AURA is Australia’s national program for surveillance of antimicrobial use and resistance in human health. The Australian Government funds it, including the key surveillance groups and programs (AURA program partners) that contribute to it. These are:
- Australian Group on Antimicrobial Resistance
- National Antimicrobial Utilisation Surveillance Program
- National Antimicrobial Prescribing Survey
- Australian Passive AMR Surveillance
- National Alert System for Critical Antimicrobial Resistances
- HOTspots pilot
- Global Antimicrobial Resistance and Use Surveillance System.
Antimicrobial Use and Resistance in Australia (AURA)
What it is
AURA is Australia’s first nationally coordinated surveillance program for gathering data on antimicrobial use and resistance in human health.
Why it’s important
This program gives us the picture of antimicrobial use and resistance across Australia. It allows us to:
- detect emerging resistance and trends
- see links between antibiotic use and resistance
- know where we need to act to address the misuse of antimicrobials.
This helps us to:
- raise awareness of antimicrobial resistance among the public
- promote the appropriate use of antimicrobials (especially antibiotics)
- stop antimicrobial resistance from getting worse.
Who is involved
The Australian Government funds AURA and the key surveillance groups and programs (AURA program partners) that collect and report to it.
From 1 January 2021 the Australian Government Department of Health and Aged Care took over its management from the Australian Commission on Safety and Quality in Health Care.
How it works
AURA program partners collect and report on data from hospitals, aged care homes, laboratories and the community. This provides a national picture of antimicrobial use and resistance.
How AURA fits in to the bigger picture
We will use data from AURA in the national One Health Surveillance System. This system will collect and report on antimicrobial use and resistance across other areas, such as animal health and the environment, as well as in human health. This will give us even better information about antimicrobial resistance in Australia, where it’s occurring and how quickly it’s developing.
Find out more
Learn more by reading the AURA report from 2023. It covers antimicrobial use and resistance and the appropriateness of antimicrobial prescribing in Australia.
National AURA reports are also available for:
The Australian Commission on Safety and Quality in Health Care also has information on AURA.
In addition to the National AURA reports, the department funded the Australian Commission on Safety and Quality in Health Care to prepare and publish reports on:
- antimicrobial use and appropriateness in the community: 2020–2021
- antimicrobial use and appropriateness in the community: 2023.
The Commission has also published a report with analysis of 2015–2022 PBS and RPBS antimicrobial dispensing data.
Australian Group on Antimicrobial Resistance (AGAR)
What it is
AGAR is a collaboration of clinicians and scientists from key microbiology laboratories around Australia that conducts targeted AMR surveillance on bacteria known to cause important and life-threatening infections.
It has gathered information on the level of AMR in bacteria since 1985.
Why it’s important
The data collected allow for better use of antibiotics based on known Australia-wide resistance patterns.
Who is involved
The Australian Society for Antimicrobials (ASA) coordinates AGAR. Approximately 40 laboratories provide data and samples on 3 particularly dangerous groups of bacteria to AGAR-coordinating laboratories.
How it works
The coordinating laboratories undertake molecular testing on samples and provide their findings to AGAR.
Reports are then prepared by AGAR for each of the 3 types of bacteria. Each report is part of a separate AGAR program:
- Australian Staphylococcal Surveillance Outcome Program (ASSOP)
- Australian Enterococcal Surveillance Outcome Program (AESOP
- Gram-negative Surveillance Outcome Program (GNSOP).
AGAR publishes annual reports on the outcomes of these surveys, as well as a range of articles and presentations on findings.
AGAR collaborates with the Australian Commission on Safety and Quality in Health Care to combine the findings of the 3 surveillance outcome programs each year. Health and Aged Care funds this collaboration. These programs were previously called Sepsis Outcome Programs.
Find out more
Read the Combined AGAR Surveillance Outcome Programs reports.
National Antimicrobial Utilisation Surveillance Program (NAUSP)
What it is
SA Health established NAUSP in 2004 to monitor the consumption of antimicrobials in Australian public and private hospitals.
Why it’s important
NAUSP is an important tool to support antimicrobial stewardship in hospitals. The program publishes reports on antimicrobial usage twice a year.
Who is involved
SA Health administers the program. Over 300 public and private hospitals from all states and territories voluntarily contribute antimicrobial usage data to it.
How it works
It works by providing hospitals with information on their use of antimicrobials. This tells them about potential overuse or unexpected changes in use.
Participating hospitals can get reports on their usage rates at any time.
Find out more
View the NAUSP annual report and their antimicrobial utilisation reports.
The Australian Commission on Safety and Quality in Health Care published NAUSP reports prior to the 2020 annual report.
National Antimicrobial Prescribing Survey (NAPS)
What it is
NAPS collects data on how Australian hospitals and aged care homes prescribe antimicrobial medications.
Why it’s important
Through NAPS, hospitals and aged care homes can check their prescribing for appropriateness and compliance with guidelines. They use this information to:
- benchmark their performance
- contribute to reports about national trends
- identify key targets for action in their prescribing behaviours.
Who is involved
A multidisciplinary team from the Royal Melbourne Hospital together with the National Centre for Antimicrobial Stewardship at the Doherty Institute run this program.
