar y Sc h o o l. V ic to ri an D ep ar tm en t o f E co n o m ic D ev el o p m en t, Jo b s, T ra n sp o rt a n d R es o u rc es D ec em b er 2 01 7 1. 1. 8 D el iv er a s er ie s o f p re se n ta ti o n s to a vi an e n th u si as ts a t va ri o u s co n ve n ti o n s an d m ee ti n g s (p o u lt ry , c ag eb ir d s, p ig eo n s) o n to p ic s in cl u d in g b io se cu ri ty , p ro p er m an ag em en t to re d u ce u se o f an ti m ic ro b ia ls , w it h h o ld in g p er io d s, a n d v ac ci n at io n s. Th e U n iv er si ty o f Q u ee n sl an d O n g o in g — as a t 1 A p ri l 20 16 , p re se n ta ti o n s h av e b ee n g iv en in B ri sb an e (2 ), N an an g o (1 ) a n d B u n d ab er g (1 ) S e c to r A c ti v it y /i e s Le a d O rg a n is a ti o n T im e fr a m e s fo r c o m p le ti o n Implementation Plan: Australia’s First National Antimicrobial Resistance Strategy 2015–2019 23 P R IO R IT Y A R E A F O R A C T IO N 1 .2 : In c re a se s u p p o rt f o r h u m a n a n d a n im a l h e a lt h p ro fe ss io n a ls i n r e in fo rc in g k e y m e ss a g e s w it h p a ti e n ts a n d c li e n ts . O n e H e a lt h 1. 2. 1 Pr o vi d e an im al a n d h u m an h ea lt h p ro fe ss io n al s a su it e o f t o o ls a n d ed u ca ti o n al re so u rc es to re in fo rc e ke y m es sa g es to c o n su m er s vi a fo rm al t ra in in g a n d p ro vi si o n o f o n lin e co n su m er re so u rc es . N at io n al C en tr e fo r A n ti m ic ro b ia l St ew ar d sh ip * 20 16 o n w ar d s 1. 2. 2 In ve st ig at e m u lt ip le s ta ke h o ld er p er sp ec ti ve s ab o u t A M R (G Ps , m ed ic al sp ec ia lis ts , h o sp it al d o ct o rs , d en ti st s, v et er in ar y p ro fe ss io n al s) , t o id en ti fy w h at t h ey s ee a s b ar ri er s to a ch ie vi n g e ff ec ti ve m an ag em en t o f A M R an d id en ti fy fu tu re re se ar ch n ee d s an d p o lic y o p ti o n s. U n iv er si ty o f S yd n ey (M B I) D ec em b er 2 01 6 1. 2. 3 C o n ve n e tw o C it iz en s’ Ju ri es to d el ib er at e o n t h e fe as ib ili ty a n d fa ir n es s o f i n tr o d u ci n g d iff er en t m ec h an is m s to c h an g e co n su m er a n d p re sc ri b er b eh av io u r. U n iv er si ty o f S yd n ey (M B I; C RE ID ) A p r 2 01 7– Se p 2 01 7: fin di ng s p re se nt ed to k ey s ta ke ho ld er s an d fu rt he r a ct io ns im p le m en te d by e nd 20 17 1. 2. 4 U n d er ta ke re se ar ch to d et er m in e d o m in an t fa ct o rs in flu en ci n g d ec is io n m ak in g a b o u t an ti b io ti c u se b y G Ps , c o m m u n it y p h ar m ac is ts an d c o n su m er s in t h e A u st ra lia n p ri m ar y h ea lt h ca re s ec to r. Q u ee n sl an d U n iv er si ty o f Te ch n o lo g y (C RE R H A I), A u st ra lia n C en tr e fo r H ea lt h S er vi ce s In n o va ti o n Ju n e 20 17 H u m a n H e a lt h 1. 2. 5 a) D ev el o p p ap er b as ed p at ie n t d ec is io n a id s (P D A s) to s u p p o rt G Ps to en g ag e in s h ar ed d ec is io n m ak in g w it h p at ie n ts o n a n ti b io ti c u se fo r so re t h ro at , m id d le e ar c o m p la in ts a n d a cu te b ro n ch it is . b) P D A s tr ia lle d w ith a c om m un ity s am pl e of p ar en ts fo r e ffe ct o n an tic ip at ed fu tu re b eh av io ur a nd p ro ce ss m ea su re s (a cc ep ta bi lit y of th e PD A s) . c) P D A s tr ia lle d in a ra n d o m c lin ic al t ri al w it h G Ps w it h a n ti b io ti c d is p en si n g ra te s as a p ri n ci p al o u tc o m e. A C SQ H C , B o n d U n iv er si ty * a) P D A s co m p le te d N o ve m b er 2 01 5 b ) T o b e p u b lis h ed la te 2 01 6 c) T o b e p u b lis h ed la te 2 01 7 1. 2. 6 D ev el o p a g en er al p ra ct ic e ‘n u d g e’ to o lk it c o n ta in in g re so u rc es s u ch as G en er al P ra ct ic e p le d g e ce rt ifi ca te s, c o u n se lli n g re so u rc es a n d ac co m p an yi n g le afl et h o ld er s, c o n ve rs at io n t ip s fo r G Ps , A n ti b io ti c Sy m p to m at ic M an ag em en t Pa d , e d u ca ti o n a n d c o m m u n ic at io n to o ls fo r w ai ti n g ro o m s in cl u d in g e d u ca ti o n c ar to o n a n d c o lo u ri n g a ct iv it ie s fo r c h ild re n . N PS M ed ic in eW is e* Ju n e 20 16 1. 2. 7 D ev el o p in fo rm at io n t ar g et ed a t p at ie n ts a n d t h ei r G Ps re g ar d in g p ru d en t u se o f a n ti m ic ro b ia ls in in fe ct io n s fo r p at ie n ts w it h a d ia g n o si s o f m u lt i re si st an t o rg an is m s (a n d C . d iffi ci le ). A C T H ea lt h : C an b er ra H o sp it al & H ea lt h S er vi ce s, H ea lt h ca re A ss o ci at ed In fe ct io n S ta n d ar d s G ro u p 20 17 *D en o te s ac ti vi ty /i es fo r w h ic h t h e A u st ra lia n G o ve rn m en t h as p ro vi d ed fu n d in g . 24 A n im a l H e a lt h a n d A g ri c u lt u re 1. 2. 8 Pr es en ta ti o n s to a n im al h ea lt h p ro fe ss io n al s an d p ro d u ce rs w it h in th e fe ed lo t an d p ig in d u st ri es to im p ro ve t h ei r u n d er st an d in g o f t h e g lo b al a n d n at io n al s it u at io n re g ar d in g a n ti m ic ro b ia l r es is ta n ce , a n d th e im p o rt an ce o f r es p o n si b le u se to t h e m an ag em en t o f a n ti m ic ro b ia l re si st an ce a s an in d u st ry . Z o et is A u st ra lia O ct o b er 2 01 6 an d o n g o in g 1. 2. 9 C o m m u n ic at e ke y m es sa g es t h ro u g h m ee ti n g s, fa ct sh ee ts a n d s o ci al m ed ia to a n im al in d u st ri es , f ar m er s an d v et er in ar ia n s in Q u ee n sl an d ab o u t A M R an d t h e u se o f a n ti b io ti cs fo r f ar m a n im al s an d u p d at es o n A M R in li n e w it h t h e Q u ee n sl an d B io se cu ri ty A ct 2 01 4 (e ff ec ti ve o n 1 Ju ly 2 01 6) . B io se cu ri ty Q u ee n sl an d , Q u ee n sl an d G o ve rn m en t D ep ar tm en t o f A g ri cu lt u re a n d Fi sh er ie s O n g o in g — p ro g re ss re p o rt a n n u al ly fr o m D ec em b er 2 01 5 1. 2. 10 D ev el o p in fo rm at io n fo r v et er in ar ia n s, fa rm er s an d v et er in ar y st aff o n ri sk s as so ci at ed w it h a n ti m ic ro b ia l r es is ta n ce . V ic to ri an D ep ar tm en t o f E co n o m ic D ev el o p m en t, Jo b s, T ra n sp o rt a n d R es o u rc es Ju n e 20 17 1. 2. 11 R ev is e th e A C T Ve te ri n ar y Su rg eo n s St an d ar d s St at em en t to in co rp o ra te in fo rm at io n o n A M R an d t h e N at io n al A M R St ra te g y to g u id e th e re sp o n se to t h e th re at o f a n ti b io ti c m is u se a n d re si st an ce . Th is w o u ld b e p la ce d u n d er t h e se ct io n o f G u id el in e D o cu m en ts w it h a lin k to t h e A M R w eb si te . A C T Ve te ri n ar y Su rg eo n s B o ar d Ju n e 20 16 P R IO R IT Y A R E A F O R A C T IO N 1 .3 : S tr e n g th e n c o m m u n ic a ti o n a n d e d u c a ti o n i n it ia ti v e s fo r h e a lt h p ro fe ss io n a ls a n d h e a lt h c a re t e a m m e m b e rs . O n e H e a lt h 1. 3. 1 N at io n al c o o rd in at io n o f A n ti b io ti c A w ar en es s W ee k, t ak in g a O n e H ea lt h a p p ro ac h , t h ro u g h t h e A n ti b io ti c A w ar en es s W ee k W o rk in g G ro u p . T h e W o rk in g G ro u p p ro vi d es a fo ru m fo r a d vi ce a n d as si st an ce o n is su es re la ti n g to n at io n al c o o rd in at io n o f A n ti b io ti c A w ar en es s W ee k in A u st ra lia a n d e n ab le s in fo rm at io n s h ar in g a n d en su re s co n si st en t m es sa g es a cr o ss s ec to rs . M em b er s in cl u d e N PS M ed ic in eW is e, A u st ra lia n G o ve rn m en t D ep ar tm en t o f H ea lt h , A u st ra lia n G o ve rn m en t D ep ar tm en t o f A g ri cu lt u re a n d W at er R es o u rc es , t h e A u st ra lia n V et er in ar y A ss o ci at io n a n d s ta te a n d te rr it o ry h ea lt h d ep ar tm en ts . A C SQ H C * A n n u al ly in N o ve m b er 1. 3. 2 H u m an h ea lt h h o sp it al fo cu ss ed A n ti b io ti c A w ar en es s W ee k C am p ai g n in cl u d in g re so u rc es to s u p p o rt h o sp it al s in u n d er ta ki n g lo ca l A n ti b io ti c A w ar en es s W ee k ev en ts . A C SQ H C * A n n u al ly in N o ve m b er 1. 3. 3 C o n su m er a n d h ea lt h p ro fe ss io n al A n ti b io ti c A w ar en es s W ee k ca m p ai g n h ig h lig h ti n g s te p s th at h ea lt h p ro fe ss io n al s an d in d iv id u al s ca n t ak e to e n su re t h ey u se a n ti b io ti cs ju d ic io u sl y an d a p p ro p ri at el y. N PS M ed ic in eW is e* A n n u al ly in N o ve m b er S e c to r A c ti v it y /i e s Le a d O rg a n is a ti o n T im e fr a m e s fo r c o m p le ti o n Implementation Plan: Australia’s First National Antimicrobial Resistance Strategy 2015–2019 25 O n e H e a lt h 1. 3. 4 U n d er ta ke a n n u al c o n su m er c am p ai g n s fo r A n ti m ic ro b ia l A w ar en es s W ee k, in cl u d in g re le as e o f i n fo rm at io n fr o m t h e N at io n al A n ti m ic ro b ia l Pr es cr ib in g S u rv ey p ro g ra m s fr o m a O n e H ea lt h p er sp ec ti ve . N at io n al C en tr e fo r A n ti m ic ro b ia l St ew ar d sh ip * 20 16 o n w ar d s 1. 3. 5 A n ti m ic ro b ia l A w ar en es s W ee k ca m p ai g n fo cu ss in g o n A M S in co m p an io n a n im al s. N at io n al C en tr e fo r A n ti m ic ro b ia l St ew ar d sh ip * N o ve m b er 2 01 6 1. 3. 6 Pa rt ic ip at e in A n ti b io ti c A w ar en es s w ee k th ro u g h s ta ke h o ld er p ro m o ti o n a n d Q u al it y St an d ar d a rt ic le . A u st ra lia n A g ed C ar e Q u al it y A g en cy * N o ve m b er 2 01 6 1. 3. 7 Pr o vi d e tr ai n in g w o rk sh o p s an d o n lin e ed u ca ti o n al a ct iv it ie s to k ey h ea lt h p ro fe ss io n al s: p h ar m ac is ts , p h ys ic ia n s, in fe ct io n p re ve n ti o n n u rs es , g en er al p ra ct ic e n u rs es , v et er in ar ia n s, v et er in ar y n u rs es o n an ti m ic ro b ia l s te w ar d sh ip , A M R, a n ti b io ti c u se . N at io n al C en tr e fo r A n ti m ic ro b ia l St ew ar d sh ip * 20 16 o n w ar d s H u m a n H e a lt h 1. 3. 8 A ss es s th e A u st ra lia n N at io n al U n iv er si ty M ed ic al S ch o o l c u rr ic u lu m to in cl u d e le ct u re s o n a n ti m ic ro b ia l r es is ta n ce a n d a n ti m ic ro b ia l st ew ar d sh ip . A C T H ea lt h , A u st ra lia n N at io n al U n iv er si ty M ed ic al S ch o o l C o m p le te d 2 01 5 1. 3. 9 U p d at e Th e Ro ya l A us tr al ia n C ol le ge o f G en er al P ra ct it io ne rs (R A CG P) C ur ri cu lu m fo r A us tr al ia n G en er al P ra ct ic e 20 11 , i n cl u d in g t h e q u al it y u se o f m ed ic in es s ta te m en t w h ic h s p ec ifi ca lly in cl u d es A M R. Th e R o ya l A u st ra lia n C o lle g e o f G en er al P ra ct it io n er s Ju ly 2 01 6 1. 3. 10 U n d er ta ke re se ar ch to d et er m in e th e eff ec ti ve n es s o f o n lin e an d fa ce to f ac e tr ai n in g fo r e ar ly c ar ee r G Ps in c o m m u n ic at in g w it h p at ie n ts ab o u t A M R an d a n ti b io ti c u se . C h an g e th e A n ti b io ti c Pr es cr ib in g o f G en er al P ra ct ic e (C h A P) S tu d y, U n iv er si ty o f Q u ee n sl an d , f u n d ed b y R A C G P, T h er ap eu ti c G u id el in es Lt d , A u st ra lia n G o ve rn m en t D ep ar tm en t o f H ea lt h , B o n d U n iv er si ty , Q u ee n sl an d U n iv er si ty o f Te ch n o lo g y Ju n e 20 16 1. 3. 11 D ev el o p o n lin e tr ai n in g fo r G Ps (i n cl u d in g o ve rs ea s tr ai n ed ), w it h d iff er en t co lle g es ’ w eb b as ed le ar n in g s it es , t o c o m m u n ic at e w it h p at ie n ts o n t h e b en efi ts a n d h ar m s o f a n ti b io ti c u se . Fu n d ed b y A C SQ H C a n d s u p p o rt ed b y R A C G P an d o th er s p ec ia lis t co lle g es D ec em b er 2 01 6 1. 3. 12 D ev el o p o n lin e co m p et en cy t ra in in g a n d a ss es sm en t to e n su re IP C p ra ct it io n er s ar e p ro fic ie n t in s ta n d ar d is ed s u rv ei lla n ce m et h o d o lo g y. V IC N IS S C o o rd in at in g C en tr e Tr ai n in g m o d u le av ai la b le o n lin e si n ce A u g u st 2 01 5 *D en o te s ac ti vi ty /i es fo r w h ic h t h e A u st ra lia n G o ve rn m en t h as p ro vi d ed fu n d in g . 26 H u m a n H e a lt h 1. 3. 13 H ea lt h s er vi ce o rg an is at io n s to s u p p o rt t h e in cl u si o n o f n u rs es o n an ti m ic ro b ia l s te w ar d sh ip c o m m it te es . Ed u ca ti o n to s u p p o rt e n h an ce d k n o w le d g e an d d ev el o p m en t o f n u rs es , i n fe ct io n c o n tr o l p ra ct it io n er s an d n u rs e p ra ct it io n er s in an ti m ic ro b ia l m an ag em en t an d s te w ar d sh ip . A c h ap te r o n t h e ro le s o f n u rs es , I n fe ct io n C o n tr o l P h ys ic ia n s an d N u rs e Pr ac ti ti o n er s w ill b e in cl u d ed in t h e re vi si o n o f A n ti m ic ro b ia l St ew ar d sh ip in A u st ra lia n H o sp it al s. A C SQ H C , A u st ra lia n C o lle g e fo r In fe ct io n P re ve n ti o n a n d C o n tr o l, N at io n al C en tr e fo r A n ti m ic ro b ia l St ew ar d sh ip 20 16 –1 9 1. 3. 14 H o ld s ym p o si u m o n : A nt im ic ro bi al S te w ar ds hi p an d St an da rd s— th e ro ad to im pl em en ta ti on . W A H ea lt h Fu ll d ay e ve n t co m p le te d 2 01 4 an d 2 01 5 A n im a l H e a lt h a n d A g ri c u lt u re 1. 3. 15 Pr ov id e in fo rm at io n to v et er in ar y p ra ct iti on er s th ro ug h th e A us tr al ia n Ve te rin ar y A ss oc ia tio n (V ic to ria n Br an ch ) a nd V et er in ar y Pr ac tit io ne rs Re gi st ra tio n Bo ar d of V ic to ria o n th e ris ks a ss oc ia te d w ith A M R an d th e ne ed fo r j ud ic io us a nt ib io tic u se v ia w eb si te in fo rm at io n an d a ne w sl et te r a rt ic le . V ic to ri an D ep ar tm en t o f E co n o m ic D ev el o p m en t, Jo b s, T ra n sp o rt a n d R es o u rc es D ec em b er 2 01 6 P R IO R IT Y A R E A F O R A C T IO N 1 .4 : D e v e lo p a s ta k e h o ld e r e n g a g e m e n t a n d c o m m u n ic a ti o n p la n t o s u p p o rt w h o le o f so c ie ty a w a re n e ss o f, a n d p a rt ic ip a ti o n i n im p le m e n ti n g t h e S tr a te g y. O n e H e a lt h 1. 4. 1 D ev el o p a O n e H ea lt h w eb si te a s a ce n tr al re p o si to ry fo r t ru st ed in fo rm at io n a n d re so u rc es re la te d to a n ti b io ti c u se a n d a n ti m ic ro b ia l re si st an ce . A u st ra lia n G o ve rn m en t D ep ar tm en t o f H ea lt h w it h A u st ra lia n G o ve rn m en t D ep ar tm en t o f A g ri cu lt u re a n d W at er R es o u rc es * Ju n e 20 17 1. 4. 