CIPARS 2013 – Annual Report

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 2013 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 to AMR and AMU data are also reported.

As of April 2013, the Farm Surveillance component was expanded to collect AMR and AMU information from broiler chickens across the four major poultry-producing provinces in Canada (British Columbia, Alberta, Ontario, and Québec). For the first time in 2013, CIPARS will present integrated AMU data from five different sources: human pharmacy, human hospital, physician diagnosis and antimicrobial recommendations, on-farm questionnaires (grower-finisher pigs and broiler chickens), and antimicrobials distributed for sale for use in animals.

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

Chapter 2. Antimicrobial Resistance

Chapter 2 of the 2013 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 remained stable in 2013, with 26% of all infections resistant to one or more antimicrobials. Resistance to gentamicin, an antimicrobial considered of high importance to human medicine (Category II), increased among human S. Newport infections. Resistance to ciprofloxacin (Category I) among S. Typhi human infections continued to increase with 10% resistance observed in 2012 compared to 18% in 2013.

In the agri-food sector, notable increases of ciprofloxacin resistance in Campylobacter recovered from chickens and chicken meat were observed in 2013. Ceftiofur resistance (Category I) among Salmonella recovered from chicken meat has decreased in Ontario since 2004 but increased in Québec, along with resistance in E. coli, since the reintroduction of the use of that antimicrobial in 2007. Additionally, multiclass resistance increased among E. coli recovered from beef cattle. Other significant trends were found for other important antimicrobials in various food animals in Canada and have been highlighted in this chapter.

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

Chapter 3. Antimicrobial Use in Animals

The Canadian Integrated Program for Antimicrobial Resistance Surveillance (CIPARS) collects, analyses, and communicates trends in antimicrobial use and antimicrobial resistance in selected bacteria from humans, animals, and retail meat across Canada. The bacteria under surveillance are known as enteric bacteria (can be found within or infecting 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 among animals, food, and people, with the aim of prolonging the effectiveness of antimicrobials.

This chapter highlights trends in animal antimicrobial use (AMU) in animals in Canada. The AMU findings are based on questionnaire information from sentinel broiler chicken and grower-finisher pig farms. Additionally, this chapter presents antimicrobial sales/distribution data provided by the Canadian Animal Health Institute (CAHI) for all animals in Canada.

In 2013, antimicrobials were used in feed by 77% of grower-finisher pig herds, administered by injection on 61% of herds, and administered by water for 26% of herds. The proportion of grower-finisher pigs exposed to antimicrobials through feed or water was typically 100%, compared to less than 5% for antimicrobials administered by injection. The most common reason for antimicrobial use in feed was for disease prevention (51%), followed by growth promotion (41%) and disease treatment (8%). The antimicrobials used in the greatest quantity in feed were chlortetracycline, tylosin, lincomycin, sulfamethazine, and salinomycin. Antimicrobials were most commonly used to treat or prevent infection with Streptococcus suis, E. coli, and Mycoplasma in nursery piglets, and Streptococcus suis, Mycoplasma, and Lawsonia in grower-finisher pigs.

In 2013, 93% of broiler chicken flocks used antimicrobials in feed. Ceftiofur and enrofloxacin were the only Category I (antimicrobials in classes considered of very high importance to human medicine) antimicrobials used in broiler flocks. Use of ceftiofur at the hatchery was reported by 31% of participating flocks and use of enrofloxacin was reported on 2 flocks. This documented use of these antimicrobials is prior to the start of a voluntary change by the industry to eliminate the preventive use of antimicrobials that are considered of very high importance to human medicine. Overall, disease prevention was the most frequently reported reason for antimicrobial use in broiler chickens on farm for the following reasons:

Hatchery-level uses aim to prevent neonatal diseases (i.e., yolk sacculitis and septicemia primarily);
Feed use aims to prevent two economically significant broiler enteric diseases: necrotic enteritis caused by Clostridium perfringens and coccidiosis caused by various species of Eimeria.

In 2013, 1.5 million kilograms of antimicrobials were distributed for sale by CAHI member companies for use in animals in Canada; a decrease of 9% relative to the 2012 total. Of the 1.5 million kilograms distributed, 24% were in Category IV (considered to be of low importance to human medicine). When adjusted for underlying populations and weights of animals, the total quantity of antimicrobials distributed for sale from 2006 to 2013 was relatively stable. There were provincial differences in the quantities of antimicrobials distributed for sale. In 2013, the quantity of antimicrobials distributed for use in companion animals was 0.2% of the total antimicrobials distributed for sale for use in animals. Antimicrobials distributed for use in companion animals were mostly cephalosporins, β-lactams, and sulfonamides including trimethoprim, while in production animals the most common antimicrobial classes were tetracyclines, ionophores, and β-lactams.

To request a copy of the full report (PDF format), please send an email to cipars-picra@phac-aspc.gc.ca or call us at 519-826-2174.

Chapter 4. Integrated Findings and Discussion

Salmonella Enteritidis was the most common Salmonella identified from humans and was commonly isolated from retail chicken meat in 2013. Resistance was not detected in S. Enteritidis from farm, abattoir, or retail meat samples for any animal species tested. Resistant S. Enteritidis infections in people do not appear to be coming from the major Canadian agri-food commodities sampled in this program (cattle, chickens, and pigs) but retail chicken meat may be an important exposure source for people infected with susceptible S. Enteritidis in Canada.

Similar to previous years, there is evidence of resistance to medically important antimicrobials in non-typhoidal Salmonella and generic E. coli. Most resistance to third-generation cephalosporins (antimicrobials of very high importance to human medicine) were found in S. Heidelberg from ill people and in S. Heidelberg and S. Kentucky in chickens and chicken meat. Resistance to third generation cephalosporins in E. coli isolates from broiler chickens generally correlates well with reported antimicrobial use on farm.

Campylobacter jejuni was frequently detected in retail chicken meat suggesting 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-resistant (an antimicrobial of very high importance to human medicine) 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 medically-important antimicrobials distributed and/or sold for use in animals than people in 2013. Seventy-six percent of antimicrobials distributed for sale for animals were medically important. Among antimicrobials distributed for use in Canada, 79% were intended for use in production animals (food animals and horses); 20% were intended for people, and less than 1% was intended for use in companion animals. Although many of the same antimicrobial drugs are distributed and/or sold for use in both humans and animals, the relative amounts used differ between people and animals and between the different animal species.

There are important differences in the primary reasons for antimicrobial use and how they are administered between people and different livestock species. The most commonly reported primary reason for use on sampled grower-finisher pigs and broiler chicken farms was disease prevention.