The modules currently contributing to the AURA surveillance program are:
- Hospital NAPS
- Surgical NAPS
- Aged Care NAPS.
How it works
NAPS is an online survey for hospitals and aged care settings. It supports antimicrobial stewardship programs by giving participating centres an online tool to view and explore their own prescribing data.
Find out more
See the latest NAPS reports and data:
- hospital NAPS annual report
- surgical NAPS annual report
- aged care NAPS annual report
- NAPS circulars
- NAPS website
Prior to the 2020 annual reports, the Australian Commission on Safety and Quality in Health Care published hospital NAPS, surgical NAPS and aged care NAPS annual reports.
Australian Passive AMR Surveillance (APAS)
What it is
APAS collects, analyses and reports on de-identified patient-level AMR data.
Why it’s important
APAS provides the largest volume of resistance surveillance data to AURA. By December 2023, it had captured over 98 million AMR susceptibility results.
These data provide access to geographical and organism-related trends in resistance. They inform response strategies at local, state and national levels.
Who is involved
The Australian Commission on Safety and Quality in Health Care established the APAS system in 2015. It has enhanced it over time.
Public and private pathology services across Australia voluntarily contribute these data. Several pathology services capture statewide data through their information systems.
How it works
Participating laboratories can access their own data to prepare local reports. This helps them support their antimicrobial stewardship and infection-prevention programs.
Find out more
APAS data analyses have been published in the AURA 2021 report, AURA 2023 report and in the APAS technical reports including:
- An update of resistance trends in multidrug-resistant organisms – 2006 to 2023
- Trends in macrolide resistance in Streptococcus agalactiae and Streptococcus pyogenes – 2006 to 2023.
More information about APAS is available from Australian Commission on Safety and Quality in Health Care.
National Alert System for Critical Antimicrobial Resistances (CARAlert)
What it is
CARAlert collects data on nationally agreed priority organisms with critical resistances known to present a serious threat to the effectiveness of last-line antimicrobials.
Why it’s important
Monitoring and regular reporting of critical antimicrobial resistances in Australia provide timely information to support:
- clinicians
- policy makers
- system managers.
This information informs actions that help to prevent and contain AMR outbreaks.
Who is involved
The Australian Commission on Safety and Quality in Health Care established CARAlert in 2016. Public and private health services across Australia provide data for it.
How it works
Services voluntarily provide de-identified details of confirmed critical antimicrobial resistances to the CARAlert web portal.
Find out more
Learn more by seeing the CARAlert reports.
HOTspots pilot
What it is
HOTspots is an online AMR surveillance tool managed by the CSIRO. It operates across the northernmost part of Australia.
Why it’s important
The HOTspots tool aims to provide local and timely AMR data to help healthcare professionals make antibiotic choices for patients based on evidence.
Who is involved
The Department of Health and Aged Care piloted the HOTspots program as part of the AURA surveillance program in 2022–23.
HOTspots data have been available to clinicians in rural and remote northern Australia since January 2019. The data are being widely used across hospitals and clinics in these locations. Data from HOTspots were included in the AURA 2021 report and the AURA 2023 report.
How it works
Pathology providers across the northermost part of Australia provide data on antimicrobial resistant infections they process. HOTspots formats the data for practitioners to access. Practitioners can then survey the resistant microbes that may be prevalent in their region. This helps them choose the most appropriate treatment for their patients.
Find out more
Learn more by viewing the HOTspots antimicrobial resistance video and visiting the HOTspots digital platform.
Global Antimicrobial Resistance and Use Surveillance System (GLASS)
What it is
GLASS is the first global system to collect official national AMR data on selected organisms that cause common infections in humans.
Why it’s important
GLASS aims to support the implementation of the WHO Global Action Plan on AMR.
Data from GLASS help inform national, regional and global decision-making, strategies and advocacy.
Who is involved
The World Health Organization (WHO) launched GLASS in 2015. There are more than 120 participating countries that provide data.
Australia joined GLASS in 2019 and contributes AMR data each year. In 2023 Australia submitted AMR data on all 8 GLASS priority organisms:
- Escherichia coli
- Klebsiella pneumoniae
- Acinetobacter spp.
- Salmonella spp.
- Staphylococcus aureus
- Streptococcus pneumoniae
- Shigella spp.
- Neisseria gonorrhoeae.
Data came from all 4 GLASS priority specimen sites:
- blood
- urine
- faeces
- genital.
Data were sourced from the:
- Australian Gonococcal Surveillance Program (AGSP)
- Australian Passive AMR Surveillance (APAS) system
- Australian Group on Antimicrobial Resistance (AGAR).
The WHO Collaborating Centre for Sexually Transmitted Infections and AMR in Sydney is Australia’s GLASS national coordinating centre. Along with the Australian Government Department of Health and Aged Care, it is a GLASS national focal point.
How it works
Participating countries choose which AMR and antimicrobial usage information they report according to their own priorities.
The WHO regularly reviews and expands the list of organisms, specimens and antimicrobials.
Find out more
Learn more by viewing WHO’s GLASS content.