Antimicrobial use and resistance surveillance

AMRNet is a national One Health surveillance system that gathers data from bacterial and fungal clinical samples tested for antimicrobial resistance in human and veterinary laboratories. The network organizes this data into a standardized format and makes it available to the public health and scientific community. These data are then used to inform interventions that can prevent illness and reduce the spread of antimicrobial resistance.

The project is a collaboration between PHAC, provincial and territorial public health organizations, and clinical and veterinary laboratories across Canada.

Learn more:

• About AMRNet and data dashboard

The system integrates and synthesizes information from various surveillance systems and laboratory reference services covering:

• humans, animals, food chain and the environment to present data on antimicrobial resistance
• antimicrobial use and other indicators in human (hospital and community), animal and environmental settings

Learn more:

• Data dashboard on antimicrobial use
• Data dashboard on antimicrobial resistance
• Canadian Antimicrobial Resistance Surveillance System publications

CIPARS tracks and reports trends across Canada in:

1. the amount of antimicrobials sold or used in people, animals (on land and in water), plants and crops
2. antimicrobial resistance in select bacteria found in people, animals (on land), food, animal feed, the farm environment and water

The program brings together different sectors embracing a One Health approach to give a full picture of how antimicrobial resistance develops and spreads. By looking at bacteria found in people, animals, food and the environment, the program helps to understand how:

• antimicrobial use is linked to resistance
• resistance spreads through the food chain

This information helps:

• identify ways to reduce the spread of resistant bacteria between animals, food and people in Canada
• develop policies to manage antimicrobial use in hospitals, communities and on farms, so these antimicrobials stay effective longer

Learn more:

• Data visualization on farm antimicrobial use
• Data visualization on veterinary antimicrobial sales reporting in Canada
• Data visualization on antimicrobial resistance in select foodborne bacteria
• About the Canadian Integrated Program for Antimicrobial Resistance Surveillance and surveillance reports

CNISP is a sentinel surveillance system which collects epidemiologic and linked microbiology data from acute-care hospitals across Canada.

The program conducts prospective surveillance of healthcare-associated infections and antimicrobial resistant organisms to:

• summarize trends in national incidence rates, antimicrobial resistance and molecular characterization
• inform evidence-based policies and control measures against antimicrobial resistance

Learn more:

• Data dashboard on healthcare-associated infections and antimicrobial resistant organisms
• About the Canadian Nosocomial Infection Surveillance Program and surveillance data publications

The system monitors drug resistance to tuberculosis (TB) across Canada by collating information provided from provinces and territories on samples tested for TB.

It provides information on:

• basic demographic data (age and sex) about reported TB cases
• drug resistance patterns including multi-drug and extensively drug-resistant strains of TB

Learn more:

• Tuberculosis (TB): Monitoring

The Enhanced Surveillance of Antimicrobial-Resistant Gonorrhea system links a subset of laboratory antimicrobial-susceptibility data from the Canadian Gonococcal Antimicrobial Surveillance Program (GASP-Canada) with enhanced epidemiologic and clinical data. This helps improve understanding of trends in antimicrobial-resistant Neisseria gonorrhoeae, the bacteria that causes gonorrhea.

ESAG monitors data on:

• risk factors, such as:
  • travel
  • sex work
  • sex of sexual partners
• infection site
• prescribed treatment
• whether treatment failure occurred among antimicrobial-resistant gonorrhea cases

These data provide insight into:

• who is affected by resistant gonorrhea
• how antimicrobials are being used
• whether prescribers are following treatment guidelines
• how resistance is evolving in key populations to support public health action, including informing treatment recommendations

Learn more:

• Enhanced Surveillance of Antimicrobial-Resistant Gonorrhea System: Data dashboard
• Antimicrobial-resistant gonorrhea: Surveillance resources and publications
• Gonococcal Antimicrobial Surveillance Program-Canada (GASP-Canada)

FluWatch+ is a multi-component surveillance system that monitors the spread of respiratory viruses, such as flu (influenza), COVID-19, and respiratory syncytial virus (RSV).

The surveillance system consists of:

• virologic surveillance
• outbreak surveillance
• syndromic surveillance
• activity level surveillance
• severe outcome surveillance
• strain characterization and surveillance on susceptibility of respiratory viruses to antivirals
• vaccine monitoring

Learn more:

• Canadian respiratory virus surveillance report
• Flu (influenza): Monitoring through FluWatch+

The program is a voluntary laboratory-based national surveillance system led by the National Microbiology Laboratory. It monitors antibiotic resistant Neisseria gonorrhoeae, the bacteria that causes gonorrhea.

The Canadian Communicable Disease Report publishes gonorrhea surveillance data annually.

GASP-Canada provides:

• summaries of trends in antimicrobial resistance and molecular characterization of resistant strains
• support to provinces and territories with N. gonorrhoeae outbreaks or investigations of cases with resistance to treatment antibiotics
• data annually to the Canadian Antimicrobial Resistance Surveillance System and the WHO Global Antimicrobial Resistance and Use Surveillance System
• data to the Enhanced Surveillance of Antimicrobial-Resistant Gonorrhea system (ESAG)

Data from GASP-Canada and ESAG:

• inform treatment recommendations in Canada
• improve the understanding of emerging gonorrhea antibiotic resistance trends in Canada

Learn more:

• Gonococcal Antimicrobial Surveillance Program of Canada: Data dashboard
• Enhanced Surveillance of Antimicrobial-Resistant Gonorrhea System (ESAG)
• Canadian Antimicrobial Resistance Surveillance System (CARSS)

eSTREP is a passive, laboratory-based system monitoring:

• invasive Streptococcus pneumoniae
• Streptococcus pyogenes (group A streptococcus, GAS)
• neonatal Streptococcus agalactiae (group B streptococcus, GBS)

All 10 provinces and 3 territories submit cultures and data to the National Microbiology Laboratory.

It:

• monitors trends in serotype, emm type and antimicrobial resistance across Canada
• supports public health outbreak investigations
• contributes to vaccine development, vaccination guidelines and treatment guidelines

The Canada Communicable Disease Report publishes surveillance reports for invasive S. pneumoniae and invasive GAS disease annually.

It also provides:

• summaries of trends and shifts in S. pneumoniae serotypes and antimicrobial resistance as a result of implementation of vaccine programs
  • The National Advisory Committee for Immunization uses the data to update vaccination guidelines.
• summaries of GAS emm types and antimicrobial resistance, and genomic characterization of urgent strains
• summaries of GBS serotypes and antimicrobial resistance in neonates, in advance of maternal vaccine formulations becoming available
• support to provinces and territories with streptococcal outbreaks or regional increases of diseases
• S. pneumoniae and GAS data annually to Canadian Antimicrobial Resistance Surveillance System and S. pneumoniae data to the WHO Global Antimicrobial Resistance and Use Surveillance System

Learn more:

• National Microbiology Laboratory: Streptococcus and STI Section
• National Advisory Committee on Immunization (NACI): Statements and publications on pneumococcal vaccines
• Canadian Antimicrobial Resistance Surveillance System (CARSS)

SHAMU monitors the quantity of antimicrobials dispensed by Canadian retail pharmacies over a rolling 72-month period.

Data are broken down by province, region and WHO AWaRe classification (Access, Watch and Reserve) to:

• support antimicrobial stewardship
• inform public health decision-making

Learn more:

• Data dashboard on human antimicrobial use in Canada in the Canadian community sector