2 D ev el o p a s ta ke h o ld er e n g ag em en t an d c o m m u n ic at io n p la n to su p p o rt t h e im p le m en ta ti o n o f t h e N at io n al A M R St ra te g y. A u st ra lia n G o ve rn m en t D ep ar tm en t o f H ea lt h a n d A u st ra lia n G o ve rn m en t D ep ar tm en t o f A g ri cu lt u re a n d W at er R es o u rc es * D ec em b er 2 01 6 S e c to r A c ti v it y /i e s Le a d O rg a n is a ti o n T im e fr a m e s fo r c o m p le ti o n Implementation Plan: Australia’s First National Antimicrobial Resistance Strategy 2015–2019 27 S e c to r A c ti v it y /i e s Le a d O rg a n is a ti o n T im e fr a m e s fo r c o m p le ti o n O B JE C T IV E 2 : A N T IM IC R O B IA L S T E W A R D S H IP P R IO R IT Y A R E A F O R A C T IO N 2 .1 : E n su re t h a t ta il o re d , e v id e n c e b a se d a n ti b io ti c p re sc ri b in g g u id e li n e s a re a v a il a b le f o r a ll s e c to rs . H u m a n H e a lt h 2. 1. 1 U n d er ta ke a d ig it al t ra n sf o rm at io n p ro g ra m m e to im p ro ve t h e u sa b ili ty o f t h e El ec tr o n ic T h er ap eu ti c G u id el in es (e TG ), in cl u d in g t h e d ev el o p m en t o f a n ew v er si o n t h at is fu lly fu n ct io n al w it h m o b ile ap p lic at io n s fo r A p p le a n d A n d ro id d ev ic es . Th er ap eu ti c G u id el in es L td M ar ch 2 01 6 2. 1. 2 D ev el o p a n d t ri al o f a m o b ile a p p lic at io n to e n co u ra g e co m p lia n ce w it h e le ct ro n ic T h er ap eu ti c G u id el in es (e TG ) a n d lo ca l r es tr ic te d an ti m ic ro b ia l p o lic ie s, a n d e n co u ra g e st ep d o w n t h er ap y. N o rt h er n T er ri to ry D ep ar tm en t o f H ea lt h D ep lo ye d a cr o ss T o p En d H ea lt h S er vi ce (3 o f 5 h o sp it al s w it h in N T ) w it h h ig h u sa g e b y p re sc ri b er s 2. 1. 3 D ev el o p p ae d ia tr ic a n ti b io ti c g u id el in es fo r s ev er e se p si s an d s ep ti c sh o ck . Th e C h ild re n’ s H o sp it al a t W es tm ea d , U n iv er si ty o f S yd n ey (M B I), SW H ea lt h Ju ly 2 01 6: G u id el in es d is se m in at ed a cr o ss N SW h ea lt h fa ci lit ie s 2. 1. 4 IC U s p ec ifi c re g is te r o f H A P/ VA P an d in tr a ab d o m in al s ep si s to in fo rm e vi d en ce b as ed ju ri sd ic ti o n s p ec ifi c an ti m ic ro b ia l p re sc ri b in g g u id el in es . A C T H ea lt h 20 16 2. 1. 5 U n d er ta ke re se ar ch to d efi n e ri sk fa ct o rs to in fo rm c le ar s tr at ifi ca ti o n fo r b es t p ra ct ic e p re sc ri b in g fo r H o sp it al A cq u ir ed P n eu m o n ia . A C T H ea lt h 20 16 A n im a l H e a lt h a n d A g ri c u lt u re 2. 1. 6 D ev el o p s p ec ie s sp ec ifi c an ti b io ti c g u id el in es fo r u se b y ve te ri n ar ia n s an d v et er in ar y st u d en ts in t h e cl in ic al m an ag em en t o f p ig s, p o u lt ry , ca tt le , h o rs es a n d s h ee p . A u st ra lia n V et er in ar y A ss o ci at io n * an d A n im al M ed ic in es A u st ra lia M ay 2 01 6– Ju n 2 01 8 P R IO R IT Y A R E A F O R A C T IO N 2 .2 : E n su re t h e a v a il a b il it y o f e v id e n c e b a se d , b e st p ra c ti c e a n d n a ti o n a ll y c o n si st e n t a p p ro a c h e s to A M S a c ro ss h u m a n h e a lt h a n d a n im a l c a re s e tt in g s. O n e H e a lt h 2. 2. 1 Id en ti fy a n d a ss es s in te rv en ti o n s to re d u ce A U in c o m p an io n a n d p ro d u ct io n a n im al s. Id en ti fy li n ks b et w ee n A U in a n im al p ro d u ct io n sy st em s an d d ev el o p m en t o f r es is ta n ce in b ac te ri al s p ec ie s th at m ay h av e im p lic at io n s fo r h u m an a n d a n im al h ea lt h . N at io n al C en tr e fo r A n ti m ic ro b ia l St ew ar d sh ip * 20 20 *D en o te s ac ti vi ty /i es fo r w h ic h t h e A u st ra lia n G o ve rn m en t h as p ro vi d ed fu n d in g . 28 H u m a n H e a lt h 2. 2. 2 Ex am in e ex is ti n g m o d el s o f A M S in ru ra l a n d re g io n al a re as in cl u d in g te le h ea lt h a n d p h ar m ac y le d in te rv en ti o n s to p ro vi d e ed u ca ti o n a n d tr ai n in g re so u rc es , t o o ls a n d re m o te s u p p o rt . N at io n al C en tr e fo r A n ti m ic ro b ia l St ew ar d sh ip * 20 16 –1 9 2. 2. 3 Ex am in e th e ro le o f n u rs es in A M S an d id en ti fy e d u ca ti o n n ee d s. D ev el o p s p ec ifi c to o ls a n d re so u rc es to s u p p o rt n u rs es in t h is ro le . N at io n al C en tr e fo r A n ti m ic ro b ia l St ew ar d sh ip * 20 16 –1 9 2. 2. 4 Su p p o rt t h e u se o f a p p ro p ri at e, ro u ti n e m ic ro b io lo g ic al in ve st ig at io n s fo r r es p ir at o ry t ra ct in fe ct io n s in a g ed c ar e h o m es . I d en ti fy t h e o p in io n s o f h ea lt h p ro fe ss io n al s, a n d re si d en ts a n d s ig n ifi ca n t o th er s, o f a n ti b io ti c u se fo r e n d o f lif e re sp ir at o ry t ra ct in fe ct io n s in a g ed c ar e h o m es , a n d d et er m in e th ei r p er ce p ti o n s o f A M S in it ia ti ve s fo r e n d o f lif e re sp ir at o ry t ra ct in fe ct io n s. N at io n al C en tr e fo r A n ti m ic ro b ia l St ew ar d sh ip * 20 16 –1 9 2. 2. 5 U n d er ta ke a n e co n o m ic e va lu at io n o f A M S p ro g ra m m es in m et ro p o lit an A u st ra lia n H o sp it al s to s u p p o rt p o lic y d ec is io n s, a n d re so u rc e al lo ca ti o n s. Q u ee n sl an d U n iv er si ty o f Te ch n o lo g y (C RE R H A I) D ec em b er 2 01 6 2. 2. 6 In ve st ig at e th e fe as ib ili ty o f r ap id d ia g n o st ic t ar g et in g o f t ra n sm is si b le A M R in b ac te ri a in o rd er to d ev el o p c h ea p ra p id s cr ee n in g a n d d ia g n o si s U n iv er si ty o f S yd n ey , W IM R an d M B I (C RE C I) M ar ch 2 01 7 2. 2. 7 Pr o d u ce re so u rc es to a ss is t in in fo rm ed p re sc ri b in g o f a n ti b io ti cs to tr ea t sk in in fe ct io n s an d u p p er re sp ir at o ry t ra ct in fe ct io n s co m m o n ly ca u se d b y b ac te ri a. N PS M ed ic in eW is e* M ay 2 01 6 2. 2. 8 U n d er ta ke re se ar ch to e st im at e o f t h e ab so lu te ra te o f a n ti b io ti c p re sc ri b in g in p ri m ar y ca re if g u id el in es a re a d h er ed to . C RE M A R A , B o n d U n iv er si ty w it h B EA C H M id 2 01 6 2. 2. 9 M o d el lin g o f t h e eff ec ts o f A M S in te rv en ti o n s o n a n ti b io ti c p re sc ri b in g in p ri m ar y ca re to d et er m in e th e m o st im p o rt an t in te rv en ti o n s to ro ll o u t in a n y ca m p ai g n . C RE M A R A , B o n d U n iv er si ty * La te 2 01 7 2. 2. 10 Re p or t o n th e u se o f a n ti b io ti cs to tr ea t u ri n ar y tr ac t i n fe ct io n s in re si d en ti al a g ed c ar e fa ci lit ie s u si n g W eb st er C ar e M ed ic at io n M an ag em en t S of tw ar e. N PS M ed ic in eW is e w it h W eb st er C ar e* O n g o in g 2. 2. 11 Fe ed b ac k to G Ps o n a n ti b io ti c p re sc ri b in g h ab it s to a ss is t G Ps to re fle ct o n o w n p re sc ri b in g p ra ct ic es a n d a llo w c o m p ar is o n w it h p ee rs t h ro u g h M ed ic in eI n si g h t. N PS M ed ic in eW is e* A p ri l 2 01 6 S e c to r A c ti v it y /i e s Le a d O rg a n is a ti o n T im e fr a m e s fo r c o m p le ti o n Implementation Plan: Australia’s First National Antimicrobial Resistance Strategy 2015–2019 29 H u m a n H e a lt h 2. 2. 12 Th e N at io n al A n ti m ic ro b ia l P re sc ri b in g S u rv ey p ro g ra m is a lr ea d y es ta b lis h ed a n d is w o rk in g o n a d d it io n al p ro g ra m s w it h a g ed c ar e, su rg er y an d v et er in ar ia n s. T h e ai m o f t h e p ro g ra m is to p ro vi d e d at a fo r a ct io n fo r p re sc ri b er s— in cl u d es u se r d as h b o ar d re p o rt s, b en ch m ar ki n g , a n d a cc es s to d at a fo r a n al ys is . N at io n al C en tr e fo r A n ti m ic ro b ia l St ew ar d sh ip in c o lla b o ra ti o n w it h th e A C SQ H C * O n g o in g 2. 2. 13 D es ig n , t ri al a n d e va lu at e in te rv en ti o n s to id en ti fy t h o se t h at im p ro ve p re sc ri b in g p ra ct ic e. W o rk w it h G Ps to u n d er st an d t h ei r a tt it u d es a n d ed u ca ti o n al n ee d s w it h re g ar d to a n ti b io ti c p re sc ri b in g . U ti lis e th e M el b o u rn e Ea st M o n as h G P d at ab as e (M A G N ET ) t o lo o k at p at te rn s o f A U a n d a d h er en ce to g u id el in es . N at io n al C en tr e fo r A n ti m ic ro b ia l St ew ar d sh ip w it h D ep ar tm en t o f G en er al P ra ct ic e at M o n as h U n iv er si ty * 20 18 A n im a l H e a lt h a n d A g ri c u lt u re 2. 2. 14 D ev el o p a n d p ilo t an A M S p ro g ra m a p p ro p ri at e fo r u se in c o m p an io n an im al v et er in ar y p ra ct ic es . A u st ra lia n V et er in ar y A ss o ci at io n M ar 2 01 6– D ec 2 01 7 2. 2. 15 Su rv ey a tt it u d es to a n ti m ic ro b ia l p re sc ri b in g in c o m p an io n a n d p ro d u ct io n a n im al s. D ev el o p a n d a ss es s m et h o d s fo r m o n it o ri n g A U in c o m p an io n a n d p ro d u ct io n a n im al s at t h e ve te ri n ar y p ra ct ic e le ve l. N at io n al C en tr e fo r A n ti m ic ro b ia l St ew ar d sh ip * 20 19 2. 2. 16 In ve st ig at e th e re la ti o n sh ip b et w ee n u se o f d ia g n o st ic m ic ro b io lo g y an d a n ti m ic ro b ia l p re sc ri b in g /u se in v et er in ar y p ra ct ic es . U n iv er si ty o f S yd n ey C lin ic al Sc h o o ls , M B I 20 16 : K ey s ta ke ho ld er s, p ro ce d ur es a nd in fr as tr uc tu re es ta b lis he d 20 17 : p re lim in ar y d at a an al ys ed a n d p re se n te d 2. 2. 17 D ev el o p a n d p ro m o te a n A M S p ro g ra m t h at d o cu m en ts a rr an g em en ts o n fe ed lo ts to re d u ce a n ti b io ti c u sa g e an d e n su re t h ey a re ju d ic io u sl y m an ag ed to m in im is e ri sk o f A M R. M ea t & L iv es to ck A u st ra lia Pr o g re ss re p o rt D ec em b er 2 01 6 2. 2. 18 a) E n g ag e th e d ai ry in d u st ry s u p p ly c h ai n in t h e ad o p ti o n o f t h e G ui de t o Pr ud en t U se o f A nt im ic ro bi al A ge nt s fo r D ai ry P ro du ct io n— d ai ry p ro ce ss o rs to re vi ew t h e m o n it o ri n g o f a n ti m ic ro b ia l u se a n d d ev el o p m en t o f a n im al h ea lt h a ss es sm en t to o l f o r f ar m er s. b ) E n g ag em en t o f C at tl e M ed ic in e C h ap te r o f A u st ra lia n C o lle g e o f Ve te ri n ar y Sc ie n ce . D ai ry A u st ra lia a) D ec em b er 2 01 6 b ) J u ly 2 01 5 2. 2. 19 Fr am ew or k fo r A M S im pl em en te d w ith in e ac h of th e m aj or c hi ck en m ea t co m pa ni es fo r i nt er na l r ep or tin g (r ea ss es s in 2 01 7 fo r c ol la tin g in du st ry d at a) A u st ra lia n C h ic ke n M ea t Fe d er at io n D ec em b er 2 01 6 *D en o te s ac ti vi ty /i es fo r w h ic h t h e A u st ra lia n G o ve rn m en t h as p ro vi d ed fu n d in g . 30 P R IO R IT Y A R E A F O R A C T IO N 2 .3 : D e v e lo p t a il o re d , e v id e n c e b a se d r e so u rc e s to s u p p o rt t h e i m p le m e n ta ti o n o f A M S p ro g ra m m e s. H u m a n H e a lt h 2. 3. 1 Pi lo t a s et o f e vi d en ce b as ed in te rv en tio ns a im ed a t r ed uc in g G P an tim ic ro b ia l p re sc rib in g ra te s fo r a cu te re sp ira to ry in fe ct io ns in g en er al p ra ct ic e. G en er al P ra ct it io n er A n ti m ic ro b ia l St ew ar d sh ip P ro g ra m m e St u d y, U n iv er si ty o f Q u ee n sl an d w it h B o n d U n iv er si ty a n d t h e Q u ee n sl an d U n iv er si ty o f T ec h n o lo g y* Ju n e 20 16 2. 3. 2 U p d at e o f t h e A n ti m ic ro b ia l S te w ar d sh ip in A u st ra lia n H o sp it al s p u b lic at io n to s u p p o rt in fo rm ed a n ti m ic ro b ia l p re sc ri b in g a n d u se . Th e re vi si o n w ill in cl u d e ch ap te rs o n A M S in g en er al p ra ct ic e, a g ed ca re , p ri va te s ec to r, d en ta l p ra ct ic e, ru ra l a n d re m o te s ec to r a n d h ea lt h se rv ic es fo r A b o ri g in al a n d T o rr es S tr ai t Is la n d er p eo p le s. A C SQ H C w it h t h e A n ti m ic ro b ia l St ew ar d sh ip A d vi so ry C o m m it te e* La u n ch b y D ec em b er 20 16 2. 3. 3 D ev el o p a ra n g e o f r es o u rc es to a ss is t w it h t h e im p le m en ta ti o n o f A M S p ro g ra m s in a ra n g e o f s et ti n g s. A C SQ H C * Ju n e 20 16 2. 3. 4 Im p le m en t th e G u id an ce A M S n o t fo r p ro fit w eb b as ed to o l t o su p p o rt A M S w o rk flo w in h o sp it al s in cl u d in g a n a p p ro va l s ys te m to m an ag e an ti m ic ro b ia l f o rm u la ry a n d w ar d ro u n d to o l w it h te le h ea lt h ca p ab ili ti es . G u id an ce G ro u p a t th e R o ya l M el b o u rn e H o sp it al w it h t h e N at io n al C en tr e fo r A n ti m ic ro b ia l St ew ar d sh ip 20 16 –1 8 2. 3. 5 D ev el o p a u n iq u e in d ic at io n s d at ab as e to m ap to S n o M ed C T. T h e in te n ti o n is fo r a ll eH ea lt h s ys te m s to u se t h is in fe ct io n s in d ic at io n li st to s u p p o rt re p o rt in g a n d c lin ic al re se ar ch . G u id an ce G ro u p a t th e R o ya l M el b o u rn e H o sp it al w it h t h e N at io n al C en tr e fo r A n ti m ic ro b ia l St ew ar d sh ip 20 16 2. 3. 6 R es o u rc e o n R ep or ti ng o f a nt ib io ti cs : E nh an ce m en t o f r ep or ti ng o r co m m en ts re ga rd in g th e se le ct io n of a nt ib io ti cs p ro d u ce d . R o ya l C o lle g e o f P at h o lo g is ts o f A u st ra la si a A p r 2 01 6– A p r 2 01 8 2. 3. 7 R es o u rc e o n K efl ex fo r p re ve n ti o n o f U TI s: L o n g te rm lo w d o se K efl ex fo r p re ve n ti o n o f U TI s p ro d u ce d . R o ya l C o lle g e o f P at h o lo g is ts o f A u st ra la si a A p r 2 01 6– A p r 2 01 7 2. 3. 8 R es o u rc e o n O ra l A nt ib io ti c Tr ea tm en t: Tr ea tm en t w it h or al a nt ib io ti cs fo r of te n co lo ni ze d ch ro ni c va sc ul ar u lc er s p ro d u ce d . R o ya l C o lle g e o f P at h o lo g is ts o f A u st ra la si a A p r 2 01 6– A p r 2 01 7 2. 3. 9 R es o u rc e o n L on g Te rm A nt ib io ti c Tr ea tm en t: Lo ng te rm a nt ib io ti c tr ea tm en t f or L ym e D is ea se a nd C hr on ic F at ig ue S yn dr om e p ro d u ce d . R o ya l C o lle g e o f P at h o lo g is ts o f A u st ra la si a A p r 2 01 6– O ct 2 01 7 2. 3. 10 D ev el o p a W es te rn A u st ra lia n A M S Po lic y w h ic h o u tl in es m an d at o ry re q u ir em en ts to e n su re im p le m en ta ti o n o f A M S p ro g ra m s in W es te rn A u st ra lia n H ea lt h h ea lt h ca re fa ci lit ie s. W A H ea lt h A M S O p er at io n al D ir ec ti ve re le as ed Se p te m b er 2 01 5. O ng oi ng m on ito rin g an d e va lu at io n of p ol ic y p la nn ed . S e c to r A c ti v it y /i e s Le a d O rg a n is a ti o n T im e fr a m e s fo r c o m p le ti o n Implementation Plan: Australia’s First National Antimicrobial Resistance Strategy 2015–2019 31 H u m a n H e a lt h 2. 