The COVID-19 pandemic has awakened the world to the dangers of zoonotic infectious diseases impacting human health. Another major challenge to human health is Antimicrobial Resistance (AMR) – bacteria that cannot be treated by antibiotics. To tackle this problem a ‘One Health’ approach which recognises the contribution of humans, animals, plants and the environment to AMR is required.
As part of this Australia’s response to this global threat CSIRO’s Australian e-Health Research Centre is developing the Qld One Health AMR Hub. The Hub aligns with CSIRO’s goal of developing a national AMR Mission, which is focussed on a future where antimicrobials still save lives.
The Hub will work with Queensland Health and The Herston Infectious Diseases Institute stakeholders to develop AI-driven tools for One Health surveillance and decision support. The surveillance and decision support platform will capture and integrate data across the health sector, agriculture, and the environment to provide a more comprehensive picture of AMR. This data will support applications that enable time and location-specific trends of AMR to be better measured, analysed and managed, and AI-assisted decision support for antimicrobial stewardship.
The first application to use this data is a tool to alert emergency department doctors of drug-bacteria mismatches and hence when a change of antibiotic treatment might be needed. This application has been developed in conjunction with The Prince Charles Hospital with initial results already published. The tool reconciles information from microbiology test results and patient discharge summaries and uses the SMART on FHIR health care interoperability standard to provide a decision support app.
This tool supports hospital Antimicrobial Stewardship programs by ensuring that appropriate antibiotic prescription continues through the treatment of the infection.
The second application uses de-identified and aggregated data to create a dashboard of information about antimicrobial resistant infections and their location, which can give early indications of AMR hotspots. This dashboard will use disparate data sources from HL7 microbiology test results and Antimicrobial Stewardship Data, which contain antibiotic susceptibility, utilisation and genetic testing results; ED information systems, which contain hospital interaction and antibiotic prescription information; and environmental data through the collection, monitoring and assessment of AMR pollution in wastewater ecosystems.
These tools can expedite the response to infectious disease outbreaks in hospitals and the community to provide an early warning system for escalating pathogens and resistance threats. As such the Qld AMR Hub aims to demonstrate that early surveillance can help protect Australians from antimicrobial resistant infections, reduce hospital admissions, and reduce related healthcare costs.
Ultimately, this will help minimise the development and spread of AMR and ensure the continued availability of effective antibiotics for fighting bacterial infections.