CIPARS 2012 – Annual Report

ISSN: 1925-9859 (On-line)

The Canadian Integrated Program for Antimicrobial Resistance Surveillance (CIPARS) tracks selected bacteria that reside in the intestinal tract of people and animals in order to understand trends in antimicrobial resistance use and resistance. Antimicrobials are drugs used to kill bacteria that can cause infectious diseases. These bacteria can develop or acquire resistance to these drugs, making them less or not effective.

Chapter 1. Design and Methods

Chapter 1 of the 2012 CIPARS Annual Report includes information on the design and methods used to obtain data on antimicrobial resistance (AMR) and use (AMU) in people, cattle, chickens, pigs, turkeys, horses and animal feed. Analysis methods applied on AMR and AMU data are also reported.

In 2012, new methodologies have been adopted for AMR surveillance. This chapter also includes new tables to summarize the design and methods applied since the implementation of the different AMR and AMU components of CIPARS.

Chapter 2. Antimicrobial Resistance

Chapter 2 of the 2012 CIPARS Annual Report highlights antimicrobial resistance findings over time and across different regions in Canada. The information provided helps to guide decision makers to better manage antimicrobial use in human and veterinary medicine. Highlights of the report include information about antimicrobial resistance in people, cattle, chickens, pigs, turkeys, horses and animal feed.

Of particular importance to public health, the percent of resistant human Salmonella infections decreased 3% between 2011 and 2012. Additionally, resistance to critically important antimicrobials (considered of very high importance to human medicine - Category I) in people infected with Salmonella Typhi while travelling continued to increase in 2012.

Among bacteria from animals and food, resistance to Category I antimicrobials continued to increase and was more common in bacteria from chickens and pigs compared to cattle. In Québec, ceftiofur resistance (Category I) in Salmonella or E. coli from retail chicken showed a continued rise since the reintroduction of the use of that antimicrobial in 2007. Other significant trends were found for other important antimicrobials in various food animals in Canada and have been highlighted in this chapter.

Chapter 3. Antimicrobial Use In Animals

This chapter highlights trends in animal antimicrobial use (AMU) in Canada. The AMU findings are based on information from grower-finisher pig herds collected on farm through questionnaires. Additionally, this chapter presents AMU estimations provided on the quantities of antimicrobials distributed for sale for use in animals by the Canadian Animal Health Institute (CAHI) member companies.

From 2009 to 2012, 78% of grower-finisher pig herds used antimicrobials in feed, 59% by injection, and 25% in water. The proportion of grower-finisher pigs exposed to antimicrobials through feed or water was typically 100%, compared to less than 5% when antimicrobials were administered by injection. The most commonly used antimicrobials by any route of administration in grower-finisher pig herds were penicillin G (54%), lincomycin (36%), tylosin (36%) and chlortetracycline (36%). The most common reason for antimicrobial use in feed was for disease prevention.

In 2012, 1.6 million kilograms of antimicrobials were distributed for sale by CAHI member companies for use in animals in Canada; a decrease of 8% relative to the 2006 total and an increase of 3% relative to the 2011 total. Of the 1.6 million kilograms distributed, 30% were in Category IV (considered to be of low importance to human medicine) or had not been categorized according to their importance to human medicine. When adjusted for underlying populations and weights of animals, the total quantity of antimicrobials distributed for sale from 2006 to 2012 was relatively stable. There were provincial differences in the quantities of antimicrobials distributed for sale. In 2012, the quantity of antimicrobials distributed for use in companion animals was 0.6% of the total antimicrobials distributed for sale. Antimicrobials distributed for use in companion animals were mostly cephalosporins, ß-lactams and sulfonamides, while in production animals the most common antimicrobials were tetracyclines, ionophores, and ß-lactams.

To view this chapter, please visit Publications.gc.ca (PDF Document).

Chapter 4. Integrated Findings and Discussion

This chapter brings together some of the results across surveillance components, over time, across regions, and across host or bacterial species. Salmonella Enteritidis was the most common Salmonella identified from humans and also isolated from retail chicken meat in 2012. This may indicate that fresh chicken meat may be an important source of S. Enteritidis infections in people. Resistance was not detected in S. Enteritidis from farm, abattoir, or retail meat samples for any animal species tested. Resistant S. Enteritidis from ill people does not appear to be coming from the major Canadian agri-food commodities sampled in this program (cattle, chickens, and pigs).

Salmonella Heidelberg was isolated at higher levels from ill people and chicken samples routinely collected from Eastern Canada compared to Western Canada. Similar to previous years, high levels of resistance to third-generation cephalosporins (antimicrobials of very high importance to human medicine) were found in S. Heidelberg from ill people and chicken meat.

Some human and agri-food isolates were found with resistance to 5 or more antimicrobial classes. Not all resistance trends for human salmonellosis appear to be linked to the major agri-food commodities (cattle, pig, and chicken).

Campylobacter jejuni was frequently detected in retail chicken meat. This suggests that domestic human cases may be related to handling or consumption of domestically-produced chicken products. Potential links between people and chicken meat may be further clarified with the addition of AMR data for human Campylobacter infections in the future. The pattern of ciprofloxacin (an antimicrobial of very high importance to human medicine) resistant Campylobacter in retail chicken continues to change over time and across regions.

In terms of integrating antimicrobial use information from animals and people, after adjusting for populations and weights, there were approximately 1.4 times more antimicrobials distributed and/or sold for use in animals than people in 2012 (ionophores and chemical coccidiostats excluded). Among antimicrobials distributed for use in Canada (excluding ionophores, chemical coccidiostats and arsenicals), 80% were intended for use in production animals (food animals and horses). Seventy-four percent of human antimicrobial use occurred in community settings and 26% of use was in hospitals. Less than 1% of animal antimicrobial use was for small animals.

Although the same antimicrobials are used in humans and animals, some are used at much greater volumes in human medicine than animal medicine, and vice versa.

Most antimicrobial use in humans was for respiratory and urinary tract infections; most use in pigs was to treat and/or prevent respiratory disease. Most use of antimicrobials of high importance to human medicine reported in swine was to treat and/or prevent respiratory disease.

To view this chapter, please visit Publications.gc.ca (PDF Document).

Table of Contents

Chapter 1. Design and Methods

Chapter 2. Antimicrobial Resistance

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