Objective 2: Surveillance and research

Establish a coordinated national surveillance programme of antimicrobial resistance and antimicrobial use in humans, animals and agriculture.

Develop lists of priority organisms, key resistance genes and antimicrobials for national reporting.

Ongoing activities

1  Finalise and maintain the list of priority organisms for surveillance and reporting for human health, taking into account international guidance and the New Zealand context.

2  Finalise and maintain the list of priority antimicrobials for surveillance and reporting in human health care facilities in New Zealand, and a national methodology for measuring and reporting on antimicrobial consumption in hospitals and the community.

Year 1 activities

3  Analyse antimicrobial dispensing data to identify prescriber types. Report this data back to prescribers and use it to develop and target interventions to influence appropriate antimicrobial prescribing (see also Priority action area 12, activity 2).

4  Determine additional requirements for a standardised antimicrobial resistance surveillance system in human health, including an appropriate data repository or management system.

5  Determine additional requirements for a standardised surveillance system to monitor antimicrobial prescribing in the community and hospitals in New Zealand, including an appropriate data repository or management system.

6  Determine the requirements for a critical resistance alert system to detect and confirm pathogens with critical resistance determinants in humans in real time (including specific resistance genes).

7  Develop and implement an enhanced surveillance programme for multi-resistant gram negative micro-organisms in humans, such as carbapenemase producing enterobacteriaceae (CPE). This programme should include information on screening, laboratory identification, surveillance and alerts (see also Priority action area 7, activity 3).

8  Review the requirements and capacity for genomic analysis of outbreaks that are of public health significance, including antimicrobial resistance.

9  Review the current system of collecting data on yearly sales of antimicrobials used in animal and plants, to be consistent with the practice that the World Organization for Animal Health (OIE) recently introduced.

10  Consider extending the New Zealand Veterinary Association surveillance programme on antimicrobial use to include companion animals, and to inform the development of an ongoing national surveillance programme, helping to identify the drivers of good and poor antimicrobial stewardship in animal health.

Years 2-5 activities

11  Develop the business case and implement a standardised surveillance system for antimicrobial resistance in human health, including a review of workforce capacity, capability and training and an appropriate compatible data repository or data management system to address the requirements identified in Priority action areas 3 and 4, activity 4.

12  Develop the business case and a standardised surveillance system for monitoring antimicrobial prescribing in the community and in hospitals, including a review of workforce capacity, capability and training and an appropriate compatible data repository or data management system to address the requirements identified in Priority action areas 3 and 4, activity 5.

13  Develop the business case for the critical resistance alert system to detect and confirm pathogens with critical resistance determinants in humans in real time (including specific resistance genes) (see also Priority action areas 3 and 4, activity 6).

14  Develop and implement a national strategy for providing real-time genomic analysis of outbreaks that are of public health significance, including antimicrobial resistance (in line with Priority action areas 3 and 4, activity 8).

15  Implement initiatives to strengthen national surveillance for antimicrobial resistance and antimicrobial consumption in animal health and agriculture production as identified in Priority action areas 3 and 4, activities 9–10. This should include working in partnership with livestock industries and dairy and veterinary representatives.

16  Establish a regular programme for monitoring regulatory control (audit/verification and information transfer) of antimicrobial-based veterinary medicines.

17  Consider integrating surveillance mechanisms to help identify emerging risks and trends of antimicrobial resistance in human, animal and agricultural settings in New Zealand and implement them, as appropriate.

Implement a national minimum standard for laboratory testing and reporting of antimicrobial susceptibility.

Ongoing activities

1  Human health diagnostic microbiology laboratories develop, publish and widely disseminate antibiograms annually (see also Priority action area 5, activity 3)

Year 1 activities

2  Establish a national antimicrobial susceptibility testing committee to provide expert guidance to laboratories and other stakeholders on all aspects of human antimicrobial susceptibility testing and reporting.

3  Standardise the methodology and reporting of antimicrobial resistance data (antibiograms, including microbes and antimicrobials) from human health laboratories (in line with Priority action area 5, activity 1).

4  Implement appropriate international standards for laboratory testing methods for antimicrobial susceptibility of pathogens isolated from animals and plants.

5  Establish a national system for veterinary laboratories to report on the antimicrobial susceptibility of common animal pathogens.

Years 2-5 activities

6  Human health diagnostic microbiology laboratories to update antibiograms (including microbes and antimicrobials) using the nationally agreed reporting methodology (in line with Priority action area 5, activities 1 and 3) and continue to publish and disseminate them annually.

7  Consider extending the national antimicrobial susceptibility testing committee (in line with Priority action area 5, activity 2) to include antimicrobial susceptibility testing for animal health laboratories.

8  Build capacity in animal health and industry laboratories to ensure standard laboratory work-up of key organisms and susceptibility testing according to surveillance requirements (see Priority action area 5, activity 5).

Support national priorities for research on antimicrobial resistance, antimicrobial consumption and stewardship in human health, animal health and agriculture.

Ongoing activities

1  Promote research funding for antimicrobial resistance, consumption and stewardship activities across human health, animal health and agriculture.

2  Encourage research collaborations on antimicrobial resistance, consumption and stewardship across human health, animal health and agriculture, as well as on drivers of behaviour.

Year 1 activities

3  Identify current gaps and agree on national research and development priorities for antimicrobial resistance, consumption and stewardship in humans, animals and agriculture, including how antimicrobial consumption and resistance in these sectors impact each other.

Years 2-5 activities

4  Promote research on antimicrobial resistance, consumption and stewardship to address the gaps identified in Priority action area 6, activity 3.