Antimicrobial Resistance: A global public health threat · 2019-05-10 · Antimicrobial Resistance:...
Transcript of Antimicrobial Resistance: A global public health threat · 2019-05-10 · Antimicrobial Resistance:...
AntimicrobialResistance:Aglobalpublichealththreat
DrMarkSchippAustralianChiefVeterinaryOfficer
Rotary–WAMay2019
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AveryquickintroductionWhatisAMR?- Whenmicro-organismsevolveresistanceto
antimicrobialsubstances,likeantibiotics.WhyisAMRimportant?- AMRthreatenstheeffectivepreventionand
treatmentofanever-increasingrangeofinfections.- Anincreasinglyseriousthreattoglobalpublic
healththatrequiresactionacrossallgovernmentsectorsandsociety.
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Natureoftheproblem
• AMRisanincreasinghealthconcerninAustraliaandaroundtheworld.
• Ifnotaddressed,simpleinfectionscouldcausesignificantharm.
• Itisestimatedthatby2050,tenmillionpeoplewilldieeveryyearasaresultofAMR.• Eventoday,700,000peopledieof
resistantinfectionseveryyear.
Whydowehaveaproblem?
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Whyisavetspeakingtous?
• Mostantibioticsareusedinanimalindustries
• AMRmaybetransmittedthroughfood
• AOneHealthissue• OneHealthrecognisesthe
interconnectednessofhuman,animalandenvironmentalhealth. https://www.canada.ca/en/health-canada/services/
publications/drugs-health-products/tackling-antimicrobial-resistance-use-pan-canadian-framework-action.html
AntimicrobialuseinAustralia
Referenceadaptedfrom:http://amr-review.org/sites/default/files/Antimicrobials%20in%20agriculture%20and%20the%20environment%20-%20Reducing%20unnecessary%20use%20and%20waste.pdf
Reference:http://www.safetyandquality.gov.au/wp-content/uploads/2016/06/AURA-2016-First-Australian-Report-on-Antimicroibal-use-and-resistance-in-human-health.pdf
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AntibioticuseinAustralia
• Australiansareover-usingantibioticsinhumanhealth.• Australiaisthe11thhighestuserofantibioticsoutof31OECDcountries.
• In2015,morethan30millionantibioticscriptswereprovidedthroughthePharmaceuticalBenefitsScheme.
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Whatisbeingdone?NationalAMRStrategyKeyobjectives:
1. Communication,educationandtraining2. AntimicrobialStewardship3. Surveillance4. Infectionpreventionandcontrol5. Researchanddevelopment6. Internationalengagement7. Governance
Animalhealthkeyinitiatives§ Bestpracticeantibioticprescribingguidelines–pigs
§ Veterinaryantimicrobialstewardshiponlinetrainingprogram
§ Antimicrobialgrowthpromotants(AGPs)–nolabelclaims
§ OIEantimicrobialusage(AMU)annualquestionnaire
§ AntibioticAwarenessWeek
§ ASTAGAntibacteriallistworkinggroup
§ Compendiumreportonantimicrobialstewardshipefforts–livestockindustries
§ AntimicrobialStewardshipGuidelinesfortheAustralianCattleFeedlotIndustry
§ Factsheetsonresponsibleantibioticuse–companionanimals,livestockandhorses
§ Therearecurrentlyonlythreeantibioticsregisteredwithgrowthpromotantclaims,noneofwhicharecurrentlyimportantforhumanmedicine
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HowarethingsinAustralia?ü Anexcellentanimalhealthstatusü Abestpracticeanimalidentificationandtraceabilitysystem
ü Wehavegoodpartnershipsbetweenindustryandgovernment
ü Oursystemsareflexibleandresponsive
ü Wehavegoodagriculturalpracticesincludingon-farmhygieneandbiosecurity
ü ManyofourindustriesimplementbiosecuritymanualsandQAsystems
ü AustralianveterinarianshavebeenproactivelymitigatingAMRforsometime.
ü AustraliaalreadyhasaregulatorysystemworkingtominimiseAMRü Australiahasbeenveryconservativeinregisteringantibioticsforuseinfoodanimals.
ü NearlyallantimicrobialsusedinanimalsareSchedule4medicines.
ü Ourfeedlotindustryarethefirstanywhereintheworldtoimplementastewardshipprogram,andhowtouseantimicrobialsappropriately.
ü OpportunitiesforAustralia
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Isfoodarisk?
InAustraliawehavesurveyedanimals:ü Cattle(2013)–(Note:beefcattle,dairycattleandvealcalf)ü Pigs(2018)ü Chickenmeat(2018)ü ChickenEggs(2018)o Salmono Barramundio ChickenEgg–furtherwork? Others(Note:Thisrelatestosamplesfromhealthyanimals.)
Reference:https://www.spok.com/blog/swiss-cheese-model-patient-safety-errors-closing-holes-message-accountability
Whataboutimportedfood?SourcingCertificationTestingDiseasestatusCookedProcessedGeneticmaterialResiduetesting
FutureVision
Ø Coordination–government/industry,OneHealth,internationally
Ø Surveillance–human/animal/food/environment,use,resistance
Ø Keydatasystems–Antimicrobialsused,laboratoryresults,standardised,integrated
Ø Resourced–communityawareness,research,preventive
• A time for action
• Opportunities for the future
• More work needed
Summary
Reference:http://www.oie.int/en/for-the-media/amr/waaw2015/
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