3. 11 D ev el o p g u id an ce to im p ro ve t h e ap p ro p ri at e p re sc ri b in g o f an ti m ic ro b ia ls fo r s u rg ic al p ro p h yl ax is . A C SQ H C in c o n ju n ct io n w it h t h e R o ya l A u st ra la si an C o lle g e o f Su rg eo n s an d t h e N at io n al C en tr e fo r A n ti m ic ro b ia l S te w ar d sh ip * 20 16 –1 8 *D en o te s ac ti vi ty /i es fo r w h ic h t h e A u st ra lia n G o ve rn m en t h as p ro vi d ed fu n d in g . P R IO R IT Y A R E A F O R A C T IO N 2 .4 : R e v ie w e x is ti n g a c c re d it a ti o n a n d q u a li ty a ss u ra n c e p ro g ra m m e s to e n su re t h e y a p p ro p ri a te ly s u p p o rt a n d e n c o u ra g e c o m p li a n c e w it h b e st p ra c ti c e A M S a p p ro a c h e s. H u m a n H e a lt h 2. 4. 1 U p d at e th e N at io na l S af et y an d Q ua lit y H ea lt h Se rv ic e St an da rd s, St an da rd 3 : P re ve nt in g an d co nt ro lli ng h ea lt hc ar e as so ci at ed in fe ct io ns to p ro vi d e re so u rc es fo r a d d it io n al s et ti n g s su ch a s h o sp it al s an d d ay p ro ce d u re s er vi ce s, d en ta l p ra ct ic es , c o m m u n it y h ea lt h s er vi ce s an d sm al l r u ra l h ea lt h s er vi ce s. A C SQ H C * TB C 2. 4. 2 R ev ie w o f a g ed c ar e st an d ar d s an d re la te d d o cu m en ts to p ro m o te m at er ia ls s u p p o rt in g A M S. A u st ra lia n G o ve rn m en t D ep ar tm en t o f H ea lt h * 20 16 –1 8 2. 4. 3 D ev el o p A M S st an d ar d s in A g ed C ar e fa ci lit ie s fo r i n cl u si o n w it h ac cr ed it at io n a n d q u al it y as su ra n ce p ro g ra m s. N at io n al C en tr e fo r A n ti m ic ro b ia l St ew ar d sh ip w it h A C SQ H C a n d A u st ra lia n G o ve rn m en t D ep ar tm en t o f H ea lt h * 20 16 –1 8 2. 4. 4 R ev ie w o f t h e R o ya l A u st ra lia n C o lle g e o f G en er al P ra ct it io n er s St an d ar d s fo r G en er al P ra ct ic e (4 th E d it io n ). Th e R o ya l A u st ra lia n C o lle g e o f G en er al P ra ct it io n er s O ct o b er 2 01 7 A n im a l H e a lt h a n d A g ri c u lt u re 2. 4. 5 R ev ie w a n d u p d at e th e N at io n al F ee d lo t A cc re d it at io n S ch em e to e n su re t h at it a p p ro p ri at el y su p p o rt s an d e n co u ra g es fe ed lo t co m p lia n ce w it h re le va n t re g u la ti o n s an d b es t p ra ct ic e ar ra n g em en ts in A M S o n fe ed lo ts . M ea t & L iv es to ck A u st ra lia Pr o g re ss re p o rt D ec em b er 2 01 6 A n im a l H e a lt h a n d A g ri c u lt u re 2. 3. 12 D ev el o p e vi d en ce b as ed re so u rc es to s u p p o rt t h e im p le m en ta ti o n o f a ch ic ke n m ea t A M S (t h at c an b e ea si ly t ai lo re d fo r o th er p o u lt ry m ea t in d u st ri es e .g . t u rk ey ) A u st ra lia n C h ic ke n M ea t Fe d er at io n O ct o b er 2 01 6 32 S e c to r A c ti v it y /i e s Le a d O rg a n is a ti o n T im e fr a m e s fo r c o m p le ti o n P R IO R IT Y A R E A F O R A C T IO N 2 .5 : S tr e n g th e n e x is ti n g m e a su re s to b e tt e r su p p o rt a p p ro p ri a te a n d j u d ic io u s u se . O n e H e a lt h 2. 5. 1 C o n ti n u e to e n h an ce G u id an ce A M S an d N at io n al A n ti m ic ro b ia l Pr es cr ib in g S u rv ey to s u p p o rt a n d m ea su re e ffi ci en t an d ju d ic io u s an ti m ic ro b ia l u se . N at io n al C en tr e fo r A n ti m ic ro b ia l St ew ar d sh ip * 20 16 –2 0 2. 5. 2 C o n ti n u e to fu n d t h e N at io n al R et u rn o f U n w an te d M ed ic in es L im it ed (N at RU M ) w h ic h p ro vi d es fo r t h e co lle ct io n a n d e n vi ro n m en ta lly fr ie n d ly d is p o sa l o f u n w an te d o r u n u se d m ed ic in es . H ea lt h c ar e co n su m er s ar e ab le to re tu rn t h ei r m ed ic in es to a n y p h ar m ac y in A u st ra lia , f re e o f c h ar g e, fo r d is p o sa l. Th is p re ve n ts m ed ic at io n m is u se , re d u ce s th e ri sk o f m ed ic in e re la te d h ar m to c h ild re n , a n d p re ve n ts en vi ro n m en ta l c o n ta m in at io n b y m ed ic in es , i n cl u d in g a n ti b io ti cs . A u st ra lia n G o ve rn m en t D ep ar tm en t o f H ea lt h w it h N at io n al R et u rn o f U n w an te d M ed ic in es L td * Ju n e 20 18 H u m a n H e a lt h 2. 5. 3 O n g o in g im p le m en ta ti o n a n d re vi ew o f t h e re st ri ct ed a n ti m ic ro b ia l p o lic y an d a p p ro va l s ys te m in t h e N o rt h er n T er ri to ry (N T ) w h ic h al lo ca te s al l a n ti m ic ro b ia ls li st ed o n t h e N T fo rm u la ry in to t h re e ca te g o ri es : A — n o a p p ro va l r eq u ir ed B — ap p ro va l r eq u ir ed w it h in 4 8 h o u rs o f i n it ia ti o n C — ap p ro va l r eq u ir ed p ri o r t o in it ia ti o n Th is a p p ro ac h e n co u ra g es t h e u se o f n ar ro w s p ec tr u m a n ti m ic ro b ia ls an d a llo w s fo r s p ec ia lis t in p u t w h en b ro ad er s p ec tr u m o r c o m p le x an ti m ic ro b ia ls a re re q u ir ed . N o rt h er n T er ri to ry D ep ar tm en t o f H ea lt h O n g o in g — re vi ew ed tr ie n n ia lly o r a s n ew ev id en ce b ec o m es av ai la b le 2. 5. 4 R ev ie w t h e p u b lic at io n M ed ic al c ar e of o ld er p er so ns in re si de nt ia l ag ed c ar e fa ci lit ie s (t h e Si lv er B o o k) to e n su re it p ro vi d es a p p ro p ri at e in fo rm at io n o n A M R. Th e R o ya l A u st ra lia n C o lle g e o f G en er al P ra ct it io n er s 20 17 2. 5. 5 Pi lo t an A M S p ro g ra m in re si d en ti al a g ed c ar e fa ci lit ie s w h ic h u ti lis es a ra n g e o f m ec h an is m s to im p ro ve h ea lt h o u tc o m es o f R A C F re si d en ts . Th is p ilo t w ill b e u se d to in fo rm t h e tr an sf er ab ili ty o f t h e A M S p ro g ra m ac ro ss a g ed c ar e fa ci lit ie s an d lo ca l h ea lt h n et w o rk p ro vi d er s. So u th er n A d el ai d e Lo ca l H ea lt h N et w o rk (S A LH N ) Ju n e 20 17 A n im a l H e a lt h a n d A g ri c u lt u re 2. 5. 6 Su p p o rt m as ti ti s p re ve n ti o n a n d c o n tr o l w it h g u id an ce a n d to o ls fo r s el ec ti ve t re at m en t o f c o w s— re vi si o n o f g u id el in es fo r d ry c o w th er ap y. D ai ry A u st ra lia Ju n e 20 16 Implementation Plan: Australia’s First National Antimicrobial Resistance Strategy 2015–2019 33 S e c to r A c ti v it y /i e s Le a d O rg a n is a ti o n T im e fr a m e s fo r c o m p le ti o n *D en o te s ac ti vi ty /i es fo r w h ic h t h e A u st ra lia n G o ve rn m en t h as p ro vi d ed fu n d in g . O B JE C T IV E 3 : S U R V E IL LA N C E P R IO R IT Y A R E A F O R A C T IO N 3 .1 : E st a b li sh t h e f o u n d a ti o n s fo r n a ti o n a l O n e H e a lt h s u rv e il la n c e . O n e H e a lt h 3. 1. 1 Ex te n d N at io n al A n ti m ic ro b ia l P re sc ri b in g S u rv ey in to a ll se ct o rs o f h u m an a n d a n im al h ea lt h c ar e in cl u d in g a g ed c ar e, p ri m ar y ca re a n d ve te ri n ar ia n , a n d e n ab le c o m b in in g o f b o th p re sc ri b in g a n d re si st an ce d at a. N at io n al C en tr e fo r A n ti m ic ro b ia l St ew ar d sh ip * 20 16 –2 0 H u m a n H e a lt h 3. 1. 2 D ev el o p a n at io n al s u rv ei lla n ce s ys te m fo r h u m an h ea lt h to b u ild o n ex is ti n g p ro g ra m s an d d at a co lle ct io n s at t h e st at e/ te rr it o ry le ve l a n d th e n at io n al le ve l, as w el l a s es ta b lis h c ap ac it y fo r f u tu re in te g ra ti o n w it h a n im al h ea lt h a n d a g ri cu lt u ra l s u rv ei lla n ce . Th e n at io n al s u rv ei lla n ce s ys te m w ill c o lle ct , c o o rd in at e, a n al ys e, a n d re p o rt A M R an d A U s u rv ei lla n ce d at a fr o m m u lt ip le s so u rc es c o ve ri n g b o th h o sp it al a n d c o m m u n it y se tt in g s in p ar tn er sh ip w it h e xi st in g p ro g ra m s. Fu rt h er d et ai l t h e o n t h is a ct iv it y is p ro vi d ed u n d er 3 .5 . A C SQ H C t h ro u g h t h e A U R A p ro je ct * Ju n e 20 16 : s ys te m es ta b lis h ed a n d fi rs t n at io n al re p o rt A n im a l H e a lt h a n d A g ri c u lt u re 3. 1. 3 Im p ro ve re g u la r r ep o rt in g o f i m p o rt s, e xp o rt s an d m an u fa ct u re o f ac ti ve c o n st it u en ts in v et er in ar y m ed ic in es . A u st ra lia n P es ti ci d es a n d V et er in ar y M ed ic in es A u th o ri ty a n d t h e A u st ra lia n G o ve rn m en t D ep ar tm en t o f A g ri cu lt u re a n d W at er R es o u rc es * 20 15 –1 6 co lle ct io n in Q 1 20 16 –1 7 P R IO R IT Y A R E A F O R A C T IO N 3 .2 : A g re e t h e o b je c ti v e s o f su rv e il la n c e f o r e a c h s e c to r, e n su ri n g t h e y a li g n w it h t h e o v e ra rc h in g o b je c ti v e s fo r th e n a ti o n a l O n e H e a lt h s u rv e il la n c e s y st e m . O n e H e a lt h 3. 2. 1 D ev el o p a u d it to o ls to g et h er w it h e ac h s ec to r t o e n su re d at a is m ea n in g fu l, en co u ra g e cr o ss s ec to r c o lla b o ra ti o n a n d e n co u ra g e u ti lis at io n o f u n iq u e in d ic at io n s d at as et . N at io n al C en tr e fo r A n ti m ic ro b ia l St ew ar d sh ip * 20 16 –2 0 H u m a n H e a lt h 3. 2. 2 D ev el o p c le ar o b je ct iv es fo r h u m an h ea lt h s u rv ei lla n ce t h at w ill g u id e sy st em d ev el o p m en t n o w a n d in to t h e fu tu re , i n cl u d in g s ys te m s co p e, p ri o ri ty a re as , e n d u se s o f d at a, a n d a p p ro p ri at e re p o rt in g c yc le s. N at io n al C en tr e fo r E p id em io lo g y an d P o p u la ti o n H ea lt h a n d t h e A u st ra lia n G o ve rn m en t D ep ar tm en t o f H ea lt h C o m p le te d N o ve m b er 20 15 34 H u m a n H e a lt h 3. 2. 3 U n d er ta ke re se ar ch t h ro u g h t h e A u st ra lia n N at io n al H ea lt h ca re A ss o ci at ed In fe ct io n S u rv ei lla n ce P ro g ra m (P h D p ro je ct ) t o p ro vi d e re co m m en d at io n s fo r a n at io n al in fe ct io n s u rv ei lla n ce p ro g ra m , w h ic h m ay t ra n sl at e ac ro ss to A M R su rv ei lla n ce . Q u ee n sl an d U n iv er si ty o f Te ch n o lo g y (C RE R H A I) Ju ly 2 01 6 3. 2. 4 D ev el o p a n A C T H ea lt h p o lic y o n s u rv ei lla n ce a n d m an ag em en t o f A M R th ro u g h a n A C T H ea lt h w id e an ti m ic ro b ia l r es is ta n ce in te re st g ro u p . C an b er ra H o sp it al a n d H ea lt h Se rv ic es , A C T Pa th o lo g y 20 17 P R IO R IT Y A R E A F O R A C T IO N 3 .3 : D e v e lo p l is ts o f p ri o ri ty o rg a n is m s a n d a ss o c ia te d a n ti m ic ro b ia ls f o r n a ti o n a l re p o rt in g . H u m a n H e a lt h 3. 3. 1 D ev el o p a n d m ai n ta in a li st o f p ri o ri ty o rg an is m s an d a ss o ci at ed an ti m ic ro b ia ls fo r r ep o rt in g t h ro u g h t h e n at io n al h u m an h ea lt h su rv ei lla n ce s ys te m . A C SQ H C t h ro u g h t h e A U R A p ro je ct * A n n u al ly , o r m o re re g u la rl y as re q u ir ed 3. 3. 2 D ev el o p s ta te w id e se rv ic e to p ro vi d e g en o m ic a n al ys is o f o u tb re ak s o f p at h o g en s o f p u b lic h ea lt h s ig n ifi ca n ce . U n iv er si ty o f S yd n ey (M B I), N SW H ea lt h P at h o lo g y (C RE ID ) Ju n e 20 16 : r ep o rt o n fir st p ro je ct s M ar 2 01 7: e st ab lis h ed ar ch it ec tu re fo r n et w o rk in g o f p la tf o rm s w it h p ar tn er s in o th er s ta te s Ju n e 20 17 : i n it ia l p ro je ct o u tc o m es co m m u n ic at ed to k ey st ak eh o ld er s 3. 3. 3 D ev el o p n at io n al n et w o rk to p ro vi d e g en et ic a n d g en o m ic a n al ys is o f o u tb re ak s o f t ra n sm is si b le a n ti b io ti c re si st an ce o f m aj o r p u b lic h ea lt h im p o rt an ce . U n iv er si ty o f S yd n ey W IM R & M B I (C RE C I) Ju n e 20 16 : fi rs t n at io n al m ee ti n g G N S ep si s o u tc o m es p ro g ra m (G N SO P) ; p u b lic at io n o f d et ai le d g en et ic a n al ys is o f tr an sm is si b le g en e p o o l i n E . c ol i & K. p ne um on ia e (A u st ra lia n a n d in te rn at io n al p ar tn er s ) S e c to r A c ti v it y /i e s Le a d O rg a n is a ti o n T im e fr a m e s fo r c o m p le ti o n Implementation Plan: Australia’s First National Antimicrobial Resistance Strategy 2015–2019 35 H u m a n H e a lt h 3. 3. 4 O n lin e p u b lic at io n o f T as m an ia n p u b lic h o sp it al h ea lt h ca re a ss o ci at ed in fe ct io n s u rv ei lla n ce re p o rt s w h ic h p ro vi d es d at a o n p ri o ri ty o rg an is m s. Pu b lic H ea lt h S er vi ce s, T as m an ia Q u ar te rl y an d a n n u al re p o rt s p ro d u ce d 3. 3. 5 C ar b ap en em as e p ro d u ci n g E nt er ob ac te ri ac ea e (C PE ) c as es n o ti fia b le in Ta sm an ia . Pu b lic H ea lt h S er vi ce s, T as m an ia C o m p le te d J an u ar y 20 16 O n g o in g m o n it o ri n g an d re p o rt in g o f d at a P R IO R IT Y A R E A F O R A C T IO N 3 .4 : A g re e a n d i m p le m e n t a u n if o rm s ta n d a rd f o r la b o ra to ry t e st in g m e th o d s fo r a n ti b a c te ri a l su sc e p ti b il it y. H u m a n H e a lt h 3. 4. 1 Es ta b lis h m en t o f a W o rk in g G ro u p to c h ar ac te ri se p ro ce ss es w h er eb y ju ri sd ic ti o n al p u b lic h ea lt h a g en ci es a re in vo lv ed in t h e su rv ei lla n ce an d re sp o n se to m u lt i re si st an t o rg an is m s, p ar ti cu la rl y in c o m m u n it y se tt in g s, a n d t h e re sp ec ti ve ro le s an d c o o rd in at io n o f p u b lic h ea lt h , co m m u n it y an d h o sp it al f o cu ss ed a g en ci es . C o m m u n ic ab le D is ea se N et w o rk A u st ra lia (C D N A ) v ia a M u lt i R es is ta n t O rg an is m s W o rk in g G ro u p 20 16 –1 7 3. 4. 2 D ev el o p a n a p p ro ac h a n d t im ef ra m es fo r a ch ie vi n g s ta n d ar d is ed d efi n it io n s o f ‘ re si st an ce ’ f o r l ab o ra to ri es a n d a g re ed d efi n it io n fo r d at a co lle ct io n fo r k ey b ac te ri a. A C SQ H C t h ro u g h t h e A U R A p ro je ct * C o m p le te d D ec em b er 2 01 5 3. 4. 3 D ev el o p m en t o f s ta n d ar d s, q u al it y sy st em s an d e d u ca ti o n to o ls o n ev id en ce b as ed b es t p ra ct ic e o n in d ic at io n s fo r s p ec im en c o lle ct io n an d p er fo rm in g m ic ro b io lo g y la b o ra to ry te st s an d re su lt in te rp re ta ti o n . Pa th W es t B as el in e m o n it o ri n g sy st em is c u rr en tl y b ei n g d ev el o p ed . C o m m en ce c lin ic al co lla b o ra ti o n fo r im p ro ve m en t in 2 01 6. A n im a l H e a lt h a n d A g ri c u lt u re 3. 