Canadian Integrated Program for Antimicrobial Resistance Surveillance (CIPARS) - About CIPARS

The Canadian Integrated Program for Antimicrobial Resistance Surveillance (CIPARS) is a national integrated surveillance program which is coordinated by the Public Health Agency of Canada’s Centre for Food-borne, Environmental and Zoonotic Infectious Diseases and the National Microbiology Laboratory in collaboration with federal, provincial, and private industry partners. CIPARS collects, analyzes, and communicates trends in antimicrobial use and in antimicrobial resistance for select bacteria from humans, animals, and retail meat across Canada. The bacteria under surveillance are known as enteric bacteria (can be found in the intestines of people and animals) and can be transmitted between animals and people. Information from CIPARS supports measures to contain the emergence and spread of resistant bacteria between animals, food, and people, with the aim of prolonging the effectiveness of antimicrobials.

The program is based on several representative and methodologically unified surveillance components which can be linked to examine the relationship between antimicrobials used in food-animals and humans and the associated health impacts. This information supports: (i) the creation of evidence-based policies to control antimicrobial use in hospital, community, and agricultural settings, and thus prolong the effectiveness of these drugs, and (ii) the identification of appropriate measures to contain the emergence and spread of resistant bacteria between animals, food, and people in Canada.

On this page

The CIPARS Team

Program coordinators in 2019
Rebecca Irwin1, Richard Reid-Smith1, and Michael Mulvey2

Surveillance component leads

Antimicrobial resistance data management and analysis leads
Brent Avery

Antimicrobial use data management and analysis leads
Agnes Agunos, Carolee Carson, Anne Deckert, Sheryl Gow, and David Léger

Authors/analysts

Antimicrobial resistance
Agnes Agunos, Brent Avery, Anne Deckert, Sheryl Gow, and Colleen Murphy

Antimicrobial use
Agnes Agunos, Angelina Bosman, Carolee Carson, Anne Deckert, Sheryl Gow, and David Léger

Communications and report production
Brent Avery, Carolee Carson, Dolly Kambo, Colleen Murphy, Courtney Primeau, Mark Reist, Michelle Tessier, and Virginia Young

CIPARS activities

The Canadian Integrated Program for Antimicrobial Resistance Surveillance (CIPARS) monitors trends in antimicrobial use (AMU) and antimicrobial resistance (AMR) in select bacterial species from people, animal and food sources across Canada (Figure 1).

Antimicrobial Resistance: human, animal, and food surveillance

CIPARS surveillance of the human population includes passive surveillance activities for human cases of Salmonella and Campylobacter. Human cases of Salmonella and Campylobacter are nationally notifiable. Samples are collected during a medical visit and materials are submitted by provincial public laboratories to the Public Health Agency of Canada’s National Microbiology Laboratory (NML) in Winnipeg, Manitoba, for AMR testing. CIPARS uses samples collected through FoodNet Canada for surveillance of human Campylobacter cases with testing for AMR conducted at the NML Winnipeg.

CIPARS surveillance in animal populations and food includes active and passive surveillance activities. Active surveillance includes samples from healthy cattle, pigs, chickens, and turkeys along the agri-food chain (farm, abattoir, and retail) for Salmonella, E. coli and Campylobacter. Passive surveillance includes information from Salmonella isolates submitted to provincial or private animal health laboratories from sick or dead animals (primarily cattle, pigs, chickens, turkeys, and horses). Bacterial isolation (active surveillance components) and testing for AMR are conducted at NML in Guelph, Ontario and Saint-Hyacinthe, Québec.

Antimicrobial Use and Sales Data: Animals and crops

Starting in 2017, Health Canada regulations required manufacturers, importers and compounders to report annual sales of medically important antimicrobials intended for use in animals. To meet this requirement, the Public Health Agency of Canada and Health Canada designed and developed the online reporting tool, the Veterinary Antimicrobial Sales Reporting (VASR) system. The VASR system collects data on volumes of antimicrobials and quantity sold or compounded by animal species and by province/territory. Prior to 2019, data on antimicrobials distributed for sale for use in animals was voluntarily provided to CIPARS by the Canadian Animal Health Institute (CAHI).

Data regarding antimicrobials intended for use as pesticides on food crops are collected by Health Canada’s Pest Management Regulatory Agency and are provided to CIPARS.

Fisheries and Oceans Canada under the authority of the Aquaculture Activities regulations within the Fisheries Act require industry owners and operators to report on use of drugs and pesticides, including antimicrobials. Quantities of antimicrobials are available under open data under the National Aquaculture Public Reporting Data.

CIPARS collects on-farm antimicrobial use data through questionnaires administered to volunteer sentinel farms for broiler chickens, grower-finisher pigs, and turkeys. The questionnaires are completed by the veterinarian or designated staff and are submitted to CIPARS for analysis.

Integration

Integration of data by CIPARS includes assessment and interpretation of 1) trends in antimicrobial use and resistance; 2) trends in antimicrobial resistance across bacterial species, across and within animal populations, and with human antimicrobial resistance; 3) potential links between antimicrobial use and antimicrobial resistance; and 4) the detection of new resistance, with an emphasis on critically important antimicrobials.

Figure 1. CIPARS integrated surveillance components

CIPARS integrated surveillance components
Figure 1 – Text equivalent

CIPARS brings together antimicrobial resistance and antimicrobial use data from various activities in humans, animals and crops.

