Canadian Integrated Program for Antimicrobial Resistance Surveillance (CIPARS) 2017: Integrated Findings

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To promote and protect the health of Canadians through leadership, partnership, innovation and action in public health, Public Health Agency of Canada.

Working towards the preservation of effective antimicrobials for humans and animals, Canadian Integrated Program for Antimicrobial Resistance Surveillance.

Également disponible en français sous le titre :

Programme intégré canadien de surveillance de la résistance aux antimicrobiens (PICRA) 2017 : Résultats intégrés

To obtain additional information, please contact:

Dolly Kambo
Executive assistant
Public Health Agency of Canada
370 Speedvale Avenue West, Guelph, ON N1H 7M7
Telephone: 519-826-2174
Fax: 519-826-2255
E-mail: phac.cipars-picra.aspc@canada.ca

This publication can be made available in alternative formats upon request.

©Her Majesty the Queen in Right of Canada, as represented by the Minister of Health, 2020

Publication date: January 2020

This publication may be reproduced for personal or internal use only without permission provided the source is fully acknowledged.

Cat.: HP2-4/2017E-2-PDF
PDF ISBN: 978-0-660-32669-6
Pub.: 190361

Suggested Citation:

Government of Canada. Canadian Integrated Program for Antimicrobial Resistance Surveillance (CIPARS) 2017: Integrated Findings. Public Health Agency of Canada, Guelph, Ontario, 2020.

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phac.cipars-picra.aspc@canada.ca

https://www.canada.ca/en/public-health/services/surveillance/canadian-integrated-program-antimicrobial-resistance-surveillance-cipars/cipars-reports.html

CIPARS 2017: Figures and Tables

CIPARS Methodology

Overview of CIPARS activities

Figure 1. CIPARS brings together diverse sources of data in a robust and sound manner

Figure 1. CIPARS brings together diverse sources of data in a robust and sound manner. Text description follows.
Figure 1 - Text Description

CIPARS brings together diverse sources of data in a robust and sound manner

This diagram represents all of the surveillance components that contribute to the Canadian Integrated Program for Antimicrobial Resistance Surveillance (CIPARS). The top half of the figure depicts all of the surveillance components related to antimicrobial resistance. On the left side, a component of passive surveillance (green arrows) associated with clinical samples of Salmonella (green circle) and Campylobacter (red triangle) of human origin is presented. These human samples are taken during the medical visit and sent to a local laboratory, then to a provincial/territorial laboratory, and finally to the National Microbiology Laboratory of Public Health Agency of Canada (PHAC) in Winnipeg. On the right side, there is a passive surveillance component (green arrows) and three active surveillance components (yellow arrows) from the Agri-Food sector. The passive surveillance component (green arrows) relies on clinical samples from sick animals (cattle, pigs, chickens, horses, and turkeys) that are submitted to provincial or private animal health laboratories for the isolation of Salmonella (green circle). Further on the right are presented the active surveillance components (yellow arrows) based on animal samples from the farm (cattle, pigs, chickens and turkeys), the abattoir (beef cattle, chickens, pigs) and also on retail meat samples (beef, pork, chicken and turkey). In general, samples from diseased animals are sent to the PHAC National Microbiology Laboratory in Guelph through provincial or private animal health laboratories. For other Agri-Food samples, most will be sent directly to the Saint-Hyacinthe National Microbiology Laboratory of the PHAC for the isolation of Salmonella (green circle), Campylobacter (red triangle), and Escherichia coli (green square).

The bottom of the diagram lists the surveillance components for antimicrobial use. On the left, three components related to the use of antimicrobials in humans and based on physician diagnostic data, hospital purchases and pharmacy sales data are shown. The data from humans are analyzed by the Canadian Antimicrobial Resistance Surveillance System of the PHAC and will be integrated with other CIPARS data. In the center, there is a component that monitors antimicrobials distributed for sale for use in crops. These data are processed by Health Canada's Pest Management Regulatory Agency and are also incorporated into some CIPARS data. There is also a component that monitors antimicrobials distributed to animals. This includes antimicrobials distributed for sale for use in production animals (cattle, pigs, chickens, turkey, etc.) and companion animals (dogs, cats, horses, etc.). The latter are processed by the Canadian Animal Health Institute and are sent to CIPARS for further integration. On the right, there are two surveillance components related to antimicrobial use on farm, the finfish antimicrobial use data (processed by Fisheries and Oceans Canada) and the sentinel flock antimicrobial use data (cattle, pigs, chickens and turkeys).

