Bridging healthcare gaps in rural Australia through AMR data

[Music plays and several technology-related images appear inside a circle on the screen. The CSIRO logo appears from the circle. The vision cuts to Teresa Wozniak, CSIRO Research Scientist, who is sitting in a room with plants in the background.]

TW: We know that antimicrobial resistance is a global problem in Australia. The problem is hidden – national surveillance activities don'tactually capture the most vulnerable populations of Australia.

[Screen cuts to Branwen Morgan, Lead of CSIRO’s Antimicrobial Resistance Mission, seated on a soft armchair in a small room. The video is framed in white and in front of a pale blue background.Branwen has headphones on and is speaking directly to the camera.]

BW: The Minimising Antimicrobial Resistance Mission has been co-designed with the Department of Health and Aged and the Department of Agriculture, Fisheries and Forestry. And what we're really working to do is to halt the rising death rate and economic burden of antimicrobial resistance in Australia by 2030.

[Screen cuts to Bhavini Patel, Executive Director of Medicine Management of NT Health, sitting in front of a hallway in amedical facility.]

BP: At the moment, if you go and visit your GP, your general practitioner, or visit a remote health center and they think you've got an infection, there's no clear way of understanding what the right antibiotic is going to be based on local resistance patterns.

[Screen cuts to Anne Kleinitz, a Senior Rural Medical Practitioner, seated in a bright, open room with comfortable chairs.]

AK: As doctors, we look after a population that covers a really large geographical area. 

In all those areas, the antimicrobial resistance varies.So having a platform that can giveus data specific to each region will be really useful. 

We have this sort of data, we can feel confident that perhaps, for example, a narrow spectrum antibiotic may really work for this patient and we can confidently use it.

[Screen cuts to Amy Legg, a pharmacist, who is sitting in a nondescript room in front of a glass wall.]

AL: The HOTspots platform is a new platform that's been developed. 

What it does is it takes data that we have been collecting and really been concentrating in some of the major areas such as Darwin and Alice Springs, and makes it relate to some of the more remote areas where we actually see a really high burden of infections. 

What'sreally interesting about the sort of data and reporting that we do is it's mandated that we do report on our antimicrobial resistance patterns. But a lot of that data hasn't necessarily been optimally used in terms of guideline writing. 

Now what we'll have is really robust data to drive probably significant differences that will help optimise care for our patients because we'll have access to this data for them and where they live.

[Screen cuts back to Bhavini Patel.]

BP: The great thing about HOTspots is this allows each region to have its own antibiotic biogrambased on the infections and treatment that's occurred over the last twelve months. 

The HOTspots data actually allows the clinical person to have a look at what the sensitivities were for those likely infection bugs and make that decision a lot quicker.

[Screen cuts back to Teresa Wozniak.]

TW: So not only are we looking to diversify geographically with HOTspots program, we recognise that antimicrobial resistance goes across the one health sector, and we want to expand the HOTspotsprogram beyond human antimicrobial resistance.

[Screen cuts back to Branwen Morgan.]

BW: What'sreally important to the mission is that we form enduring collaborative partnerships. 

That is why surveillance platforms such as HOTspots are incredibly important to help us get that data and to really understand what is going on in society. 

When we think about what we might actually need to halt the rising death rate and economic burden of antimicrobial resistance, we can't just think about the technological solutions. We have tothink about the environment in which they'll be used and also the behavioural change that will be required. Because unless we have an enabling ecosystem ― so where there's appropriate funding, appropriate policy― some of these solutions will never have the impact that we want them to have.

[Screen cuts back to Bhavini Patel.]

BP: I'mreally excited to see the HOTspots come into clinical practice, because it's got great benefits for patients. It'll reduce the workload of clinicians and have a really major impact on improving antimicrobial stewardship across the top end.

[Screen cuts back to Teresa Wozniak.]

TW: The need for the HOTspotsprogram really came from the ground. It came from building very strong relationships and partnerships with local clinicians, with local policymakers. 

Importantly, the HOTspots program has two components. It has the disease surveillance component. It also has the component where that information is then used for action. 

Currently, over 200 sites contribute to the HOTspots program. We get data directly from pathology providers, from hospitals, community clinics, and GP practices. 

So what does the future hold for HOTspots? Well, HOTspotsis expanding. Humans aren't the only creatures that are affected by antimicrobial resistance, and we need to better understand how antimicrobial resistance fits within the ecosystem of One Health.

We want to go beyond Northern Australia, and we think that the HOTspots app can be used as a national atlas for antimicrobial resistance.

[Screen fills with white and the CSIRO logo appears.]