CIPARS has passive and active surveillance activities in humans and animals (including cattle, pigs, chickens, turkeys, and horses). Human antimicrobial resistance surveillance data is derived from human cases of Salmonella and Campylobacter infection. Animal antimicrobial resistance surveillance data includes data from healthy farm animals sampled on-farm, at abattoirs, and retail meats. CIPARS also has surveillance activities for on-farm antimicrobial use on sentinel farms, and reports antimicrobial sales and distribution data from multiple data sources. CIPARS analysts and epidemiologists analyze and report antimicrobial resistance and antimicrobial use findings for each surveillance year including integration of findings from the various surveillance activities and data sources.

Data sources include:

  • The National Microbiology Laboratories (NML), Public Health Agency of Canada (PHAC) in Winnipeg, Manitoba (1), Guelph, Ontario (2) and Saint-Hyacinthe, Québec (2)
  • Canadian Integrated Program for Antimicrobial Resistance Surveillance, PHAC (3), Programme intégré canadien de surveillance de la résistance aux antimicrobiens, PHAC (4)
  • The Canadian Antimicrobial Resistance Surveillance System (CARSS), PHAC. Data source: IQVIA (5)
  • Health Canada’s (HC) Pest Management Regulatory Agency (6)
  • Canadian Animal Health Institute (CAHI) (7)
  • Veterinary Antimicrobial Sales Reporting, HC Veterinary Drugs Directorate and PHAC (7)
  • Fisheries and Oceans Canada (8)
  • FoodNet Canada, PHAC (9)

Antimicrobial resistance

Antimicrobial resistance (also known as antibiotic resistance) is an urgent, global public health concern, and threatens human and animal health. Antimicrobials are medications used to treat bacterial infections. Antimicrobial resistance occurs when bacteria become resistant to these medications, and they are no longer effective in treating these infections which may lead to life-threatening or fatal antimicrobial-resistant infections. Antimicrobial resistance also threatens modern health care. Antimicrobials are important tools for the prevention and treatment of infections following surgeries like joint replacements and cardiac procedures, or during treatments like cancer therapies. Antimicrobial resistance can lead to situations where these and other procedures or treatments cannot be performed.

Although antimicrobials are life-saving medications, any use of antimicrobials can lead to antimicrobial resistance. Antimicrobial use is widely considered a major contributor to the development of antimicrobial resistance. However, the epidemiology or causes of antimicrobial resistance are complex involving many hosts (animals, human), the environment, and numerous direct and indirect transmission pathways (Figure 2).

CIPARS is working towards the preservation of effective antimicrobials for humans and animals through monitoring trends in antimicrobial use and antimicrobial resistance.

Figure 2. Epidemiology of antimicrobial resistancea

Epidemiology of antimicrobial resistance
Figure 2 – Text equivalent

The epidemiology of antimicrobial resistance is complex involving many hosts and settings where antimicrobial resistance may emerge, persist or be transmitted (directly and indirectly). Since antimicrobial use is a major contributor to the occurrence of antimicrobial resistance, understanding its contribution to the emergence, persistence and transmission of antimicrobial resistance is important.

Host or settings where there is antimicrobial use or exposure:

  • Humans (hospitalized, urban, and rural community, extended care facilities, travellers)
  • Food animals (cattle, poultry, sheep, swine, veal calves, other farmed livestock)
  • Companion animals (example: dogs, cats, horses, fish, others)
  • Aquaculture (salmon and other finfish, crustaceans)
  • Vegetation, seed crops, fruit
  • Industrial and household antibacterial chemicals
  • Ethanol fuel producers

Host or settings where antimicrobial resistance may emerge, persist or transmit:

  • Humans (hospitalized, urban, and rural community, extended care facilities, travellers)
  • Food animals (cattle, poultry, sheep, swine, veal calves, other farmed livestock, imports)
  • Companion animals
  • Aquaculture
  • Vegetation, seed crops, fruit
  • Farm effluents and manure spreading
  • Animal feeds, rendering, dead stock, offal, commercial abattoirs/processing plants, retail meat, as well as handling, preparation, and consumption of food (including imported animal feed and meat products)
  • Drinking water, rivers and streams, seas and lakes, swimming
  • Landfill, soil, wildlife, and sewage

aThis figure has elements representing 1) hosts or settings where antimicrobial resistance may emerge, persist and/or be transmitted (solid-filled circles, rectangles, squares or ovals); 2) routes of transmission of antimicrobial resistance including the direction of transmission (arrows); 3) modes of transmission (open squares); and 4) settings of antimicrobial use or exposure (solid-filled circles or ovals).

After Linton AH (1977), modified by Irwin RJ.

Contact information

To obtain additional information, please contact us:

Canadian Integrated Program for Antimicrobial Resistance Surveillance
Food-borne Disease and Antimicrobial Resistance Surveillance Division
Public Health Agency of Canada
370 Speedvale Avenue West, Unit 201, Guelph, Ontario N1H 7M7

E-mail: phac.cipars-picra.aspc@phac-aspc.gc.ca

1

Centre for Food‐borne, Environmental and Zoonotic Infectious Diseases, Public Health Agency of Canada (PHAC)

Return to footnote 1 referrer

2

National Microbiology Laboratory, Winnipeg, PHAC

Return to footnote 2 referrer

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