Antimicrobials are medicines which treat or prevent infections with bacteria, viruses, fungi or parasites. Antimicrobial resistance (AMR), also sometimes called antibiotic or drug resistance, occurs when microorganisms evolve and become able to replicate despite antimicrobial treatment. AMR makes infections much harder to treat as these medicines become less effective. It represents one of the most serious global public health threats.

Infections can occur in anyone, but it is the most vulnerable, including the very young, the elderly and people with weakened immune systems, who are particularly affected.  AMR affects our ability to perform medical treatments and procedures safely, such as surgery and cancer chemotherapy. AMR also means relatively mild and common infections may become untreatable.

Some countries have a much higher prevalence of AMR than others. Aotearoa New Zealand generally has low rates of AMR compared to other countries but rates are increasing. AMR surveillance helps monitor what is happening and to identify any new AMR threats as they emerge.

ESR’s reference laboratories are responsible for national surveillance of AMR among human pathogens (the microorganisms that cause disease),  for providing confirmation of susceptibility results to diagnostic laboratories when needed, and for investigation of outbreaks. ESR collates data from diagnostic laboratories around New Zealand who perform AMR testing, on behalf of the Ministry of Health.

ESR request bacterial isolates listed below to be referred routinely by diagnostic laboratories to the ESR antibiotic reference laboratory for characterisation and surveillance purposes (this does not include specimens for diagnostic testing, nor for requests on a fee for test basis).

Current pathogens to refer to ESR Antibiotic Reference:

• Carbapenemase-producing Enterobacterales and Pseudomonas spp.

• Carbapenem-resistant Acinetobacter baumannii

• Colistin-resistant Escherichia coli and Klebsiella pneumoniae

• Vancomycin-resistant or linezolid-resistant Enterococcus faecium and Enterococcus faecalis 

• Neisseria gonorrhoeae with decreased susceptibility to ceftriaxone or high-level azithromycin resistance (≥ 16 mg/L.)

• Vancomycin non-susceptible, daptomycin-resistant or linezolid-resistant Staphylococcus aureus

• Penicillin non-susceptible Streptococcus pyogenes

• Organisms with other critical emerging or unusual resistance patterns

• Multidrug-resistant organisms associated with outbreaks (following consultation with ESR)

ESR also manages the New Zealand Microbiology Network, and the New Zealand national antimicrobial susceptibility testing committee.