Transcript roles and responsibilities_much2x

Roles and Responsibilities of the
Stakeholders within the AMR
Surveillance and Monitoring Programs
Dr. Peter Much
Austrian Agency for Health and Food Safety
Multi-beneficiary Workshop on Veterinary Drugs Residue and Antimicrobial Resistance
AGR 57207
Zagreb, February 9-10th 2015
www.ages.at
Österreichische Agentur für Gesundheit und Ernährungssicherheit GmbH
Introduction
• Infections in humans and animals
-
Treatment failures due to resistant bacteria
Increased fatalities
Longer fattening periods
Increased costs
• Transfer of AMR
-
Hospital-acquired
Human-to-human, human-to-animal
Animal-to-human (direct or via food)
Environment-to-human/animal
• AMR surveillance and usage of antibiotics from stable to
table
- Better understand contexts
2
Outline of the presentation
• AMR surveillance
- Human sector
- Food sector
- Veterinary sector
• Usage of antibiotics
- Human sector
- Veterinary sector
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Federal Ministry of Health (FMH)
• Orders
• Coordinates
• Expects optimal realization of programs
- Also consument and taxpayer
• Publication of results
- AURES: annual Austrian Resistance Report
o AMR
surveillance
o Usage of antibiotics
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AMR surveillance (I)
Human sector
• According to EARS-Net
• NRL nosocomial infections
and AMR
- Hospitals and laboratories
- Invasive bacteria
- Since 2012: EUCAST
criteria applied
• Reporting to EARS-Net
• AURES
Veterinary/food sector
• AGES
- Speciality Unit: Data,
Statistics, and Risk
Assessment (DSR)
- Laboratories
o Diagnostic
labs
o NRL AMR: EUCAST
ECOFFs
• Provinces
- Vets, food inspectors or
AGES-stuff
• Slaughterhouses, retail
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AMR surveillance (II)
• AGES DSR
- Randomized sampling plan according to EFSA publications or
Commission Decision Nr. 2013/652/EU
• FMH
- Decree for the provinces (Bundesländer) to arrange/perform
sampling
• Provinces
- Officially designated veterinarians
sampling at slaughterhouse
o Transport of cooled samples within the limit (3 days) into laboratory
o
• Poultry Health Data and Veterinary Information System
- Provide data systems for samples taken in slaughterhouses
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AMR surveillance (III)
• AGES laboratories
- Analysis of samples
- Typing of isolates
- Antimicrobial susceptibility testing
• AGES DSR
- Analysis of laboratory data
o EUCAST
epidemiological Cut-Offs
- Reporting to FMH
- Reporting to EFSA
- Report published in Austrian Resistance Report (AURES)
o Annual
data
o Trends of antimicrobial resistance
o Analysis using EUCAST clinical breakpoints
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Resistance rates in E. coli isolated from
slaughter pigs, 2004-2013
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Usage of antibiotics
Human sector
• ESAC-Net
• NRL AMR and nosokomial
infections
• Main Association of
Austrian Social Security
Organisations
- Consumption of
antimicrobials
- Consumption in hospitals
excluded
• Reporting
Veterinary sector
• ESVAC
• FMH
• AGES
• Distributors
- Sales of veterinary
antimicrobials
• Since 2014
- flow of quantities of
antibiotics (see presentation
on implementation)
• Reporting
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Veterinary sector: AGES
• Electronically data collection on sales or prescription
of veterinary antimicrobial agents from the
distributors
• Evaluation and analysis
- No attribution of active ingredients to animal populations
• Exception: poultry data
- Poultry health service: each usage of antimicrobials in
flocks of poultry documented
- Analysis of linkage between use and occurrence of
resistance on the way
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AGES
• Report for FMH
• Report published in Austrian Resistance Report
(AURES)
• Data delivery to ESVAC
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Sales in tons of active ingredients by
pharmaceutical forms, 2010-2013
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Sales of antimicrobial substances in
tons in AT, 2010-2013
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Mandatory, reporting
once per year
New data recording structure
Distributors or producers of
pharmaceuticals
S
Vet dispensing
stations
A
E
Vet dispensing
stations
Vet dispensing
stations
D I S P O S A L
Holding
Voluntary
L
U
S
Holding
A
G
Holding
Holding
E
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Summary
• AMR surveillance
- Lack of money: Program in AT continuously reduced
o CD
2013/652/EU
o co-financed
• Usage of antimicrobials
- Sales data
- Disposal data
o Animal
species, quantity applied per day, period of application,
code of diagnosis, etc.
- Usage data
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Thank you for your attention
Vielen Dank für Ihre Aufmerksamkeit
Dr. Peter Much
Agentur für Gesundheit und Ernährungssicherheit
Integrative Risikobewertung, Daten und Statistik
1220 Wien  Spargelfeldstraße 191
Tel. +43-664-8398065  FAX +43-50555-9537303
[email protected]  www.ages.at
Physikatskurs 2012/13
Dr. Peter
Much