1. 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 57207 Zagreb, February 9-10 th 2015 Roles and Responsibilities of the Stakeholders within the AMR Surveillance and Monitoring Programs

2. 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. 3 AMR surveillance -Human sector -Food sector -Veterinary sector Usage of antibiotics -Human sector -Veterinary sector Outline of the presentation

4. 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. 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. 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. 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. 8 Resistance rates in E. coli isolated from slaughter pigs, 2004-2013

9. 9 Veterinary sector ESVAC FMH AGES Distributors -Sales of veterinary antimicrobials Since 2014 -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. 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. 11 Report for FMH Report published in Austrian Resistance Report (AURES) Data delivery to ESVAC AGES

12. 12 Sales in tons of active ingredients by pharmaceutical forms, 2010-2013

13. 13 Sales of antimicrobial substances in tons in AT, 2010-2013

14. 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. 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

16. 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. +43-664-8398065  FAX +43-50555-9537303 peter.much@ages.atpeter.much@ages.at  www.ages.atwww.ages.at Thank you for your attention