The central section of this diagram illustrates the collection of all data related to antimicrobial resistance and antimicrobial use within the CIPARS program. All data collected are integrated to figure out trend evolution and status of antimicrobial resistance and use in humans and the agri-food sector in Canada.

What's new for CIPARS in 2017

We are modernizing how we share our information with different audiences and are transitioning to new communication tools and formats. In the meantime, CIPARS will continue to deliver the same information, but in a modified manner.

For the 2017 data, we will be releasing 4 documents:

Antimicrobial use

Antimicrobial resistance

2017 Key findings

Antimicrobial use

In 2017, fewer farms participating in CIPARS surveillance reported using antimicrobials:

The reductions in antimicrobial use on broiler chicken and pig farms may be in response to new policy regulations for medically important antimicrobials (eliminating use for growth promotion and available by prescription only).

Antimicrobial resistance

Since 2011, we have observed an increasing number of human and agri-food isolates resistant to more than 5 antimicrobial classes.

Integrated antimicrobial use and resistance data

Chicken and people

Ceftiofur use in poultry

The poultry industry initiative to eliminate use of Category I antimicrobials (including the 3rd generation cephalosporin ceftiofur) for disease prevention appears to have had the desired effect to reduce antimicrobial resistance:

Campylobacter

There are currently regional differences in the prevalence of fluoroquinolone-resistant Campylobacter from chickens and chicken meat.

In 2017, resistance to ciprofloxacin was more commonly identified in human Campylobacter isolates and retail chicken from British Columbia compared to Alberta and Ontario.

Integrated findings and discussion

Integrated antimicrobial use

Antimicrobials are grouped into categories based on their importance to human medicine and the potential consequences of resistance to these drugs:

Similar to 2016, antimicrobials of low importance (Category IV, with the exception of flavophospholipids) were removed from the integrated AMU reporting. Data will be available in other CIPARS products.

Note: chemical coccidiostats are considered unclassified antimicrobials.

For reporting data on antimicrobials used in animals, we use different metrics or ways of reporting the information.

Why do we use different metrics?

Comparing humans, animals, and crops

Canada is a major producer of food animals for domestic and international markets.

Figure 2. Human and animal population estimates with total kilograms of antimicrobials distributed and/or sold in 2017

Figure 2. Percentage of antimicrobials distributed or sold in 2017. Text description follows.
Figure 2 - Text Description
Human and animal population estimates with total kilograms of antimicrobials distributed and/or sold in 2017
Population Estimated number Ratio Antimicrobials distributed and/or sold (kg)
Humans 36,540,268 1 249,026
Animals 768,334,311 21 948,615

Approximately 77% of antimicrobials distributed or soldFigure 3 footnote * (when measured by kilograms of active ingredient) in 2017 were intended for production animals, 20% were for humans, 2% for crops and 1% for companion animals.

Figure 3. Proportion of total kilograms of antimicrobials distributed and/or sold in Canada in 2017, by sector

Figure 3. Proportion of total kilograms of antimicrobials distributed and/or sold in Canada in 2017, by sector. Text description follows.
Figure 3 footnote *

When measured by kilograms of active ingredient.

Return to Figure 3 footnote * referrer

Figure 3 - Text Description
Proportion of total kilograms of antimicrobials distributed and/or sold in Canada in 2017, by sector
Antimicrobials distributed and/or sold %
Companion animals 1%
Crops 2%
Human hospital purchases 3%
Human pharmacy dispensations 17%
Terrestrial production animals 76%
Marine and freshwater fish 1%
Total (across all sectors) 100%

Note: This graph is based on total kilograms distributed and is not adjusted for biomass. Animal distribution data currently does not account for quantities imported for own use, or as active pharmaceutical ingredients for further compounding; hence are underestimates of total quantities used.