4. 4 Ev al u at io n a n d a d o p ti o n o f C lin ic al a n d L ab o ra to ry S ta n d ar d s In st it u te d is c d iff u si o n m et h o d o lo g y fo r v et er in ar y b ac te ri al p at h o g en s an d re vi ew o p ti o n s fo r i m p ro ve d o rg an is m id en ti fic at io n . N SW D ep ar tm en t o f P ri m ar y In d u st ri es 31 D ec 2 01 6 P R IO R IT Y A R E A F O R A C T IO N 3 .5 : Im p ro v e h u m a n h e a lt h s u rv e il la n c e . H u m a n H e a lt h 3. 5. 1 Ex p an d t h e N at io n al A n ti m ic ro b ia l U ti lis at io n S u rv ei lla n ce P ro g ra m (N A U SP ) t o p ro vi d e a m o re re p re se n ta ti ve d at a se t, as w el l a s en h an ce sy st em s to im p ro ve h o sp it al a cc es s to d at a an d c o m p ar at iv e an al ys es . A C SQ H C , i n a ss o ci at io n w it h N A U SP * Ju n e 20 16 *D en o te s ac ti vi ty /i es fo r w h ic h t h e A u st ra lia n G o ve rn m en t h as p ro vi d ed fu n d in g . 36 H u m a n H e a lt h 3. 5. 2 Ex p an d t h e A u st ra lia n G ro u p o n A M R (A G A R) s u rv ei lla n ce p ro g ra m to co lle ct d at a fr o m m o re s ig h ts a n d o n a d d it io n al p ri o ri ty o rg an is m s, to in cl u d e Ps eu do m on as a er ug in os a, a n d A ci ne to ba ct er s p ec ie s. C o n si d er o p ti o n s fo r c o lle ct io n o f d at a o n S tr ep to co cc us p ne um on ia e. A C SQ H C , i n a ss o ci at io n w it h A G A R* D ec em b er 2 01 6 3. 5. 3 In cr ea se p ar ti ci p at io n in t h e N at io n al A n ti m ic ro b ia l P re sc ri b in g S u rv ey (N A PS ) h o sp it al s u rv ey a n d d ev el o p a s u rg ic al m o d u le to t ar g et s u rg ic al p ro p h yl ax is . Ex p an d N A PS in to re si d en ti al a g ed c ar e fa ci lit ie s (r ef er re d to a s ac N A PS ) an d b u ild o n t h e su cc es s o f t h e 20 15 p ilo t. A C SQ H C , i n a ss o ci at io n w it h N at io n al C en tr e fo r A n ti m ic ro b ia l St ew ar d sh ip * M ay 2 01 6 3. 5. 4 En h an ce d at a re p o rt ed to t h e N at io n al N o ti fia b le D is ea se S u rv ei lla n ce Sy st em (N N D SS ) f o r t u b er cu lo si s, in va si ve p n eu m o co cc al d is ea se , g o n o rr h o ea a n d s al m o n el la fo r r eg u la r r ep o rt in g b y th e N N D SS to t h e n at io n al s u rv ei lla n ce s ys te m . A u st ra lia n G o ve rn m en t D ep ar tm en t o f H ea lt h * 20 16 –2 01 7 3. 5. 5 Ex p an d t h e Q u ee n sl an d O rg TR X p as si ve s u rv ei lla n ce s ys te m to o th er in te re st ed s ta te s an d te rr it o ri es . T h is s ys te m p ro vi d es a ‘d at a cu b e’ an d a llo w s p ar ti ci p an ts to g en er at e cu m u la ti ve a n ti b io g ra m s an d in ve st ig at e re si st an ce t re n d s. A C SQ H C , w o rk in g w it h Q u ee n sl an d H ea lt h (O rg TR x) a n d o th er ju ri sd ic ti o n s* Pr o g re ss iv e ro ll o u t fr o m 2 01 5 3. 5. 6 D ev el o p a w eb p o rt al (“ C A R A le rt ”) fo r c o n fir m in g la b o ra to ri es to e n te r in fo rm at io n o n c ri ti ca l a n ti m ic ro b ia l r es is ta n ce s. T h is in fo rm at io n is th en re p o rt ed v ia S M S o r e m ai l t o ju ri sd ic ti o n al s ta ke h o ld er s to a le rt th em to t h e em er g en ce o r s p re ad o f c ri ti ca l a n ti m ic ro b ia l r es is ta n ce s. R ef er re d to a s “ C A R A le rt ”. A C SQ H C t h ro u g h t h e A U R A p ro je ct * C o m m en ce d in M ar ch 2 01 6— al er ts u n d er w ay 3. 5. 7 D ev el o p a U n iq u e In d ic at io n s D at ab as e th at p ro vi d es a li st o f i n fe ct io n s an d in d ic at io n s fo r A U to s u p p o rt in te ro p er ab ili ty b et w ee n IT s ys te m s (e .g . e H ea lt h , N A PS ). R o ya l M el b o u rn e H o sp it al a t th e D o h er ty In st it u te 20 16 –1 8 S e c to r A c ti v it y /i e s Le a d O rg a n is a ti o n T im e fr a m e s fo r c o m p le ti o n Implementation Plan: Australia’s First National Antimicrobial Resistance Strategy 2015–2019 37 H u m a n H e a lt h 3. 5. 8 U n d er ta ke a p ilo t st u d y to a ss es s th e p re va le n ce o f c o m m o n b ac te ri al u p p er re sp ir at o ry t ra ct c o m m en sa ls a n d p at h o g en s in t h e n o se a n d th ro at s w ab s o f g en er al p ra ct ic e st aff a n d p at ie n ts a tt en d in g t h e G P p ra ct ic e fo r c o n su lt at io n w it h n o n i n fe ct io u s co n d it io n s; a n d t h e ra te o f an ti m ic ro b ia l r es is ta n ce in o rg an is m s is o la te d to in fo rm IP C p ra ct ic e in g en er al p ra ct ic e se tt in g s. D et er m in e th e fe as ib ili ty o f u si n g t h e A u st ra lia n S en ti n el P ra ct ic e R es ea rc h N et w o rk (A SP RE N ) s u rv ei lla n ce s ys te m to c o n tr ib u te to n at io n al a n ti b io ti c re si st an ce s u rv ei lla n ce . Sc h o o l o f P o p u la ti o n H ea lt h , t h e U n iv er si ty o f Q u ee n sl an d Ja n 2 01 6: P ilo t st u d y co m p le te Ju ly 2 01 6: P ilo t re su lt s av ai la b le 3. 5. 9 D ev el o p a s u p er b u g a n al yt ic s d as h b o ar d to p ro vi d e a n ea r r ea l ti m e o ve rv ie w o f A U a n d A M R in h o sp it al s an d in t h e co m m u n it y, to d et ec t u n u su al a n ti b io ti c u se , i d en ti fy c h an g in g re si st an ce p at te rn s, a n d fe ed b ac k o n t h e im p ac t o f i n te rv en ti o n s o r p ro g ra m s. Th e In st it u te fo r M o le cu la r B io sc ie n ce , U n iv er si ty o f Q u ee n sl an d 20 18 3. 5. 10 In cl u d e an ti b io ti c d is p en si n g t re n d s in t h e A u st ra lia n A tl as o f H ea lt h ca re V ar ia ti o n to in fo rm im p ro ve m en ts to p re sc ri b in g p ra ct ic es co n si st en t w it h n at io n al g u id el in es . R ec o m m en d at io n s in A tl as 1 .0 in cl u d ed d ev el o p in g b en ch m ar ks fo r b es t p ra ct ic e p re sc ri b in g ; P B A C re vi ew u se o f t o p ic al q u in o lo n es ; al ig n in g A M S p ro g ra m s in G P w it h N A RS fo r a m ox ic ill in ; a n d c ap ac it y fo r P H N a n d L H N to t ra ck a n d c o m p ar e an ti m ic ro b ia l p re sc ri b in g ra te s. Th e C o m m is si o n is d ev el o p in g a n im p le m en ta ti o n s tr at eg y in cl u si ve o f a ct io n s fo r t h e A u st ra lia n G o ve rn m en t D ep ar tm en t o f H ea lt h , P B A C , cl in ic al c o lle g es , P H N a n d L H N , a n d n at io n al b o ar d s an d A H PR A . A C SQ H C * A tl as s u cc es sf u lly la u n ch ed in N o ve m b er 20 15 . Im p le m en ta ti o n st ra te g y w ill b e p re se n te d to A H M A C in M ay 2 01 6. In te ra ct iv e w eb A tl as is c u rr en tl y b ei n g d ev el o p ed . 3. 5. 11 C re at e a re fe re n ce la b o ra to ry fo r c ar b ap en em r es is ta n t En te ro ba ct er ia ce ae to e n ab le ra p id m o le cu la r c h ar ac te ri sa ti o n , n at io n al d at a re p o rt in g a n d c o m p ar is o n . Pa th W es t; W A H ea lt h O n g o in g P R IO R IT Y A R E A F O R A C T IO N 3 .6 : Im p ro v e a n im a l h e a lt h a n d a g ri c u lt u re s u rv e il la n c e . A n im a l H e a lt h a n d A g ri c u lt u re 3. 6. 1 In ve st ig at e a su rv ei lla n ce m o d el fo r A M R in t h e p ig in d u st ry b as ed o n p ig fa ec es a t th e ti m e o f s la u g h te r t h at m ay a ls o b e ap p lie d to o th er m aj o r f o o d in d u st ri es in t h e fu tu re . A u st ra lia n P o rk L im it ed * A u g u st 2 01 6 3. 6. 2 M ea su re a n d a ss es s an ti b io ti c u se in t h e m ea t an d li ve st o ck in d u st ry th ro u g h o n g o in g m o n it o ri n g a n d a n al ys is o f a n ti b io ti c tr ea tm en t d at a fr o m a (r ep re se n ta ti ve ) s am p le o f f ee d lo ts to im p ro ve ju d ic io u s u se . M ea t & L iv es to ck A u st ra lia C o m p le te d in la te 20 15 *D en o te s ac ti vi ty /i es fo r w h ic h t h e A u st ra lia n G o ve rn m en t h as p ro vi d ed fu n d in g . 38 A n im a l H e a lt h a n d A g ri c u lt u re 3. 6. 3 D ev el o p a n d a ss es s m et h o d s fo r m o n it o ri n g a n ti m ic ro b ia l u sa g e in co m p an io n a n d p ro d u ct io n a n im al s at t h e ve te ri n ar y p ra ct ic e le ve l. N at io n al C en tr e fo r A n ti m ic ro b ia l St ew ar d sh ip * 20 20 3. 6. 4 U n d er ta ke re se ar ch p ro je ct in to m u lt i d ru g re si st an t p at h o g en ic E. c ol i a n d m et h ic ill in re si st an t St ap hy lo co cc us s pp . i so la te d fr o m a n im al in fe ct io n s to d et er m in e th ei r s ig n ifi ca n ce to a n im al a n d p u b lic h ea lt h . Th is p ro je ct w ill a n al ys e th e cl in ic al d at a ac co m p an yi n g t h es e is o la te s an d p re sc ri b in g p ra ct ic es fo r v et er in ar ia n s to id en ti fy s p ec ifi c se le ct io n fo ci fo r r es is ta n t is o la te s an d to in ve st ig at e n o ve l a g en ts fo r t h ei r tr ea tm en t. Th e U n iv er si ty o f A d el ai d e w it h t h e A u st ra lia n R es ea rc h C o u n ci l Pr o g re ss re p o rt D ec em b er 2 01 6 3. 6. 5 In ve st ig at e A M R in E . c ol i, Sa lm on el la a n d C am py lo ba ct er in b ac ky ar d ch ic ke n s to a ss es s th e h ea lt h r is k p o se d to h u m an s an d re d u ce t h e ri sk o f o n w ar d t ra n sm is si o n to h u m an s. Th e U n iv er si ty o f Q u ee n sl an d Ja n 2 01 5– Ju n 2 01 5 3. 6. 6 U n d er ta ke s tu d y o n a vi an p at h o g en ic E . c ol i i n c o m m er ci al b ro ile r ch ic ke n s in S o u th ea st Q u ee n sl an d to d et er m in e A M R, v ir u le n ce a n d in ve st ig at e th e ri sk o f t ra n sm is si o n o f t h e d is ea se to h u m an s. Th e U n iv er si ty o f Q u ee n sl an d 20 12 –1 6 3. 6. 7 D et er m in e an ti m ic ro b ia l s u sc ep ti b ili ty p at te rn s in b ac te ri a cu lt u re d fr o m s ep ti ca em ic n eo n at al fo al s an d id en ti fic at io n o f g eo g ra p h ic d iff er en ce s in t h o se p at te rn s, to p ro vi d e re co m m en d at io n s o n an ti m ic ro b ia l c h o ic e fo r f ro n t lin e eq u in e ve te ri n ar ia n s. Th e U n iv er si ty o f Q u ee n sl an d 20 15 –1 6 3. 6. 8 Tr an sv er se a n d lo n g it u d in al e va lu at io n o f t h e p re va le n ce o f m et h ic ill in re si st an t St ap hy lo co cc us s pp . c ar ri ag e in d o g s an d c at s in t h e g re at er B ri sb an e ar ea . Th e U n iv er si ty o f Q u ee n sl an d 20 15 –1 6 St u d y is o n g o in g . 1s t p h as e ai m ed to b e fin is h ed b y th e en d o f 20 16 3. 6. 9 U n d er ta ke a p ilo t st u d y to s cr ee n e n vi ro n m en ta l s am p le s (f ro m vi n ey ar d s an d c ro p s w it h h ig h a zo le fu n g ic id e u se ) a n d c lin ic al is o la te s o f A sp er gi llu s fu m ig at us fo r p h en o ty p ic re si st an ce to a zo le d ru g s an d p er fo rm m o le cu la r g en o ty p in g to d et er m in e if m u ta ti o n s ar e co n si st en t w it h b io ci d e in d u ce d re si st an ce . U n iv er si ty o f S yd n ey (M B I; C RE ID ), co n tr ib u ti n g to a g lo b al s tu d y an d a n al ys is le d b y Im p er ia l C o lle g e, L o n d o n 20 16 –1 7 3. 6. 10 In d u st ry w o rk sh o p to d ev el o p a n d u n d er ta ke a s m al l p ilo t A M R su rv ei lla n ce p ro je ct in t h e sa lm o n in d u st ry , c o m p ar ab le to t h o se u n d er ta ke n in A u st ra lia n li ve st o ck in d u st ri es Ta sm an ia n S al m o n id G ro w er s A ss o ci at io n O ct o b er 2 01 7 3. 6. 11 U n d er ta ke A M R su rv ei lla n ce p ro je ct in t h e ch ic ke n m ea t in d u st ry to p ro vi d e b as el in e in fo rm at io n fo r f u tu re s u rv ei lla n ce A u st ra lia n C h ic ke n M ea t Fe d er at io n * A u g u st 2 01 7 S e c to r A c ti v it y /i e s Le a d O rg a n is a ti o n T im e fr a m e s fo r c o m p le ti o n Implementation Plan: Australia’s First National Antimicrobial Resistance Strategy 2015–2019 39 P R IO R IT Y A R E A F O R A C T IO N 3 .7 : In v e st ig a te r e q u ir e m e n ts f o r su rv e il la n c e i n f o o d . O n e H e a lt h 3. 7. 2 D ev el o p m en t o f s ta n d ar d is ed a n ti b io ti c su sc ep ti b ili ty re p o rt in g p ro fil es co m p le te d fo r M RS A , V RE , C RE a n d C .d iffi ci le . Pa th W es t C o m p le te d 3. 7. 3 U n d er ta ke s u rv ei lla n ce o f f ae ca l s p ec im en fr o m li ve st o ck p ro d u ct io n g ro u p s to u n d er st an d t h e im p ac t o f A U o n A M R in a n im al s. N at io n al C en tr e fo r A n ti m ic ro b ia l St ew ar d sh ip * 20 20 H u m a n H e a lt h 3. 7. 4 To u n d er ta ke a re vi ew o f t h e sc ie n ti fic li te ra tu re to d et er m in e th e ex te n t to w h ic h A M R is p re se n t in fo o d , t h e ex te n t to w h ic h fo o d is a ro u te o f t ra n sm is si o n o f A M R, a n d id en ti fy g ap s to in fo rm d ec is io n m ak in g a b o u t th e ex te n t o f s u rv ei lla n ce re q u ir ed a n d fu tu re w o rk . A u st ra lia n G o ve rn m en t D ep ar tm en t o f H ea lt h * 20 16 –1 7 A n im a l H e a lt h a n d A g ri c u lt u re 3. 7. 5 O n g o in g m o n it o ri n g t h ro u g h t h e Im p o rt ed F o o d In sp ec ti o n S ch em e o f a n ti m ic ro b ia l r es id u es in im p o rt ed s ea fo o d t h at is fr o m a q u ac u lt u re o r h as b ee n fa rm ed . A b i an n u al re p o rt w ill b e p ro d u ce d o n w h er e re si d u es h av e b ee n d et ec te d t h at e xc ee d t h e m ax im u m li m it s co n ta in ed w it h in t h e A u st ra lia N ew Z ea la n d F o o d S ta n d ar d s C o d e. Pr o vi d es s ix m o n th ly in sp ec ti o n d at a re p o rt s an d m o n th ly fa ili n g fo o d re p o rt s. A re vi se d s cr ee n o f a n ti m ic ro b ia l c h em ic al s w ill b e d ev el o p ed b as ed o n t h o se c o n si d er ed to b e o f i m p o rt an ce to h u m an h ea lt h m ed ic in e an d w h er e co n ce rn s h av e b ee n ra is ed re la ti n g to h ig h u sa g e, w h ic h w ill th en b e u se d to m o n it o r c o m p lia n ce w it h t h e m ax im u m re si d u e lim it s. A u st ra lia n G o ve rn m en t D ep ar tm en t o f A g ri cu lt u re a n d W at er R es o u rc es * R ep o rt c o ve ri n g Ja n u ar y to J u n e o f ea ch y ea r r el ea se d in N o ve m b er . R ep o rt c o ve ri n g J u ly to D ec em b er o f e ac h y ea r re le as ed in M ay . Ex p ec te d re vi si on an d a m en d m en t of s cr ee n in g fo r an ti m ic ro b ia l c h em ic al s 2n d q u ar te r o f 2 01 6. *D en o te s ac ti vi ty /i es fo r w h ic h t h e A u st ra lia n G o ve rn m en t h as p ro vi d ed fu n d in g . 