A One-Health Approach to Antimicrobial Resistance Surveillance in Australia

Abstract

A One Health Approach to Antimicrobial Resistance Surveillance in Australia Ramon Shaban,1 Geoff Simon,1 Darren Trott,2* John Turnidge,3 David Jordan2, 4 1School of Nursing and Midwifery, Centre for Health Practice Innovation, Griffith University, Queensland; 2School of Animal and Veterinary Sciences; and 3School of Medicine, The University of Adelaide, South Australia; 4New South Wales Department of Primary Industries, Wollongbar, NSW, AUSTRALIA.

Australia is a large, isolated island with diverse climate and geography, a sparse human population (22.7 million, 2.9 people per km2 with over 60% living in cities of greater than 1 million people), significant populations of food-producing animals (e.g. 74.7 million sheep; 28.5 million cattle) and a substantial meat export industry. In line with restrictions on fluoroquinolone use in humans, Australia is the only country that has legal measures in place to exclude the use of this class of antibiotic in food-animal species. Label constraints for third generation cephalosporin use in Australian food-animals are very strict by international comparison (for example, they are not registered for use in poultry). There also are large differences between Australia and other countries with respect to animal production (a stronger reliance on extensive production without housing), quarantine bans on the importation of fresh meat and live animals, and the fact that Australia is geographically isolated with no shared land borders.

Whilst Australia also does not currently have a national, federally funded antimicrobial resistance and antibiotic usage surveillance programme focused on animals, a number of notable one-off surveys have been conducted in recent years. These studies have consistently confirmed a low public health risk in the food-animal sector related to resistance against critically important drugs such as fluoroquinolones. Through funding from the federal Department of Health and Aging, The Australian Group on Antimicrobial Resistance (AGAR) has been conducting national surveillance and reporting of antimicrobial resistance and antibiotic usage in humans since the mid 2000s. In 2014, the federal Department of Agriculture provided funding to develop a detailed report on how antimicrobial resistance and antibiotic usage surveillance could be conducted in animals in Australia, given the considerable differences and challenges outlined above. The report comprises an extensive critical review of existing surveillance systems adopted throughout the world, a summary of recent survey activity in Australia and a list of recommendations to move towards an integrated, “One Health” surveillance system.