Österreichische Agentur für Gesundheit und Ernährungssicherheit GmbHwww.ages.at Dr. Peter Much Austrian Agency for Health and Food Safety Multi-beneficiary Workshop on Veterinary Drugs Residue and Antimicrobial Resistance AGR Zagreb, February 9-10 th 2015 Roles and Responsibilities of the Stakeholders within the AMR Surveillance and Monitoring Programs

2 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 Introduction

3 AMR surveillance -Human sector -Food sector -Veterinary sector Usage of antibiotics -Human sector -Veterinary sector Outline of the presentation

4 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 Federal Ministry of Health (FMH)

5 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 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 AMR surveillance (I)

6 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 o sampling at slaughterhouse o Transport of cooled samples within the limit (3 days) into laboratory Poultry Health Data and Veterinary Information System -Provide data systems for samples taken in slaughterhouses AMR surveillance (II)

7 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 AMR surveillance (III)

8 Resistance rates in E. coli isolated from slaughter pigs,

9 Veterinary sector ESVAC FMH AGES Distributors -Sales of veterinary antimicrobials Since flow of quantities of antibiotics ( see presentation on implementation ) Reporting Human sector ESAC-Net NRL AMR and nosokomial infections Main Association of Austrian Social Security Organisations -Consumption of antimicrobials -Consumption in hospitals excluded Reporting Usage of antibiotics

10 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 Veterinary sector: AGES

11 Report for FMH Report published in Austrian Resistance Report (AURES) Data delivery to ESVAC AGES

12 Sales in tons of active ingredients by pharmaceutical forms,

13 Sales of antimicrobial substances in tons in AT,

14 New data recording structure Distributors or producers of pharmaceuticals Vet dispensing stations Holding SALE USAGE DISPOSAL 14 Mandatory, reporting once per year Voluntary

15 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 Summary

Dr. Peter Much Physikatskurs 2012/13 Vielen Dank für Ihre Aufmerksamkeit Dr. Peter Much Agentur für Gesundheit und Ernährungssicherheit Integrative Risikobewertung, Daten und Statistik 1220 Wien  Spargelfeldstraße 191 Tel  FAX  Thank you for your attention