40 O B JE C T IV E 4 : IN F E C T IO N P R E V E N T IO N A N D C O N T R O L P R IO R IT Y A R E A F O R A C T IO N 4 .1 : E n su re t h e a v a il a b il it y o f e v id e n c e b a se d , b e st p ra c ti c e a n d n a ti o n a ll y c o n si st e n t st a n d a rd s fo r IP C a c ro ss h u m a n h e a lt h a n d a n im a l c a re s e tt in g s. H u m a n H e a lt h 4. 1. 1 R ev ie w o f t h e A us tr al ia n G ui de lin es fo r P re ve nt io n an d C on tr ol o f I nf ec ti on in H ea lt hc ar e (2 01 0) to id en ti fy g ap s ag ai n st t h e ev id en ce b as e an d a n y n ec es sa ry re vi si o n s. N at io n al H ea lt h a n d M ed ic al R es ea rc h C o u n ci l* D ec em b er 2 01 5 4. 1. 2 R ev ie w o f t h e Re co m m en da ti on s fo r t he c on tr ol o f m ul ti d ru g re si st an t gr am n eg at iv es : C ar ba pe ne m as e Pr od uc in g En te ro ba ct er ia ce ae . Su p p le m en ta ry re so u rc es to b e m ad e av ai la b le fo llo w in g t h e re le as e o f th e G u id e. A C SQ H C * Ju ly 2 01 6 D ec em b er 2 01 6 4. 1. 3 Fo rm at io n o f C RE A ct io n T ea m in t h e A C T (C RE AT E) w o rk in g g ro u p to m o n it o r C RE a n d u se a va ila b le d at a to in fo rm A C T In fe ct io n P re ve n ti o n an d C o n tr o l U n it a n d A M S st ra te g ie s. C RE AT E w o rk in g g ro u p , A C T H ea lt h O n g o in g fr o m 2 01 5 4. 1. 4 D ev el o p g u id el in es fo r h ea lt h s er vi ce s an d re si d en ti al c ar e fa ci lit ie s o n IP C s tr at eg ie s fo r c ar b ap en em as e p ro d u ci n g E nt er ob ac te ri ac ea e. V ic to ri an D ep ar tm en t o f H ea lt h a n d H u m an S er vi ce s H ea lt h s er vi ce g u id el in e co m p le te d D ec em b er 2 01 5. R es id en ti al c ar e fa ci lit y sp ec ifi c g u id el in e TB C 4. 1. 5 R ev ie w a n d u p d at e st at e w id e m u lt i re si st an t o rg an is m g u id el in e an d tr ig g er re sp o n se to o ls Q u ee n sl an d H ea lt h R ev ie w ed S ep te m b er 20 14 a n d N o ve m b er 20 14 4. 1. 6 D ev el o p s ta te w id e in fe ct io n c o n tr o l a le rt s p o lic y an d p ro ce d u re . Pu b lic H ea lt h S er vi ce s, T as m an ia N o ve m b er 2 01 5 4. 1. 7 D ev el o p s ta te p o lic ie s fo r t h e m an ag em en t o f c ar b ap en em as e p ro d u ci n g E nt er ob ac te ri ac ea e. C RE AT E w o rk in g g ro u p , A C T H ea lt h Ju n e 20 16 4. 1. 8 D ev el o p s ta te g u id el in es o n m an ag em en t o f p at ie n ts in fe ct ed o r co lo n is ed w it h m u lt id ru g r es is ta n t G ra m n eg at iv e m ic ro o rg an is m s. SA H ea lt h M id 2 01 6 S e c to r A c ti v it y /i e s Le a d O rg a n is a ti o n T im e fr a m e s fo r c o m p le ti o n Implementation Plan: Australia’s First National Antimicrobial Resistance Strategy 2015–2019 41 S e c to r A c ti v it y /i e s Le a d O rg a n is a ti o n T im e fr a m e s fo r c o m p le ti o n H u m a n H e a lt h 4. 1. 9 Im p le m en t a n at io n al a p p ro ac h to in cr ea se h an d h yg ie n e co m p lia n ce ra te s in a ll se ct o rs a n d a m o n g a ll p ro fe ss io n al g ro u p s u n d er t h e N at io n al H an d H yg ie n e In it ia ti ve . H H A h as d ev el o p ed a d d it io n al o n lin e le ar n in g p ac ka g es ; a u d it in g c an n o w b e u n d er ta ke n o n lin e. A n ew b en ch m ar k fo r h an d h yg ie n e co m p lia n ce fo r a ll p ro fe ss io n al g ro u p s an d in d iv id u al m o m en ts h as b ee n a g re ed to b y A H M A C . A C SQ H C w it h H an d H yg ie n e A u st ra lia (H H A )* O n g o in g 20 17 4. 1. 9 Im p le m en t a n at io n al a p p ro ac h to in cr ea se h an d h yg ie n e co m p lia n ce ra te s in a ll se ct o rs a n d a m o n g a ll p ro fe ss io n al g ro u p s u n d er t h e N at io n al H an d H yg ie n e In it ia ti ve . H H A h as d ev el o p ed a d d it io n al o n lin e le ar n in g p ac ka g es ; a u d it in g c an n o w b e u n d er ta ke n o n lin e. A n ew b en ch m ar k fo r h an d h yg ie n e co m p lia n ce fo r a ll p ro fe ss io n al g ro u p s an d in d iv id u al m o m en ts h as b ee n a g re ed to b y A H M A C . A C SQ H C w it h H an d H yg ie n e A u st ra lia (H H A )* O n g o in g 20 17 A n im a l H e a lt h a n d A g ri c u lt u re 4. 1. 10 D ev el o p a n d p ro m u lg at e ve te ri n ar y IP C g u id el in es . Z o et is A u st ra lia D ec em b er 2 01 6 4. 1. 11 Pa rt ic ip at e in B io se cu ri ty Q u ee n sl an d [M in is te ri al ] A d vi so ry C o m m it te e to d ev el o p b io se cu ri ty g u id el in es . Th es e g u id el in es s tr es s th at a n ti m ic ro b ia ls s h o u ld n o t b e u se d to re p la ce m an ag em en t st ra te g ie s an d s h o u ld o n ly b e ad m in is te re d u n d er ve te ri n ar y g u id an ce . Th e U n iv er si ty o f Q u ee n sl an d Th es e m ee ti n g s w er e h el d b et w ee n N o ve m b er 2 01 5 & Fe b ru ar y 20 16 . A su b m is si o n is n o w b ef o re P ar lia m en t. P R IO R IT Y A R E A F O R A C T IO N 4 .2 : R e v ie w e x is ti n g a c c re d it a ti o n a n d q u a li ty a ss u ra n c e p ro g ra m m e s to e n su re t h e y a p p ro p ri a te ly s u p p o rt a n d e n c o u ra g e c o m p li a n c e w it h b e st p ra c ti c e I P C m e a su re s. H u m a n H e a lt h 4. 2. 1 U p d at e o f T he R oy al A us tr al ia n C ol le ge o f G en er al P ra ct it io ne rs S ta nd ar ds fo r G en er al P ra ct ic e (4 th E di ti on ), w h ic h in cl u d es in fo rm at io n o n IP C (G P M o d u le , S ta n d ar d 2 ). Th e R o ya l A u st ra lia n C o lle g e o f G en er al P ra ct it io n er s O ct o b er 2 01 7 4. 2. 2 U p d at e th e N at io na l S af et y an d Q ua lit y H ea lt h Se rv ic e St an da rd s, St an da rd 3 : P re ve nt in g an d co nt ro lli ng h ea lt hc ar e as so ci at ed in fe ct io ns . A C SQ H C * A n ti ci p at ed fo r r el ea se in m id 2 01 7 4. 2. 3 U n d er ta ke a re se ar ch p ro je ct to u n d er st an d t h e im p ac t an d e ff ec t o f in tr o d u ci n g N at io n al H ea lt h ca re S ta n d ar d s (in p ar ti cu la r S ta n d ar d 3 ) i n A u st ra lia n h o sp it al s. Q u ee n sl an d U n iv er si ty o f Te ch n o lo g y (C RE R H A I) D ec em b er 2 01 7 *D en o te s ac ti vi ty /i es fo r w h ic h t h e A u st ra lia n G o ve rn m en t h as p ro vi d ed fu n d in g . 42 A n im a l H e a lt h a n d A g ri c u lt u re 4. 2. 4 R ev ie w a n d u p d at e th e N at io n al F ee d lo t A cc re d it at io n S ch em e to e n su re t h at it a p p ro p ri at el y su p p o rt s an d e n co u ra g es fe ed lo t co m p lia n ce w it h b es t p ra ct ic e IP C p ra ct ic es o n fe ed lo ts . M ea t & L iv es to ck A u st ra lia D ec em b er 2 01 6 P R IO R IT Y A R E A F O R A C T IO N 4 .3 : D e v e lo p a d d it io n a l in it ia ti v e s a n d r e so u rc e s to s tr e n g th e n I P C i n a ll h u m a n h e a lt h c a re s e tt in g s. H u m a n H e a lt h 4. 3. 1 R es ea rc h e ff ec ti ve a p p ro ac h es to c le an in g in h o sp it al s th ro u g h a ra n d o m is ed c o n tr o lle d t ri al o f a n o ve l c le an in g b u n d le in te rv en ti o n to im p ro ve c le an in g p er fo rm an ce a n d re d u ce r is k o f i n fe ct io n in A u st ra lia n h o sp it al s. T h e fin d in g s w ill in fo rm t h e im p le m en ta ti o n o f a c le an in g p o lic y fo r I PC in a ra n g e o f A u st ra lia n h o sp it al c o n te xt s. Q u ee n sl an d U n iv er si ty o f Te ch n o lo g y (C RE R H A I) 20 16 –1 7 4. 3. 2 A ss es s p at ie n ts ’ u n d er st an d in g a n d e xp ec ta ti o n s o f c lin ic ia n s’ IP C b eh av io u rs a n d id en ti fy t h ei r p o te n ti al c o n tr ib u ti o n s to p ro te ct in g th em se lv es a n d o th er p at ie n ts fr o m M R O a cq u is it io n a n d t ra n sm is si o n U se v id eo re fle xi ve e th n o g ra p h y to id en ti fy p o te n ti al s tr at eg ie s to im p ro ve c o m m u n ic at io n a b o u t I PC b et w ee n c lin ic ia n s’ an d p at ie n ts a n d d ev el o p a c o lla b o ra ti ve a p p ro ac h to re d u ci n g p at h o g en t ra n sm is si o n U n iv er si ty o f S yd n ey (M B I) w it h U n iv er si ty o f T as m an ia (S yd n ey ) ca m p u s (C RE ID ) Pr o je ct a n d in te rp re ta ti o n o f d at a co m p le te d J u l– Se p 20 16 . Pl an fo r p ro d u ct io n o f vi d eo s in 2 01 7. 4. 3. 3 U se v id eo re fle xi ve e th n o g ra p h y in s et ti n g s w it h h ig h p re va le n ce o f M RS A a n d o th er M RO s to v id eo c lin ic ia n s d ay t o d ay c lin ic al a ct iv it ie s, h av e th em re vi ew c lip s, id en ti fy , d is cu ss a n d re fle ct o n o th er w is e u n re co g n iz ed r is ks o f p o te n ti al p at h o g en t ra n sm is si o n a n d d ev is e st ra te g ie s to m in im is e th em . U n iv er si ty o f S yd n ey (M B I) w it h U n iv er si ty o f T as m an ia (S yd n ey ) ca m p u s (C RE ID ) Pr o je ct c o m p le te D ec em b er 2 01 6 20 17 : w o rk w it h N SW h ea lt h fo r s ta te im p le m en ta ti o n & A C SQ H C fo r n at io n al im p le m en ta ti o n o f o u tc o m es 4. 3. 4 R ev ie w a n d m ai n ta in t h e ev id en ce b as ed I C A RE in te rv en ti o n b u n d le to a ss is t fa ci lit ie s to d ec re as e th e in ci d en ce o f b lo o d st re am in fe ct io n s as so ci at ed w it h in tr av as cu la r d ev ic es . Q u ee n sl an d H ea lt h La st re vi ew ed J an u ar y 20 15 4. 3. 5 Pr o d u ce Y o uT u b e vi d eo s d em o n st ra ti n g t h e co rr ec t u se o f p er so n al p ro te ct iv e eq u ip m en t fo r s ta n d ar d a n d t ra n sm is si o n b as ed p re ca u ti o n s. Pu b lic H ea lt h S er vi ce s, T as m an ia C o m p le te d N o ve m b er 20 15 S e c to r A c ti v it y /i e s Le a d O rg a n is a ti o n T im e fr a m e s fo r c o m p le ti o n Implementation Plan: Australia’s First National Antimicrobial Resistance Strategy 2015–2019 43 H u m a n H e a lt h 4. 3. 6 Im p le m en ta ti o n o f a n a u to m at ed s u rv ei lla n ce te ch n o lo g y (A ST ) s ys te m fo r I PC p ro g ra m s in a ll W A p u b lic h o sp it al s A ST w ill p ro vi d e au to m at ic re al t im e in te rf ac e w it h h o sp it al s ys te m s in cl u d in g iP h ar m ac y th at w ill st re n g th en IP C p ro g ra m s w it h im p ro ve d t ra ck in g o f p at ie n ts w it h M RO s an d a ss is t h o sp it al A M S p ro g ra m s. W A H ea lt h 20 15 : P ro je ct fu nd in g ap p ro ve d. 20 16 : T en d er a nd se le ct io n p ro ce ss o f p re fe rr ed p ro vi d er fo llo w ed b y im p le m en ta tio n of A ST . 4. 3. 7 Su rv ei lla n ce o f h ea lt h ca re a ss o ci at ed in fe ct io n s ca u se d b y M RS A , V RE an d C .d iffi ci le to in fo rm e vi d en ce b as ed IP C M RO p o lic y in W A a n d re p o rt s to k ey s ta ke h o ld er s, W A M R O a n d H IC W A g ro u p s. W A H ea lt h 20 16 : i n tr o d u ce d p ro ce ss to m o n it o r C RE H A Is 4. 3. 8 O n g o in g re vi si o n a n d m ai n te n an ce o f t h e el ec tr o n ic m ic ro a le rt sy st em t h at fl ag s p at ie n ts w it h M RO s o n h o sp it al p at ie n t m an ag em en t sy st em s. W A H ea lt h Th e M A G g ro u p (s u b co m m it te e o f W A M R O ) h as b ee n fo rm ed to o ve rs ee th e m ic ro a le rt sy st em a n d e n su re fu n ct io n al it y o f t h e sy st em is m ai n ta in ed . 4. 3. 9 Im p le m en ta ti o n o f n ew IT p la tf o rm fo r b lo o d s tr ea m in fe ct io n s d at ab as e su rv ei lla n ce a n d In fe ct io n P re ve n ti o n C o n tr o l U n it su rv ei lla n ce in te g ra ti n g A M S an d M ic ro d at a. A C T H ea lt h 20 16 4. 3. 10 D ev el o p a s ys te m fo r i n te g ra ti o n o f i n fo rm at io n o n in fe ct io n c o n tr o l re la te d in ci d en ts c o n ta in ed in t h e st at e Sa fe ty L ea rn in g S ys te m w it h in fo rm at io n o n t h e in ci d en ce o f h ea lt h ca re re la te d in fe ct io n a va ila b le in th e st at e in fe ct io n c o n tr o l i n fo rm at io n m an ag em en t sy st em . SA H ea lt h 20 17 4. 3. 11 R ed ev el o p t h e ex is ti n g s ta te w id e in fe ct io n c o n tr o l i n fo rm at io n m an ag em en t sy st em in to t h e n ew s ta te e le ct ro n ic p at ie n t ad m in is tr at io n s ys te m (E PA S) w it h p o te n ti al fo r i m p ro ve d id en ti fic at io n o f p at ie n ts w it h r is k fa ct o rs fo r m u lt i re si st an t o rg an is m c ar ri ag e. SA H ea lt h 20 18 4. 3. 12 Li n ka g e o f d at a co n ce rn in g in fe ct io n s in IC U s an d p ro ce ss es fo r re d u ci n g in fe ct io n t ra n sm is si o n in A u st ra lia n IC U s to d et er m in e ri sk fa ct o rs fo r i n fe ct io n s in IC U p at ie n ts . V IC N IS S C o o rd in at in g C en tr e O n g o in g *D en o te s ac ti vi ty /i es fo r w h ic h t h e A u st ra lia n G o ve rn m en t h as p ro vi d ed fu n d in g . 44 H u m a n H e a lt h 4. 3. 13 U n d er ta ke s u rv ei lla n ce o f a n te ri o r n as al a n d t h ro at s w ab s in g en er al p ra ct ic e st aff a n d c o m m u n it y m em b er s to d efi n e ra te s o f t ra n sm is si o n in s ta ff a n d c o m m u n it y m em b er s at te n d in g t h e p ra ct ic e fo r co n su lt at io n w it h n o n i n fe ct io u s co m p la in ts . A s p ar t o f t h e G A PS s tu d y th er e is s u rv ei lla n ce o f: 1) a n te ri o r n as al a n d t h ro at s w ab s in g en er al p ra ct ic e st aff a n d p at ie n ts (t o d efi n e ra te s o f t ra n sm is si o n b et w ee n t h e tw o ); an d 2) o f p at ie n ts a tt en d in g G Ps w it h n o n i n fe ct io u s co m p la in ts v ia A SP R eN (f ea si b ili ty s tu d y) Sc h o o l o f P o p u la ti o n H ea lt h , t h e U n iv er si ty o f Q u ee n sl an d 30 J u n e 20 16 — C o m p le te d 4. 3. 14 a) E n h an ce d c ap ac it y fo r o u tb re ak d et ec ti o n a n d s o u rc e tr ac ki n g , re su lt in g in im p ro ve d in fe ct io n c o n tr o l. b ) D ev el o p m en t o f s p ec ie s sp ec ifi c b io in fo rm at ic s p ip el in es to a llo w d et ai le d o u tb re ak in ve st ig at io n . M ic ro b io lo g ic al D ia g n o st ic U n it Pu b lic H ea lt h L ab o ra to ry a) A u g 2 01 5: ‘I n h o u se ’ b io in fo rm at ic s p ip el in e d ev el o p ed a n d im p le m en te d b ) O ct o b er 2 01 7 4. 3. 15 U se w h o le g en o m e se q u en ci n g to d et er m in e en vi ro n m en ta l r es er vo ir s in h o sp it al s in k an d d ra in ag e sy st em s as a p o te n ti al s o u rc e o f a n o u tb re ak o f c ar b ap en em as e p ro d u ci n g E nt er ob ac te ri ac ea e in p at ie n ts to in fo rm in fe ct io n c o n tr o l s tr at eg ie s. U n iv er si ty o f S yd n ey C lin ic al Sc h o o l, U n iv er si ti es o f O xf o rd a n d U n iv er si ty o f V ir g in ia S ch o o l o f M ed ic in e, U SA 20 16 : i so la te s se q u en ce d 20 17 : r es u lt s p u b lis h ed ; i n fe ct io n co n tr o l a ct io n s d efi n ed an d im p le m en te d 4. 