Canadian Antimicrobial Resistance Surveillance System - Update 2020
This 2020 Canadian Antimicrobial Resistance Surveillance System (CARSS) Report provides a detailed assessment of antimicrobial resistance (AMR) in Canada. This report also provides recent information on the amount of antimicrobials used in humans and animals, as antimicrobial use (AMU) is one of the key drivers of AMR.
The methodology used for this report prioritizes AMR and AMU data acquired by the Public Health Agency of Canada (PHAC) and its partners. These data are often characterized by a high degree of national representation, but are not fully comprehensive. While this publication does not include projections as a result of mathematical modeling or the calculation of cost estimates, the timely availability of these data complement the existing body of evidence.
- Globally, infections caused by antimicrobial resistant organisms are becoming more frequent, leading to increased illness, death and rising healthcare costsFootnote 1 .
- Indicators show that the situation is worsening in Canada.
Between 2014 and 2018
- The rate of potentially fatal bloodstream infections (BSI) caused by AROs increased.
- The rate of healthcare-associated vancomycin-resistant Enterococcus (VRE) BSI more than doubled.
- The rate of community-associated methicillin-resistant Staphylococcus aureus (MRSA) BSI increased by 140%; of which nearly half the cases are associated with injection drug use.
- Approximately 20% of patients diagnosed with these antimicrobial-resistant BSIs died within 30 days of diagnosis.
- The effectiveness of carbapenems (a class of antimicrobial important for the treatment of multidrug-resistant infections) is threatened by a nine-fold increase in the number of patients testing positive for carbapenem-resistant organisms without signs of infection.
- The proportion of multidrug-resistant gonorrhea infections doubled.
- In Salmonella Typhi/Paratyphi (Typhoid fever) infections, ceftriaxone resistance increased from nearly undetectable levels to 3%.
- Antimicrobial use in humans continues to increase.
- Antimicrobial prescription rates for Canadians aged 65 years and older continued to increase, particularly in women.
- Antimicrobial purchasing by hospitals increased by nearly 30%.
- Although the use of “Reserve” antimicrobialsFootnote 2 (antimicrobials that should be reserved for treating multidrug-resistant infections) was <1% of all antimicrobials consumed by humans in Canada, their use increased by nearly 10%.
- The use of carbapenems increased by more than 120% in the community setting (noting a near doubling in the use of ertapenem).
- While the kilograms of antimicrobials distributed for use in animals decreased by 11%, there was a 6% increase between 2017 and 2018.
This publication contributes to the body of evidence needed to inform the development of effective antimicrobial stewardship and infection prevention and control strategies, which work towards limiting the rise of AMR infections.
Priority antimicrobial-resistant organisms in Canada
- Methicillin-resistant Staphylococcus aureus
- Vancomycin-resistant Enterococcus
- Carbapenemase-producing Enterobacteriaceae
- Clostridioides difficile
- Neisseria gonorrhoeae
- Mycobacterium tuberculosis
- Streptococcus pneumoniae
- Streptococcus pyogenes
- Typhoidal and non-typhoidal Salmonella enterica
- Acinetobacter species
- Campylobacter species
- Escherichia coli
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