AGAR Group

Antimicrobial Resistance in Australia

Antimicrobial Resistance in Australia

Antimicrobial resistance (AMR) poses one of the most important risks to our health today. AMR occurs when an organism develops resistance to an antimicrobial that is used to treat it.
Antimicrobials are an integral component of health care delivery, antimicrobials need to be readily available and effective. When resistance emerges and the effectiveness is reduced it has a significant impact on an individual’s treatment and the community more broadly.
Antimicrobial resistance (AMR) continues to be an increasing risk to patient safety because it reduces the number of antimicrobials available to treat infections. AMR increases morbidity and mortality associated with infections caused by multidrug-resistant organisms. AMR may limit future 
capacity to perform medical procedures such as organ transplantation, cancer chemotherapy, diabetes management and major surgery, because of a lack of effective antimicrobials

Key findings from the 2021 AURA report

National rates of resistance for many priority organisms have not changed substantially from those reported in AURA 2019. However, several changes in resistance are important to consider in the context of infection prevention and control, and antimicrobial prescribing.

• In Escherichia coli, resistances to common agents used for treatment continue to increase. Resistance to ciprofloxacin and other fluoroquinolones has continued to rise in isolates from community-onset infections, despite restriction of access to these agents on the Pharmaceutical Benefits Scheme. These changes in resistance may mean increasing treatment failures and greater
reliance on last-line treatments such as carbapenems. Meropenem resistance has remained low.
• In Enterobacterales, rates of resistance were somewhat lower in the community than in hospitals for most agents with available data. There were no major differences between rates in public versus private hospitals. Rates in aged care homes were often as high as, or higher than, rates in hospitals.
• Carbapenem resistance in Enterobacterales remains uncommon, but is found more often in the
Enterobacter cloacae complex than in E. coli or Klebsiella pneumoniae.
• In Enterococcus faecium, the overall rates of vancomycin resistance are declining nationally, but are still above 40%.
• In Salmonella, ciprofloxacin resistance in typhoidal species (Salmonella Typhi and Salmonella Paratyphi) exceeded 78% in 2019, confirming that ciprofloxacin should no longer be relied on for
empirical treatment.
In Staphylococcus aureus, patterns of methicillin resistance continue to evolve. Clones that were previously dominant are being replaced by other clones, and community-associated methicillin-resistant S. aureus has become prominent everywhere, but especially in remote and very remote regions. This demonstrates a need for a renewed focus on infection prevention and control in both community and acute settings.