3. 16 Pr o vi d e u p to d at e g u id an ce o n t h e m an ag em en t o f p at ie n ts w it h M RS A a n d V RE in ru ra l h o sp it al s an d n o n a cu te h ea lt h ca re s et ti n g s. Pu b lic H ea lt h S er vi ce s, T as m an ia Ju n e 20 16 4. 3. 17 D ev el o p a c o m p re h en si ve n at io n w id e se p si s re g is tr y in E m er g en cy D ep ar tm en ts (e .g . v ia t h e A u st ra lia n S ep si s N et w o rk ), b eg in n in g w it h N SW S ta te re g is tr y lin ke d to C EC , i n o rd er to im p ro ve a p ri o r d ia g n o si s o f l ife t h re at en in g s ep si s. U n iv er si ty o f S yd n ey W IM R & M B I (C RE C I) Ju n e 20 16 : fi rs t p u b lic at io n s M ar 2 01 7: N SW S ep si s R eg is tr y (li n ke d to N SW H ea lt h C EC ) M ar 2 01 8: N at io n al Se p si s R eg is tr y S e c to r A c ti v it y /i e s Le a d O rg a n is a ti o n T im e fr a m e s fo r c o m p le ti o n Implementation Plan: Australia’s First National Antimicrobial Resistance Strategy 2015–2019 45 H u m a n H e a lt h 4. 3. 18 Im p le m en t a d ia g n o st ic to o l s u it ab le fo r u se in E D w it h in 6 h o u rs o f ar ri va l t h at p re d ic ts m o rt al it y ri sk a n d im p ro ve s ac cu ra cy o f d ia g n o st ic al g o ri th m s. U n iv er si ty o f S yd n ey W IM R & M B I (C RE C I) Se p t 20 16 : fi rs t p u b lic at io n s M ar 2 01 7: m u lt ic en tr e o b se rv at io n al (v al id at io n ) t ri al M ar 2 01 8: in te rv en ti o n al t ri al s P R IO R IT Y A R E A F O R A C T IO N 4 .4 : F u rt h e r d e v e lo p i n it ia ti v e s a n d r e so u rc e s to s tr e n g th e n I P C i n t h e l iv e st o c k i n d u st ry . A n im a l H e a lt h a n d A g ri c u lt u re 4. 4. 1 R es ea rc h a n d d ev el o p e vi d en ce b as ed in fe ct io n p re ve n ti o n a n d c o n tr o l m ea su re s fo r a d o p ti o n in to in d u st ry s ta n d ar d s fo r m an ag in g in fe ct io u s ca tt le d is ea se s, in cl u d in g b o vi n e re sp ir at o ry d is ea se , o n fe ed lo ts . M ea t & L iv es to ck A u st ra lia Pr o g re ss re p o rt D ec em b er 2 01 6 4. 4. 2 Pr o vi d e w o rk sh o p s an d re so u rc es o n re d u ci n g s tr es s th ro u g h c at tl e ac cl im at io n te ch n iq u es a n d im p ro ve d re m o te d ia g n o st ic te ch n o lo g y fo r m o re a cc u ra te a n d e ar lie r d et ec ti o n o f s ic k ca tt le . M ea t & L iv es to ck A u st ra lia Pr o g re ss re p o rt D ec em b er 2 01 6 4. 4. 3 D ev el o p a n d d el iv er a ra n g e o f e xt en si o n a ct iv it ie s an d re so u rc es to en h an ce w h o le fa rm p la n n in g a n d b io se cu ri ty r is ks to re d u ce t h e in ci d en ce o f i n fe ct io u s d is ea se s an d re q u ir em en ts fo r a n ti b io ti c u se . D ai ry A u st ra lia Ju n e 20 17 4. 4. 4 D el iv er y o f e xt en si o n a n d fa rm er e d u ca ti o n o n c al f h u sb an d ry — o n g o in g “R ea ri n g H ea lt h y C al ve s” w o rk sh o p s an d t ra in in g in c al f h u sb an d ry , p ro m o ti n g re co m m en d ed p ra ct ic es in cl u d in g : i m p ro ve d co lo st ru m fe ed in g , u se o f v ac ci n es , a n d u se o f e le ct ro ly te s as al te rn at iv es to a n ti b io ti cs . D ai ry A u st ra lia D ec em b er 2 01 6 4. 4. 5 R es ea rc h t h e ro le o f p ro b io ti cs fo r r ed u ci n g d ep en d en ce o n a n ti b io ti cs in p ig s an d d ev el o p a n e vi d en ce b as e fo r s u rv ei lla n ce a n d re sp o n se p ro g ra m s fo r k ey b io se cu ri ty t h re at s. U n iv er si ty o f T ec h n o lo g y Sy d n ey Pr o g re ss R ep o rt D ec em b er 2 01 6 4. 4. 6 D ev el o p p ep ti d e an ti m ic ro b ia ls t h at w ill s el ec ti ve ly t ar g et p at h o g en ic E. c ol i i n p ig le ts , i n cl u d in g c ef ti o fu r re si st an t is o la te s to re d u ce t h e cu rr en t le ve ls o f a n ti b io ti cs u se d b y th e A u st ra lia n P o rk In d u st ry . C o m m o n w ea lt h S ci en ti fic a n d In d u st ri al R es ea rc h O rg an is at io n * 20 17 : P ro o f o f co n ce p t. *D en o te s ac ti vi ty /i es fo r w h ic h t h e A u st ra lia n G o ve rn m en t h as p ro vi d ed fu n d in g . 46 A n im a l H e a lt h a n d A g ri c u lt u re 4. 4. 7 a) U n d er ta ke re se ar ch to d et er m in e d is in fe ct an t su sc ep ti b ili ti es o f E. c ol i f ro m d o m es ti c (s ig n ifi ca n tl y d is in fe ct an t ex p o se d ) a n d fe ra l ( n o t d is in fe ct an t ex p o se d ) p ig s. b ) U n d er ta ke re se ar ch to id en ti fy g en es re sp o n si b le fo r r es is ta n ce to am in o g ly co si d es a n d t h ir d g en er at io n c ep h al o sp o ri n s (b o th c la ss es o f an ti m ic ro b ia l u se d in h u m an s) in p ig is o la te s. U n iv er si ty o f S yd n ey (F ac u lt y o f V et er in ar y Sc ie n ce s; M B I) Fu n d in g : P o rk C R C a) C o m p le te b ) C o m p le ti o n a n d an al ys is e ar ly 2 01 7. P R IO R IT Y A R E A F O R A C T IO N 4 .5 : F u rt h e r d e v e lo p r e so u rc e s to s tr e n g th e n I P C i n v e te ri n a ry p ra c ti c e . A n im a l H e a lt h a n d A g ri c u lt u re 4. 5. 1 D et er m in e co rr el at io n s b et w ee n g en o ty p ic b io ci d e (d is in fe ct an t) re si st an ce fo u n d in S ta ph yl oc oc cu s is o la te s fr o m a n im al s an d p h en o ty p ic e xp re ss io n o f t h es e g en es i. e. a re o u r c u rr en t in fe ct io n co n tr o l p ra ct ic es li ke ly to b e eff ec ti ve g iv en t h e b io ci d e re si st an ce o f th es e o rg an is m s. U n iv er si ty o f S yd n ey (F ac u lt y o f Ve te ri n ar y Sc ie n ce , M B I) Ju ly 2 01 6: e xp ts co m p le te d O ct 2 01 6: In co rp o ra te re le va n t fin d in g s in to A ID A P g u id el in es M ar –J u l 2 01 7: p u b d at a in p ee r re vi ew ed jo u rn al . 4. 5. 2 D et er m in e th e le ve l o f c ar ri ag e o f M D R St ap hy lo co cc us s p ec ie s in d o g s ad m it te d fo r s ta n d ar d s u rg ic al p ro ce d u re s an d re vi ew t h e o u tc o m es o f s u rg ic al in te rv en ti o n in t h o se w it h a n d w it h o u t M D R St ap h s to d et er m in e ri sk fa ct o rs . U n iv er si ty o f S yd n ey (F ac u lt y o f Ve te ri n ar y Sc ie n ce , M B I) Ju ly 2 01 6: e xp ts co m p le te d O ct 2 01 6: fi n d in g s in co rp o ra te d in to A ID A P Pr ac ti ca l In fe ct io n C o n tr o l G u id el in es fo r ve te ri n ar y p ra ct ic es M ar –J u l 2 01 7: p u b lic at io n in p ee r re vi ew ed jo u rn al S e c to r A c ti v it y /i e s Le a d O rg a n is a ti o n T im e fr a m e s fo r c o m p le ti o n Implementation Plan: Australia’s First National Antimicrobial Resistance Strategy 2015–2019 47 P R IO R IT Y A R E A F O R A C T IO N 4 .6 : E n c o u ra g e c o n ti n u e d i n c re a se s in v a c c in a ti o n r a te s to p re v e n t in fe c ti o n s. H u m a n H e a lt h 4. 6. 1 R ev ie w o f t h e N at io n al Im m u n is at io n P ro g ra m (N IP ) a n d w h er e ap p ro p ri at e in cl u d e th e ad d it io n o f n ew v ac ci n es a n d e xt en d ed co h o rt s. A u st ra lia n G o ve rn m en t D ep ar tm en t o f H ea lt h * O n g o in g 4. 6. 2 U n d er ta ke p ilo t o f p h ar m ac is t le d w o rk fo rc e im m u n is at io n to im p ro ve va cc in at io n ra te s fo r: in flu en za ; m ea sl es , m u m p s, a n d ru b el la (M M R) ; an d d ip h th er ia , t et an u s an d p er tu ss is (D TP a) a m o n g st t h e h ea lt h w o rk fo rc e. T h is a ct iv it y al so s u p p o rt s co m p lia n ce a g ai n st s ta n d ar d s in p re ve n ti n g a n d c o n tr o lli n g h ea lt h ca re a ss o ci at ed in fe ct io n s. N o rt h er n T er ri to ry D ep ar tm en t o f H ea lt h Pi lo t to b e co m p le te d in S ep te m b er 2 01 6 4. 6. 3 D ev el o p c yt o ki n es a s n o ve l a d ju va n ts a n d t h er ap eu ti cs to im p ro ve va cc in e u se fo r m ai n ta in in g p o u lt ry h ea lt h . C o m m o n w ea lt h S ci en ti fic a n d In d u st ri al R es ea rc h O rg an is at io n * 20 16 : P ro o f o f co n ce p t fo r o u t le ad c an d id at e (In te rf er o n –l am b d a) A n im a l H e a lt h a n d A g ri c u lt u re 4. 6. 4 U n d er ta ke re se ar ch to p ro ve t h e effi ca cy o f a p o te n ti al n ew t w o i n o n e va cc in e to in cr ea se t h e ea se a n d re lia b ili ty o f v ac ci n at io n a g ai n st in fe ct io u s fe ed lo t d is ea se , e .g . b o vi n e re sp ir at o ry v ir u s, in fe ed lo t ca tt le . M ea t & L iv es to ck A u st ra lia In it ia l p en t ri al s co m p le te d in 2 01 5. Va cc in e lik el y to b ec o m e co m m er ci al ly av ai la b le in 5 –7 y ea rs . 4. 6. 5 U n d er ta ke re se ar ch to m ea su re t h e im p ac t an d b es t m et h o d s o f va cc in at in g c at tl e ag ai n st in fe ct io u s fe ed lo t d is ea se , e .g . b o vi n e re sp ir at o ry v ir u s, p ri o r t o e n te ri n g t h e fe ed lo t. M ea t & L iv es to ck A u st ra lia Pr o g re ss re p o rt D ec em b er 2 01 6 *D en o te s ac ti vi ty /i es fo r w h ic h t h e A u st ra lia n G o ve rn m en t h as p ro vi d ed fu n d in g . 48 O B JE C T IV E 5 : N A T IO N A L R E S E A R C H A G E N D A P R IO R IT Y A R E A F O R A C T IO N 5 .1 : Id e n ti fy c u rr e n t g a p s a n d a g re e n a ti o n a l re se a rc h a n d d e v e lo p m e n t p ri o ri ti e s. O n e H e a lt h 5. 1. 1 W o rk w it h re se ar ch b o d ie s an d o th er re le va n t st ak eh o ld er s to d ev el o p an a p p ro ac h to id en ti fy in g fu tu re re se ar ch p ri o ri ti es . A u st ra lia n G o ve rn m en t D ep ar tm en t o f H ea lt h * La te 2 01 6 H u m a n H e a lt h 5. 1. 2 U n d er ta ke re se ar ch to u n d er st an d a n d q u an ti fy t h e ec o n o m ic b u rd en as so ci at ed w it h A M R in t h e A u st ra lia n c o m m u n it y to in fo rm t h e d es ig n o f e ffi ci en t A M R in it ia ti ve s. Q u ee n sl an d U n iv er si ty o f Te ch n o lo g y (C RE R H A I) M ay 2 01 7 P R IO R IT Y A R E A F O R A C T IO N 5 .2 : C o o rd in a te n a ti o n a l re se a rc h a c ti v it ie s a n d t h e s h a ri n g o f in fo rm a ti o n . H u m a n H e a lt h 5. 2. 1 Es ta b lis h A M R re se ar ch c o lla b o ra ti o n s w it h U n iv er si ty o f Q u ee n sl an d , Q u ee n sl an d U n iv er si ty o f T ec h n o lo g y, B o n d U n iv er si ty , A C SQ H C , Th e R o ya l A u st ra lia n C o lle g e o f G en er al P ra ct it io n er s, A u st ra lia n G o ve rn m en t D ep ar tm en t o f H ea lt h w it h t h e ai m to li n k co n te n t ex p er ts w it h im p le m en ta ti o n e xp er ts . Sh ar in g o f t o o ls , r es o u rc es a n d c o s u p er vi so ry ro le s fo r P h D s tu d en ts ac ro ss in st it u ti o n s. N at io n al C en tr e fo r A n ti m ic ro b ia l St ew ar d sh ip * 20 16 –2 0 5. 2. 2 C o n ti n u e R es ea rc h R o u n d ta b le m ee ti n g s fo r A M R to e st ab lis h a n d en co u ra g e co lla b o ra ti o n a m o n g re se ar ch er s an d s ta ke h o ld er s in vo lv ed in A M R in g en er al p ra ct ic e in A u st ra lia . T h is c o lla b o ra ti ve a p p ro ac h sh o u ld a ss is t in re d u ci n g d u p lic at io n s o f e ff o rt s an d p ro vi si o n o f co m p le m en ta ry e xp er ti se to a re as o f f o cu s o n re se ar ch . B o n d U n iv er si ty w it h Q u ee n sl an d U n iv er si ty o f T ec h n o lo g y, N at io n al C en tr e fo r A n ti m ic ro b ia l St ew ar d sh ip , A C SQ H C , Th e R o ya l A u st ra lia n C o lle g e o f G en er al P ra ct it io n er s, A u st ra lia n G o ve rn m en t D ep ar tm en t o f H ea lt h N ex t m ee ti n g M ar ch 20 17 S e c to r A c ti v it y /i e s Le a d O rg a n is a ti o n T im e fr a m e s fo r c o m p le ti o n Implementation Plan: Australia’s First National Antimicrobial Resistance Strategy 2015–2019 49 P R IO R IT Y A R E A F O R A C T IO N 5 .3 : E x p lo re o p p o rt u n it ie s to i n c re a se s u p p o rt f o r re se a rc h a n d d e v e lo p m e n t, i n c lu d in g i n c e n ti v e s fo r g re a te r p ri v a te s e c to r in v e st m e n t. O n e H e a lt h 5. 3. 1 U n d er ta ke re se ar ch to c o rr el at e m o b ile a n ti m ic ro b ia l r es is ta n t g en et ic el em en ts fr o m h u m an h o sp it al is o la te s an d t h o se fr o m a n im al s su b je ct ed to in te n si ve fa rm in g p ra ct ic es . U n iv er si ty o f S yd n ey C lin ic al S ch o o l (M B I), U n iv er si ty o f T ec h n o lo g y, El iz ab et h M ac ar th u r R es ea rc h In st it u te a s p ar t o f t h e A u st ra lia n ce n tr e fo r g en o m ic e p id em io lo g ic al m ic ro b io lo g y (a u sg em ) M ay 2 01 6: d at a an d is o la te re tr ie va l D ec 2 01 6: Is o la te s se q u en ce d 20 17 : D at a an al ys ed an d p u b lis h ed H u m a n H e a lt h 5. 3. 2 Su p p o rt P ro d u ct D ev el o p m en t Pa rt n er sh ip to b ri n g n ew d ru g s an d d ia g n o st ic te st s to m ar ke t, in cl u d in g c lin ic al t ri al s o f n ew t re at m en ts , in cl u d in g fo r d ru g s en si ti ve a n d m u lt i d ru g re si st an t tu b er cu lo si s an d m al ar ia . A u st ra lia n G o ve rn m en t D ep ar tm en t o f F o re ig n A ff ai rs a n d T ra d e* Fu n d in g o ve r t h re e ye ar s (2 01 5 –1 7) fo r t h e TB A lli an ce , M ed ic in es fo r M al ar ia Ve n tu re (M M V ) a n d th e Fo u n d at io n fo r In n o va ti ve N ew D ia g n o st ic s (F IN D ) 5. 3. 3 Tr ea ti n g In fe ct io n — n ew a n ti b io ti cs a n d a n ti fu n g al s: u n d er ta ke a n o p en ac ce ss s cr ee n in g in it ia ti ve to v al id at e th o se w it h n o ve l a n ti m ic ro b ia l p ro p er ti es . Th e C o m m u n it y fo r O p en A n ti m ic ro b ia l D ru g D is co ve ry , U n iv er si ty o f Q u ee n sl an d 20 20 5. 3. 4 D ev el o p n ew a n ti m ic ro b ia ls fo r u se a g ai n st m u lt i d ru g re si st an t st ra in s o f M yc ob ac te ri um tu be rc ul os is w h ic h w ill in cl u d e: a) D ev el o p m en t o f s yn th et ic a n al o g u es o f l ea d c o m p o u n d s ta rg et in g ce ll w al l s yn th es is w it h h ig h er p o te n cy a g ai n st M . t u b er cu lo si s. b ) I d en ti fic at io n o f n o ve l a n ti t u b er cu lo si s ag en ts fr o m m ar in e ex tr ac ts c) Id en ti fic at io n o f n o ve l t ar g et s fo r a n ti m yc o b ac te ri al d ru g s. U n iv er si ty o f S yd n ey (C h em is tr y, In fe ct io u s D is ea se s & Im m u n o lo g y) an d C en te n ar y In st it u te a n d C RE in Tu b er cu lo si s C o n tr o l; U n iv er si ty o f Q u ee n sl an d a) D ec 2 01 7: c om pl et e pr ec lin ic al s tu di es o f effi ca cy o f c om po un ds in a ni m al m od el s of tu be rc ul os is b) D ec 2 01 7: P ur ifi ca tio n of b io ac tiv e m ar in e co m po un ds a nd pr ec lin ic al a ss es sm en t o f in v iv o po te nc y in a ni m al m od el s c) Id en tif y ne w ta rg et s by e nd o f 2 01 7, th en co nt in ue c he m ic al m od ifi ca tio n to o pt im is e po te nc y. *D en o te s ac ti vi ty /i es fo r w h ic h t h e A u st ra lia n G o ve rn m en t h as p ro vi d ed fu n d in g . 