Wozniak TM

Cuningham W

Buchanan S

Coulter S

Baird, Robert

Nimmo GR

Blyth CC

Tong SYC

Currie, Bart

Ralph, Anna

2020-08-05

Delivery of information to clinicians on evolving antimicrobial susceptibility needs to be accurate for the local needs, up-to-date and readily available at point of care. In northern Australia, bacterial infection rates are high but resistance to first- and second-line antibiotics is poorly described and currently-available datasets exclude primary healthcare data. We aimed to develop an online geospatial and interactive platform for aggregating, analysing and disseminating data on regional bacterial pathogen susceptibility. We report the epidemiology of Staphylococcus aureus as an example of the power of digital platforms to tackle the growing spread of antimicrobial resistance in a high-burden, geographically-sparse region and beyond. We developed an online geospatial platform called HOTspots that visualises antimicrobial susceptibility patterns and temporal trends. Data on clinically-important bacteria and their antibiotic susceptibility profiles were sought from retrospectively identified clinical specimens submitted to three participating pathology providers (96 unique tertiary and primary healthcare centres, n = 1,006,238 tests) between January 2008 and December 2017. Here we present data on S. aureus only. Data were available on specimen type, date and location of collection. Regions from the Australian Bureau of Statistics were used to provide spatial localisation. The online platform provides an engaging visual representation of spatial heterogeneity, demonstrating striking geographical variation in S. aureus susceptibility across northern Australia. Methicillin resistance rates vary from 46% in the west to 26% in the east. Plots generated by the platform show temporal trends in proportions of S. aureus resistant to methicillin and other antimicrobials across the three jurisdictions of northern Australia. A quarter of all, and up to 35% of methicillin-resistant S. aureus (MRSA) blood isolates in parts of the northern Australia were resistant to inducible-clindamycin. Clindamycin resistance rates in MRSA are worryingly high in regions of northern Australia and are a local impediment to empirical use of this agent for community MRSA. Visualising routinely collected laboratory data with digital platforms, allows clinicians, public health physicians and guideline developers to monitor and respond to antimicrobial resistance in a timely manner. Deployment of this platform into clinical practice supports national and global efforts to innovate traditional disease surveillance systems with the use of digital technology and to provide practical solutions to reducing the threat of antimicrobial resistance.

Menzies School of Health Research, Global & Tropical Health, Charles Darwin University, Darwin, Northern Territory, Australia. Teresa.wozniak@menzies.edu.au.

Menzies School of Health Research, Global & Tropical Health, Charles Darwin University, Darwin, Northern Territory, Australia.

Queensland Health, Communicable Diseases Branch, Brisbane, Queensland, Australia.

Territory Pathology, Northern Territory Government, Darwin, Northern Territory, Australia.

Pathology Queensland Central Laboratory, Griffith University School of Medicine, Brisbane, Queensland, Australia.

Wesfarmers Centre of Vaccines and Infectious Diseases, Telethon Kids Institute, University of Western Australia, Perth, Western Australia, Australia.

Department of Infectious Diseases, Perth Children's Hospital, Perth, Western Australia, Australia.

PathWest Laboratory Medicine, Perth, Western Australia, Australia.

Victorian Infectious Disease Service, The Royal Melbourne Hospital and Doherty Department University of Melbourne, at the Peter Doherty Institute for Infection and Immunity, Melbourne, Victoria, Australia.

Department of Infectious Diseases, Royal Darwin Hospital, Darwin, Northern Territory, Australia.

Sci Rep. 2020 Aug 5;10(1):13169. doi: 10.1038/s41598-020-69312-4.

https://pubmed.ncbi.nlm.nih.gov/32759953/?otool=iaurydwlib

https://hdl.handle.net/10137/8576

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Geospatial epidemiology of Staphylococcus aureus in a tropical setting: an enabling digital surveillance platform.

Journal Article

Publication