Objectives: To provide an update on recent developments, and outputs of, the AURA Surveillance System.

Methods: The Commission has established AURA to collect, analyse and provide reports to inform policy and practice.

AURA continues to work with a number of partners to increase data representativeness and analytical power. Funding for Australian Passive Antimicrobial Resistance (AMR) Surveillance, the National Antimicrobial Utilisation and Surveillance Program (NAUSP), the National Antimicrobial Prescribing Survey (NAPS) and the Australian Group on Antimicrobial Resistance is provided through AURA to maintain an integrated and enhanced data capability. Additional data are provided by Sullivan Nicolaides Pathology, the NPS MedicineWise MedicineInsight program, the National Neisseria Network, and the National Notifiable Diseases Surveillance System.

Results: In August 2017, the Commission released the second AURA report[1] which focussed on 2015 data and included 2016 CARAlert data. Highlights from AURA 2017 include:

• Inappropriate prescribing rates in hospitals and the community are approximately 27% and 45% respectively
• Compared with 2014, there was an increase in rates of fluoroquinolone resistance in Escherichia coli from blood cultures (+2.5%) and Shigella sonnei (+10.9%)
• The proportion of vancomycin-resistant Enterococcus faecium isolates from blood cultures in Australia is now higher than that in Europe
• Community-associated MRSA are now a more common cause of S. aureus bacteraemia than hospital-associated MRSA.

AURA 2017 highlights areas for action, including:

• Continued monitoring of the spread of resistant strains of Neisseria gonorrhoeae to inform treatment guidelines
• For vancomycin-resistant enterococci, strict adherence to infection control guidelines and effective cleaning and sterilisation in healthcare facilities
• Intensifying efforts to reduce unnecessary prescribing in the community and for surgical prophylaxis.

A number of reports have subsequently been released providing detailed analyses of antimicrobial use and resistance including NAUSP, Surgical NAPS, Aged Care NAPS and regular CARAlert updates.

Conclusion: AURA surveillance data identify trends in both antimicrobial use and resistance, and highlight areas for improved prevention and control of resistance in Australia.