50 S e c to r A c ti v it y /i e s Le a d O rg a n is a ti o n T im e fr a m e s fo r c o m p le ti o n H u m a n H e a lt h 5. 3. 5 D ev el o p t h er ap eu ti c st ra te g ie s su it ab le fo r n at io n al / in te rn at io n al t ri al s to e co lo n iz e an ti b io ti c re si st an ce fr o m t h e h u m an g u t. U n iv er si ty o f S yd n ey W IM R & M B I (C RE C ri ti ca l I n fe ct io n ) Ju n e 20 16 : fi rs t in v iv o p u b lic at io n s; Ju n e 20 17 : h u m an p ilo t st u d ie s; Ju n e 20 18 : R C T p la n n in g 5. 3. 6 In ve st ig at e th e im p ac t o f c o m m o n ly u se d a n ti b io ti cs in c ri ti ca lly ill p at ie n ts in te rm s o f d ev el o p m en t o f a n ti b io ti c re si st an ce a n d d is tu rb an ce o f t h e g u t m ic ro flo ra . U n iv er si ty o f S yd n ey W IM R & M B I (C RE C I) M ar ch 2 01 7 5. 3. 7 In ve st ig at e th e fe as ib ili ty o f r ap id d ia g n o st ic t ar g et in g o f t ra n sm is si b le A M R in b ac te ri a in o rd er to d ev el o p c h ea p ra p id s cr ee n in g a n d d ia g n o si s. U n iv er si ty o f S yd n ey W IM R & M B I (C RE C I) M ar ch 2 01 7 5. 3. 8 R es ea rc h to q u an ti fy t h e ri sk o f o ra l v an co m cy in t h er ap y fo r V RE ac q u is it io n in C D I p at ie n ts . A C T H ea lt h : C an b er ra H o sp it al & H ea lt h S er vi ce s, A n ti m ic ro b ia l St ew ar d sh ip P ro g ra m 20 17 5. 3. 9 Sy st em at ic re vi ew o f t h e h ar m s o f m ac ro lid es p re sc ri b ed fo r a n y in d ic at io n . C RE M A R A , B o n d U n iv er si ty * La te 2 01 6 5. 3. 10 a ) D ev el o p s yn th et ic a n al o g u es o f l ea d c o m p o u n d s ta rg et in g c el l w al l sy n th es is w it h h ig h er p o te n cy a g ai n st M yc o b ac te ri u m t u b er cu lo si s. b ) I d en ti fy n o ve l a n ti t u b er cu lo si s ag en ts fr o m n at u ra l p ro d u ct (m ar in e ex tr ac ts ). c) D is co ve r n o ve l t ar g et s fo r a n ti m yc o b ac te ri al d ru g s. U n iv er si ty o f S yd n ey (C h em is tr y, In fe ct io u s D is ea se s & Im m u n o lo g y) an d C en te n ar y In st it u te a n d C RE in Tu b er cu lo si s C o n tr o l; U n iv er si ty o f Q u ee n sl an d a) P re cl in ic al s tu di es in a ni m al m od el s of tu be rc ul os is e nd 2 01 7. b) P ur ifi ca tio n of bi oa ct iv e m ar in e co m po un ds a nd de te rm in at io n of ch em ic al s tr uc tu re en d 20 16 ; p re cl in ic al as se ss m en t o f i n vi vo po te nc y in a ni m al m od el s en d 20 17 . c) Id en tif y ne w ta rg et s by e nd 2 01 7, th en co nt in ue c he m ic al m od ifi ca tio n to o pt im is e po te nc y. Implementation Plan: Australia’s First National Antimicrobial Resistance Strategy 2015–2019 51 P R IO R IT Y A R E A F O R A C T IO N 5 .4 : E x p lo re o p p o rt u n it ie s to s u p p o rt t h e t ra n sl a ti o n o f p ro m is in g r e se a rc h fi n d in g s in to n e w p ro d u c ts , p o li c ie s a n d a p p ro a c h e s. H u m a n H e a lt h 5. 4. 1 C o lla b o ra te re se ar ch a cr o ss re le va n t g o ve rn m en t d ep ar tm en ts to id en ti fy e ff ec ti ve t re at m en ts a n d n u d g es fo r i m p ro vi n g a n ti b io ti c u se in A u st ra lia . A u st ra lia n G o ve rn m en t D ep ar tm en t o f H ea lt h , w it h t h e B eh av io u ra l Ec o n o m ic s Te am A u st ra lia * 20 16 –1 8 5. 4. 2 D ev el o p m en t an d s cr ee n in g o f n o ve l d ru g s th at t ar g et a u n iq u e b io ch em ic al p at h w ay in m yc o b ac te ri a th at is in vo lv ed in c el l w al l b io sy n th es is a n d d ru g m et ab o lis m . C o m m o n w ea lt h S ci en ti fic a n d In d u st ri al R es ea rc h O rg an is at io n * 20 16 : P ro o f o f co n ce p t— sc re en p o te n ti al a n ti m ic ro b ia l ca n d id at es . A n im a l H e a lt h a n d A g ri c u lt u re 5. 4. 3 Id en ti fic at io n o f n ew a n d e ff ec ti ve a n ti m ic ro b ia ls fo r s u st ai n ab le u se in in te n si ve ly fi n is h ed c at tl e. T h e id en ti fic at io n o f s u it ab le c o m p o u n d s w ill fa ci lit at e th e se g re g at ed u se o f s p ec ifi c cl as se s o f a n ti m ic ro b ia ls in ei th er a n im al s o r h u m an s, b u t n o t b o th . Th e U n iv er si ty o f Q u ee n sl an d Pi lo t st u d y co m p le te d 20 15 *D en o te s ac ti vi ty /i es fo r w h ic h t h e A u st ra lia n G o ve rn m en t h as p ro vi d ed fu n d in g . 52 O B JE C T IV E 6 : IN T E R N A T IO N A L P A R T N E R S H IP S P R IO R IT Y A R E A F O R A C T IO N 6 .1 : A c ti v e e n g a g e m e n t w it h m u lt il a te ra l o rg a n is a ti o n s a n d r e le v a n t fo ru m s to c o n tr ib u te t o r e g io n a l a n d g lo b a l a c ti o n o n a n ti m ic ro b ia l re si st a n c e . O n e H e a lt h 6. 1. 1 Fi n an ci al c o n tr ib u ti o n to t h e W o rl d H ea lt h O rg an iz at io n to w ar d s th e im p le m en ta ti o n o f a ct iv it ie s u n d er t h e G lo b al A ct io n P la n o n A M R. A u st ra lia n G o ve rn m en t D ep ar tm en t o f H ea lt h * R ep o rt d u e Ju n e 20 16 6. 1. 2 A lig n A u st ra lia ’s ac ti vi ti es u n d er t h e N at io n al A M R Im p le m en ta ti o n P la n w it h t h e G lo b al A ct io n P la n o n A M R, w h er e ap p ro p ri at e. A u st ra lia n G o ve rn m en t D ep ar tm en t o f H ea lt h a n d t h e D ep ar tm en t o f A g ri cu lt u re a n d W at er R es o u rc es * Ju n e 20 16 6. 1. 3 A tt en d W H O m ee ti n g s o n t h e G lo b al A ct io n P la n to in fo rm A u st ra lia ’s p o lic y p o si ti o n a n d p ro vi d e u p d at es to in te rn at io n al p ar tn er s o n p ro g re ss . A u st ra lia n G o ve rn m en t D ep ar tm en t o f H ea lt h * 20 16 –1 9 6. 1. 4 Pa rt ic ip at io n in t h e W H O A d vi so ry g ro u p o n In te g ra te d S u rv ei lla n ce o f A M R (A G IS A R) to s u p p o rt t h e ad o p ti o n o f t h e W H O G lo b al A ct io n P la n o n A M R an d re vi ew p ro g re ss fr o m A G IS A R p ilo t p ro je ct s. A C T Pa th o lo g y 20 19 6. 1. 5 C o n tr ib u te to p re p ar at io n s fo r t h e U n it ed N at io n s H ig h L ev el M ee ti n g o n A M R. A u st ra lia n G o ve rn m en t D ep ar tm en t o f H ea lt h , A u st ra lia n G o ve rn m en t D ep ar tm en t o f A g ri cu lt u re a n d W at er R es o u rc es * Se p te m b er 2 01 6 6. 1. 6 C o n tr ib u te to G 20 p re p ar at io n s, in cl u d in g d is cu ss io n s re la ti n g to A M R an d t h e h ea lt h a g en d a A u st ra lia n G o ve rn m en t D ep ar tm en t o f H ea lt h * 20 16 6. 1. 7 Pa rt ic ip at e in t h e m in is te ri al l ev el A lli an ce o f C h am p io n s ag ai n st A M R. A u st ra lia n G o ve rn m en t D ep ar tm en t o f H ea lt h * 20 16 –1 9 6. 1. 8 a) P ar ti ci p at io n in t h e To ky o M ee ti n g o f H ea lt h M in is te rs o n A M R in A si a an d B i re g io n al T ec h n ic al C o n su lt at io n o n A M R. b ) C o n tr ib u ti o n to p ro g re ss in g im p le m en ta ti o n o f m ee ti n g o u tc o m es , in cl u d in g d ev el o p m en t o f t h e A si a– Pa ci fic O n e H ea lt h In it ia ti ve o n A M R. A u st ra lia n G o ve rn m en t D ep ar tm en t o f H ea lt h , A u st ra lia n G o ve rn m en t D ep ar tm en t o f A g ri cu lt u re a n d W at er R es o u rc es * a) A p ri l 2 01 6 b ) O n g o in g 6. 1. 9 Pa rt ic ip at io n in C o d ex , O IE , a n d F A O fo ra . A u st ra lia n G o ve rn m en t D ep ar tm en ts o f A g ri cu lt u re a n d W at er R es o u rc es a n d H ea lt h * Ju ly 2 01 6 6. 1. 10 Pa rt ic ip at e in th e G lo b al H ea lt h S ec u ri ty A g en d a (G H SA ) A ct io n P ac ka g e o n A M R, in cl u d in g a tt en d an ce a t re le va n t G H SA m ee ti n g s. A u st ra lia n G o ve rn m en t D ep ar tm en t o f H ea lt h , A u st ra lia n G o ve rn m en t D ep ar tm en t o f A g ri cu lt u re a n d W at er R es o u rc es * O n g o in g S e c to r A c ti v it y /i e s Le a d O rg a n is a ti o n T im e fr a m e s fo r c o m p le ti o n Implementation Plan: Australia’s First National Antimicrobial Resistance Strategy 2015–2019 53 H u m a n H e a lt h 6. 1. 11 H ig h le ve l m ee ti n g o n a n ti m ic ro b ia l r es is ta n ce to b e co n ve n ed a t th e U n it ed N at io n s G en er al A ss em b ly in 2 01 6. H ea lt h M in is te rs * Se p te m b er 2 01 6 6. 1. 12 U n d er ta ke re se ar ch in to P la sm o d iu m p ar as it es to : • u n d er st an d h o w t h ey b ec o m e re si st an t to d ru g s u si n g g en o m ic s an d m o le cu la r m ar ke rs ; • d efi n e m et h o d o lo g ie s fo r s u rv ei lla n ce in re so u rc e p o o r c o u n tr ie s. C o n d u ct c lin ic al a n ti m al ar ia l t ri al s to in fo rm p o lic y. M en zi es S ch o o l o f H ea lt h R es ea rc h 1. D er iv at io n o f M ar ke rs o f C h lo ro q u in e R es is ta n ce P . v iv ax 20 19 2. Te st in g n ew d ru g s fo r m d r P la sm o d ia O n g o in g 3. M ap p in g C Q R P. vi va x ac ro ss A si a Pa ci fic O n g o in g 4. A n ti m al ar ia l C lin ic al T ri al s O n g o in g 6. 1. 13 C o lla te a n d m ap a n ti m al ar ia l r es is ta n ce d at a fr o m t h e A si a Pa ci fic th ro u g h e n g ag em en t w it h t h e W o rl d W id e A n ti m al ar ia l R es is ta n ce N et w o rk P o o l c lin ic al d at a o n a n ti m al ar ia l d ru g re si st an ce a n d a ss es s o p ti m al d o si n g s tr at eg ie s fo r a n ti m al ar ia l p o lic y M en zi es S ch o o l o f H ea lt h R es ea rc h O n g o in g 6. 1. 14 Pa rt ic ip at io n in A si a– Pa ci fic E co n o m ic C o o p er at io n (A PE C ) F o o d S af et y C o o p er at io n F o ru m (F SC F) w o rk sh o p o n C oo rd in at ed R es ea rc h In it ia ti ve fo r t he Im pl em en ta ti on o f A nt im ic ro bi al R es is ta nc e C on tr ol S tr at eg ie s. Fo o d S ta n d ar d s A u st ra lia N ew Z ea la n d C o m p le te d 30 O ct o b er 2 01 5 A n im a l H e a lt h a n d A g ri c u lt u re 6. 1. 15 A tt en d O IE m ee ti n g s an d p ro vi d e u p d at es to in te rn at io n al p ar tn er s o n p ro g re ss . A u st ra lia n G o ve rn m en t D ep ar tm en t o f A g ri cu lt u re a n d W at er R es o u rc es * O n g o in g 6. 1. 16 D ev el o p c u rr ic u la a n d te ac h in g m et h o d s th at in cl u d e im p ro ve m en ts in A M R aw ar en es s an d m it ig at io n in v et er in ar y sc h o o ls in d ev el o p in g co u n tr ie s. Th e U n iv er si ty o f Q u ee n sl an d 20 15 –1 6 6. 1. 17 In cr ea si n g a w ar en es s o f a n ti m ic ro b ia l u sa g e an d a n ti m ic ro b ia l re si st an ce in p ig p ro d u ce rs a n d p ig v et er in ar ia n s th ro u g h p re se n ta ti o n s d el iv er ed to p o rk in d u st ry a n d v et er in ar y o rg an is at io n s at a v ar ie ty o f co n fe re n ce s an d m ee ti n g s in A u st ra lia a n d t h e Ph ili p p in es . Th e U n iv er si ty o f Q u ee n sl an d O n g o in g 20 16 –1 7 *D en o te s ac ti vi ty /i es fo r w h ic h t h e A u st ra lia n G o ve rn m en t h as p ro vi d ed fu n d in g . 54 P R IO R IT Y A R E A F O R A C T IO N 6 .2 : Le a d r e g io n a l in it ia ti v e s to i n c re a se c a p a c it y t o r e sp o n d t o a n ti m ic ro b ia l re si st a n c e . H u m a n H e a lt h 6. 2. 1 W o rk w it h t h e W o rl d H ea lt h O rg an iz at io n to u n d er ta ke a n A M S g ap an al ys is in t h e A si a Pa ci fic R eg io n N at io n al C en tr e fo r A n ti m ic ro b ia l St ew ar d sh ip * Se p te m b er 2 01 6 6. 2. 2 C o lla b o ra te w it h W o rl d H ea lt h O rg an iz at io n to d ev el o p a s tr at eg y to ad d re ss g ap s id en ti fie d in A si a Pa ci fic re g io n t h ro u g h t h e d ev el o p m en t o f s p ec ifi c to o ls a n d re so u rc es . Pr o vi si o n o f N A PS to o ls to N ew Z ea la n d a n d s u p p o rt N Z A M S re se ar ch er s N at io n al C en tr e fo r A n ti m ic ro b ia l St ew ar d sh ip * 20 16 –2 0 6. 2. 3 Pr o vi d e N A PS to o ls to N ew Z ea la n d a n d s u p p o rt N ew Z ea la n d A M S re se ar ch er s. N at io n al C en tr e fo r A n ti m ic ro b ia l St ew ar d sh ip * 20 16 –2 0 6. 2. 4 Ex p an si o n o f T he ra pe ut ic G ui de lin es fo r D ev el op in g C ou nt ri es , G ui de lin es in th e Pa ci fic a nd th e Vi si ti ng E di to r P ro gr am . Th er ap eu ti c G u id el in es L td a n d T G L Fo u n d at io n 20 16 –1 9 6. 2. 5 C o o rd in at io n o f t h e an n u al W es te rn P ac ifi c R eg io n al A n ti b io ti c A w ar en es s W ee k, in cl u d in g t h e d ev el o p m en t o f r es o u rc es to b u ild ca p ac it y in d ev el o p in g c o u n tr ie s in t h e W es te rn P ac ifi c re g io n . N PS M ed ic in eW is e A n n u al ly in N o ve m b er 6. 2. 6 D efi n e an d m o n it o r a n ti m ic ro b ia l r es is ta n ce in B . p se ud om al le i i n en d em ic a re as o f A u st ra lia a n d S o u th ea st A si a, u si n g t h is in fo rm at io n to in fo rm t re at m en t p ro to co ls t h at re d u ce t h e in ci d en ce o f n ew an ti m ic ro b ia l r es is ta n ce . M en zi es S ch o o l o f H ea lt h R es ea rc h O n g o in g 6. 2. 7 Su b m it is o la te s o f E xt en si ve ly D ru g R es is ta n t T u b er cu lo si s (X D R TB ) fr o m M al ay si a to S in g ap o re fo r w h o le g en o m e se q u en ci n g to te st fo r m u lt id ru g re si st an ce . T h is w o rk w ill t h en e n ab le m ap p in g o f m u lt id ru g re si st an t is o la te s th ro u g h o u t A si a. M en zi es S ch o o l o f H ea lt h R es ea rc h O n g o in g S e c to r A c ti v it y /i e s Le a d O rg a n is a ti o n T im e fr a m e s fo r c o m p le ti o n Implementation Plan: Australia’s First National Antimicrobial Resistance Strategy 2015–2019 55 H u m a n H e a lt h 6. 2. 8 U n d er ta ke re se ar ch to im p ro ve u n d er st an d in g o f t h e m o le cu la r ep id em io lo g y o f m u lt i d ru g re si st an t (M D R) s tr ai n s o f M . t ub er cu lo si s in o u r A u st ra lia a n d re g io n . T h is a ct iv it y ai m s to : a) D efi n e th e fr eq u en cy a n d g en et ic c au se s o f d ru g re si st an t st ra in s o f M . t u b er cu lo si s in h ig h b u rd en c o u n tr ie s in o u r r eg io n . b ) E xa m in e th e ev o lu ti o n o f M D R in M . t ub er cu lo si s b y w h o le g en o m e se q u en ci n g . U n iv er si ty o f S yd n ey (M B I, C ID M ), C RE in T u b er cu lo si s C o n tr o l a n d N at io n al T B P ro g ra m in V ie tn am a) F re q u en cy o f M D R (e n d 2 01 6) a n d g en et ic ca u se s (e n d 2 01 7) o f M D R st ra in s in V ie tn am . b ) W G S o f M D R st ra in s fr o m A u st ra lia a n d h ig h b u rd en c o u n tr ie s (e n d 2 01 7) 6. 2. 9 n d er ta ke re se ar ch to im p ro ve u n d er st an d in g o f S ta ph yl oc oc cu s au re us an d G ra m n eg at iv e an ti m ic ro b ia l s u sc ep ti b ili ty in A si a an d t h e Pa ci fic re g io n . M en zi es S ch o o l o f H ea lt h R es ea rc h O n g o in g 6. 2. 10 U n d er ta ke In te rn at io n al d ip lo m at ic e n g ag em en t in re g io n al a n d m u lt ila te ra l f o ra to c at al ys e re g io n al c o lla b o ra ti o n to a ch ie ve t h e g o al o f a n A si a Pa ci fic fr ee o f m al ar ia b y 20 30 . T h is in cl u d es o u r s u p p o rt fo r t h e w o rk o f t h e A si a Pa ci fic L ea d er s M al ar ia A lli an ce (A PL M A ) a s a re g io n al ly o w n ed p ar tn er sh ip , a n d im p le m en ta ti o n o f t h e A PL M A M al ar ia E lim in at io n R o ad m ap . A u st ra lia n G o ve rn m en t D ep ar tm en t o f F o re ig n A ff ai rs a n d T ra d e* O n g o in g d ip lo m at ic en g ag em en t to su p p o rt E as t A si a Su m m it c o m m it m en ts to m al ar ia e lim in at io n 6. 2. 11 Su p p o rt s ca le u p re sp o n se s to k ey c h al le n g es in c o m b at in g m al ar ia in A si a an d t h e Pa ci fic t h ro u g h t h e R eg io n al M al ar ia a n d O th er C o m m u n ic ab le D is ea se T h re at s Tr u st F u n d . A u st ra lia n G o ve rn m en t D ep ar tm en t o f F o re ig n A ff ai rs a n d T ra d e* 20 14 –1 7 6. 2. 12 D ev el o p li n ka g es w it h t h e N at io n al P ae d ia tr ic H o sp it al in H an o i t o a ss is t in d ev el o p m en t o f a n A M S an d In fe ct io n P re ve n ti o n C o n tr o l p ro g ra m . Th e C h ild re n’ s H o sp it al a t W es tm ea d a n d U n iv er si ty o f S yd n ey (M B I) N o v 20 15 : v is it to H an o i w it h o n g o in g co lla b o ra ti o n D ec 2 01 6: e va lu at e p ro g re ss A n im a l H e a lt h a n d A g ri c u lt u re 6. 2. 13 U n d er ta ke a s u rv ey o f p o rk p ro d u ct in te g ri ty in L ao s PD R, V ie tn am a n d C h in a to d et er m in e p re va le n ce o f a n ti b io ti c re si d u es a n d e xt en t o f A M R to id en ti fy t h e ri sk d ri ve rs fo r i n ap p ro p ri at e u sa g e o f a n ti b io ti cs a n d fa ct o rs le ad in g to in cr ea se s in A M R. C o m m o n w ea lt h S ci en ti fic a n d In d u st ri al R es ea rc h O rg an is at io n * Pr o je ct co m m en ce m en t is sc h ed u le d fo r m id 20 16 *D en o te s ac ti vi ty /i es fo r w h ic h t h e A u st ra lia n G o ve rn m en t h as p ro vi d ed fu n d in g . 56 P R IO R IT Y A R E A F O R A C T IO N 6 .3 : Le a rn f ro m i n te rn a ti o n a l b e st p ra c ti c e . H u m a n H e a lt h 6. 3. 1 C o lla b o ra ti o n w it h C lin ic al L ab o ra to ry In te g ra ti o n in H ea lt h C ar e, U S C en tr es fo r D is ea se C o n tr o l, Ev id en ce B as ed L ab o ra to ry M ed ic in e in it ia ti ve s an d s im ila r b o d ie s, to d ev el o p a c o al it io n o f i n te re st ed p ar ti es to s h ar e ex p er ti se , i n si g h ts , e xp er ie n ti al le ar n in g o f e vi d en ce in p ra ct ic e. Pa th W es t D at a p re a n d p o st an al yt ic al is su es p re se n te d a t Sy m p o si u m a t C D C in A tl an ta in O ct o b er 20 15 . R ep o rt o n d ia g n o st ic s in C lo st ri d iu m d iffi ci le d u e fo r p u b lic at io n la te 2 01 6. 6. 3. 2 B en ch m ar ki n g o f A M R an d A U u se in A u st ra lia w it h m o d el c o u n tr ie s in cl u d in g N o rd ic c o u n tr ie s an d t h e N et h er la n d s th ro u g h t h e A U R A Su rv ei lla n ce S ys te m . A C SQ H C , t h ro u g h A U R A re p o rt in g * O n g o in g P R IO R IT Y A R E A F O R A C T IO N 6 .4 : P a rt ic ip a te i n i n te rn a ti o n a l su rv e il la n c e i n it ia ti v e s. H u m a n H e a lt h 6. 4. 1 C o n tr ib u te d at a fr o m A u st ra lia o n A M R an d A U to t h e W H O G lo b al A M R Su rv ei lla n ce S ys te m (G LA SS ), to in fo rm g lo b al s u rv ei lla n ce re p o rt s d ev el o p ed b y W H O . D ep ar tm en t o f H ea lt h w it h A C SQ H C * Ex p ec te d to co m m en ce 2 01 6– 17 6. 4. 2 St re n g th en In te rn at io n al g en o m ic s b as ed c o m p ar is o n s o f A M R b ac te ri a. M ic ro b io lo g ic al D ia g n o st ic U n it Pu b lic H ea lt h L ab o ra to ry A p ri l 2 01 6: In it ia te d co n tr ib u ti o n to in te rn at io n al g en o m ic d at as et s (G en o m eT ra ck r) 6. 4. 3 Es ta b lis h c o lla b o ra ti ve li n ks w it h o th er a g en ci es p er fo rm in g g en o m ic s b as ed A M R su rv ei lla n ce (P u b lic H ea lt h E n g la n d ; C D C ; P u b lic H ea lt h A g en cy o f C an ad a) M ic ro b io lo g ic al D ia g n o st ic U n it P u b lic H ea lt h L ab o ra to ry (M D U P H L) V is it to P u b lic H ea lt h En g la n d in M ar ch 20 16 . C o m p ar is o n o f A M R g en o m ic s ac ti vi ti es at M D U P H L w it h in te rn at io n al a g en ci es re p o rt ed b y D ec 2 01 6. S e c to r A c ti v it y /i e s Le a d O rg a n is a ti o n T im e fr a m e s fo r c o m p le ti o n Implementation Plan: Australia’s First National Antimicrobial Resistance Strategy 2015–2019 57 A n im a l H e a lt h a n d A g ri c u lt u re 6. 4. 4 In ve st ig at e an ti m ic ro b ia l r es is ta n ce in b ac te ri a as so ci at ed w it h p o rc in e re sp ir at o ry d is ea se in A u st ra lia a n d t h e Ph ili p p in es . Th e U n iv er si ty o f Q u ee n sl an d C o m p le te d M ay 2 01 6 P R IO R IT Y A R E A F O R A C T IO N 6 .5 : E st a b li sh c lo se r ti e s w it h i n te rn a ti o n a l c o ll a b o ra ti o n s to l in k A u st ra li a ’s n a ti o n a l re se a rc h a g e n d a w it h w h a t is h a p p e n in g in te rn a ti o n a ll y. H u m a n H e a lt h 6. 5. 1 U n d er t h e C h em ic al B io lo g ic al a n d R ad io lo g ic al M em o ra n d u m o f U n d er st an d in g — M ed ic al C o u n te rm ea su re s C o n so rt iu m A n ti m ic ro b ia l R es is ta n ce t as k R& D is b ei n g u n d er ta ke n in t h e fo llo w in g a re as : 1. A n ti m ic ro b ia l T ar g et D is co ve ry 2. M ec h an is m s o f R es is ta n ce / P er si st en ce 3. Im m u n o m o d u la ti o n . 4. N o ve l A n ti m ic ro b ia l A p p ro ac h es 5. M at h em at ic al M o d el lin g a n d S ys te m s 6. M u lt i d ru g re si st an t K le b si el la m ed ic al c o u n te rm ea su re s an d m o d el s 7. A M R d ia g n o st ic s D ef en ce S ci en ce a n d T ec h n o lo g y La b o ra to ry , U n it ed K in g d o m in p ar tn er sh ip w it h U S, C an ad ia n & A u st ra lia n — D ef en ce a n d H ea lt h D ep ar tm en ts 2– 5 ye ar s 6. 5. 2 B u ild o n re la ti o n sh ip s w it h t h e U S N at io n al In st it u te s o f H ea lt h , t h e U K M ed ic al R es ea rc h C o u n ci l a n d t h e C an ad ia n In st it u te s o f H ea lt h R es ea rc h to o p ti m is e h o w re se ar ch is fu n d ed a n d u ti lis ed . Th e N at io n al H ea lt h a n d M ed ic al R es ea rc h C o u n ci l* O n g o in g *D en o te s ac ti vi ty /i es fo r w h ic h t h e A u st ra lia n G o ve rn m en t h as p ro vi d ed fu n d in g . 58 O B JE C T IV E 7 : G O V E R N A N C E P R IO R IT Y A R E A F O R A C T IO N 7 .1 : Id e n ti fy , e st a b li sh a n d m a in ta in l in k a g e s b e tw e e n i m p le m e n ta ti o n p a rt n e rs a c ro ss a ll s e c to rs . O n e H e a lt h 7. 1. 1 Th e A u st ra lia n S tr at eg ic a n d T ec h n ic al A d vi so ry G ro u p (A ST A G ) o n A M R to p ro vi d e o n g o in g e xp er t ad vi ce o n c u rr en t an d e m er g in g is su es , re se ar ch p ri o ri ti es a n d im p le m en ta ti o n a p p ro ac h es to s u p p o rt t h e N at io n al A M R St ra te g y. A ST A G is c o c h ai re d b y th e A u st ra lia n G o ve rn m en t C h ie f Ve te ri n ar y O ffi ce r a n d A u st ra lia n G o ve rn m en t C h ie f M ed ic al O ffi ce r* O n g o in g 7. 1. 2 Th e A n ti m ic ro b ia l R es is ta n ce P re ve n ti o n a n d C o n ta in m en t (A M PR C ) St ee ri n g G ro u p to p ro vi d e le ad er sh ip o n A M R an d o ve rs ee t h e d ev el o p m en t an d im p le m en ta ti o n o f t h e N at io n al A M R St ra te g y. Th e A M RP C S te er in g g ro u p is co c h ai re d b y th e Se cr et ar y o f t h e A u st ra lia n G o ve rn m en t D ep ar tm en t o f H ea lt h a n d t h e Se cr et ar y o f t h e A u st ra lia n G o ve rn m en t D ep ar tm en t o f A g ri cu lt u re a n d W at er R es o u rc es * O n g o in g 7. 1. 3 W o rk c o lla b o ra ti ve ly w it h s ta ke h o ld er s to re vi ew a ct iv it ie s an d m o n it o r p ro g re ss u n d er t h e Im p le m en ta ti o n P la n . A M PR C S te er in g G ro u p * O n g o in g 7. 1. 4 B u ild o n re la ti o n sh ip s w it h c u rr en t st ak eh o ld er s ac ro ss a n im al a n d h u m an h ea lt h (A C SQ H C , C o m m o n w ea lt h G o ve rn m en t, ex p er t b o d ie s su ch a s C o lle g es , U n iv er si ti es ) a n d e st ab lis h n et w o rk s w it h s im ila r re se ar ch g ro u p s ac ro ss A u st ra lia to e n su re c o n si st en t an d u n ifo rm m es sa g es . N C A S w it h : U n iv er si ty o f Q u ee n sl an d (C RE R ED U C E) , Q u ee n sl an d U n iv er si ty o f T ec h n o lo g y (C RE R H A I), B o n d U n iv er si ty (C RE M A R A ), A C SQ H C , R A C G P, A u st ra lia n G o ve rn m en t D ep ar tm en t o f H ea lt h * 20 16 P R IO R IT Y A R E A F O R A C T IO N 7 .2 : W o rk w it h s ta k e h o ld e rs t o d e v e lo p a n I m p le m e n ta ti o n P la n f o r th e S tr a te g y. O n e H e a lt h 7. 2. 1 C o n ve n e a N at io n al A M R St ak eh o ld er F o ru m to c o n su lt w it h st ak eh o ld er s fr o m a cr o ss v ar io u s se ct o rs o n t h e d ev el o p m en t o f a n Im p le m en ta ti o n P la n fo r t h e N at io n al A M R St ra te g y. A u st ra lia n G o ve rn m en t D ep ar tm en t o f H ea lt h a n d A u st ra lia n G o ve rn m en t D ep ar tm en t o f A g ri cu lt u re a n d W at er R es o u rc es * C o m p le te d 17 N o ve m b er 2 01 5 A n im a l H e a lt h a n d A g ri c u lt u re 7. 2. 2 C o n d u ct a O n e H ea lt h a n ti m ic ro b ia l r es is ta n ce w o rk sh o p fo r r el ev an t ag en ci es in N ew S o u th W al es . N SW D ep ar tm en t o f P ri m ar y In d u st ri es 30 N o ve m b er 2 01 6 S e c to r A c ti v it y /i e s Le a d O rg a n is a ti o n T im e fr a m e s fo r c o m p le ti o n Implementation Plan: Australia’s First National Antimicrobial Resistance Strategy 2015–2019 59 P R IO R IT Y A R E A F O R A C T IO N 7 .3 : E st a b li sh b a se li n e m e a su re s to i n fo rm m o n it o ri n g a n d e v a lu a ti o n o f th e S tr a te g y. O n e H e a lt h 7. 3. 1 W o rk w it h t h e A u st ra lia n S tr at eg ic a n d T ec h n ic al A d vi so ry G ro u p o n A M R to id en ti fy in d ic at o rs a n d s et t ar g et s to m o n it o r p ro g re ss a g ai n st th e O b je ct iv e o f t h e N at io n al A M R St ra te g y. A M RP C S te er in g G ro u p * Ju n e 20 17 H u m a n H e a lt h 7. 3. 2 Pu b lis h a N at io n al R ep o rt to p ro vi d e a co m p re h en si ve p ic tu re o f an ti m ic ro b ia l r es is ta n ce , a n ti m ic ro b ia l u se a n d a p p ro p ri at en es s o f p re sc ri b in g in A u st ra lia (h o sp it al a n d c o m m u n it y) , a n d s et a b as el in e fo r m o n it o ri n g o ve r t im e. A C SQ H C * Ju n e 20 16 P R IO R IT Y A R E A F O R A C T IO N 7 .4 : R e v ie w r e g u la ti o n ( le g is la te d a n d o th e r) r e le v a n t to a n ti m ic ro b ia l re si st a n c e a n d a n ti b io ti c u sa g e . O n e H e a lt h 7. 4. 1 C o d ex A lim en ta ri u s— re vi ew o f p ra ct ic es a n d g u id el in es re la ti n g to an ti m ic ro b ia l r es is ta n ce a n d id en ti fy m aj o r c ap ac it y d ev el o p m en t g ap s an d o th er c h al le n g es in im p le m en ta ti o n . A u st ra lia n G o ve rn m en t D ep ar tm en ts o f A g ri cu lt u re a n d W at er R es o u rc es a n d H ea lt h * Ju ly 2 01 6 *D en o te s ac ti vi ty /i es fo r w h ic h t h e A u st ra lia n G o ve rn m en t h as p ro vi d ed fu n d in g . Implementation Plan: Australia’s First National Antimicrobial Resistance Strategy 2015–2019 61 Acronyms and abbreviations AAW Antibiotic Awareness Week ACT Australian Capital Territory ACSQHC Australian Commission on Safety and Quality in Health Care AMR Antimicrobial resistance AMRPC Antimicrobial Resistance Prevention and Containment Steering Group AMS Antimicrobial stewardship ASTAG Australian Strategic and Technical Advisory Group on antimicrobial resistance AURA Antimicrobial Use and Resistance in Australia BEACH Bettering the Evaluation and Care of Health CARs Critical antimicrobial resistances CDI Clostridium difficile infection CDC Centres for Disease Control and Prevention CRE Carbapenem-resistant Enterobacteriaceae CRE CI Centre for Research Excellence Critical Infection CRE ID Centre for Research Excellence in Protecting the Public from Emerging infectious Diseases CREMARA Centre for Research Excellence in Minimising Antibiotic Resistance from Acute Respiratory Infections CRE-REDUCE Centre for Research Excellence for Redefining Antimicrobial Use to Reduce Resistance CRE-RHAI Centre of Research Excellence in Reducing Healthcare Associated Infections FAO Food and Agriculture Organization GP General practitioner HAI Healthcare associated infection HAP Hospital acquired pneumonia ICU Intensive care unit IT Information technology LHN Local Hospital Network MDR Multidrug resistance MRSA Methicillin-resistant Staphylococcus aureus MRO Multi-resistant organism NSQHS National Safety and Quality Health Service NAUSP National Antimicrobial Utilisation Surveillance Program NCAS National Centre for Antimicrobial Stewardship NEPSS National Enteric Pathogens Surveillance System 62 NHMRC National Health and Medical Research Council NSW New South Wales OIE World Organisation for Animal Health PBAC Pharmaceutical Benefits Advisory Committee PDA Patient decision aid PHN Primary Health Network RACGP The Royal Australian College of General Practitioners SA South Australia SAB Staphylococcus aureus bacteraemia WHA World Health Assembly WHO World Health Organization N o v 2 0 1 6 www.health.gov.au www.agriculture.gov.au All information in this publication is correct as at Nov 2016 1 1 7 2 6 N ov 2 0 1 6