Figure 4. The proportions of total kilograms of antimicrobial classes distributed or sold in 2017 in humans, production animals, and companion animals

Figure 4. The proportions of total kilograms of antimicrobial classes distributed or sold in 2017 in humans, production animals, and companion animals. Text description follows.
Figure 4 - Text Description
The proportions of total kilograms of antimicrobial classes distributed or sold in 2017 in humans, production animals, and companion animals
Humans Production Animals Companion Animals
Antimicrobial Class % Antimicrobial Class % Antimicrobial Class %
Beta-lactams/penicillins 51% Tetracyclines 54% Cephalosporins 34%
Cephalosporins 20% Other antimicrobials 13% Beta-lactams/penicillins 31%
Trimethoprim and sulfonamides 8% Beta-lactams/penicillins 11% Trimethoprim and sulfonamides 30%
Fluoroquinolones and quinolones 7% Macrolides 10% Lincosamides 2%
Macrolides 6% Trimethoprim and sulfonamides 6% Fluoroquinolones 1%

For both humans and animals, the β-lactams (penicillins) were one of the main antimicrobial classes distributed/sold on a per kg of antimicrobial basis.

Similar antimicrobials are licensed for use in humans and animals; however, some antimicrobial classes are sold or distributed more for use in humans than animals and vice-versa.

Note: Cephalosporins are β-lactam antimicrobials, but we are displaying them separately for visualization purposes.

The total quantities of antimicrobials distributed for sale for use in production animals declined, both when measured in total kg and kg adjusted by biomass. These are the lowest reported values since surveillance began.

Figure 5. Quantities of antimicrobials distributed for use in animals

Figure 5. Quantities of antimicrobials distributed for use in animals. Text description follows.
Figure 5 - Text Description
Figure 5. Quantities of antimicrobials distributed for use in animals
Year Total (kg) Total (mg/PCU European weights) Total (mg/PCU Canadian weights)
2008 1,143,187 150 128
2009 1,141,213 160 137
2010 1,037,313 150 129
2011 1,121,715 168 145
2012Figure 5 footnote * 1,117,457 169 145
2013Figure 5 footnote * 1,118,097 170 145
2014Figure 5 footnote * 1,114,837 170 146
2015Figure 5 footnote * 1,187,136 183 157
2016Figure 5 footnote * 1,051,010 160 138
2017Figure 5 footnote * 934,873 141 122
Figure 5 footnote *

Indicates years where data exclude antimicrobials sold for use in companion animals.

Return to Figure 5 footnote * referrer

Figure 6. Quantities of antimicrobials used (mg/PCU) by Canada (2017) and countries participating in the European Surveillance of Veterinary Antimicrobial Consumption (ESVAC) network (2016)

Figure 6. Quantities of antimicrobials used (mg/PCU) by Canada (2017) and countries participating in the European Surveillance of Veterinary Antimicrobial Consumption (ESVAC) network (2016). Text description follows.
Figure 6 - Text Description
Quantities of antimicrobials used (mg/PCU) by Canada (2017) and countries participating in the European Surveillance of Veterinary Antimicrobial Consumption (ESVAC) network (2016)
European Countries mg/PCU Canada Median of EU countries
Austria 46 141 57
Belgium 140 141 57
Bulgaria 155 141 57
Croatia 93 141 57
Cyprus 453 141 57
Czech Republic 61 141 57
Denmark 41 141 57
Estonia 64 141 57
Finland 19 141 57
France 72 141 57
Germany 89 141 57
Greece 64 141 57
Hungary 187 141 57
Iceland 5 141 57
Ireland 52 141 57
Italy 295 141 57
Latvia 30 141 57
Lithuania 38 141 57
Luxembourg 36 141 57
Netherlands 53 141 57
Norway 3 141 57
Poland 129 141 57
Portugal 208 141 57
Romania 85 141 57
Slovakia 50 141 57
Slovenia 30 141 57
Spain 363 141 57
Sweden 12 141 57
Switzerland 47 141 57
United Kingdom 45 141 57

Data Sources: Canadian Animal Health Institute (CAHI), European Surveillance of Veterinary Antimicrobial Consumption (ESVAC), Fisheries and Oceans Canada, Health Canada's Pest Management Regulatory Agency, human pharmacy and hospital data from IQVIA via the Canadian Antimicrobial Resistance Surveillance System, Statistics Canada, Agriculture and Agri-food Canada, and Equine Canada.

Comparing farm antimicrobial use data

Comparison of antimicrobial classes (kg of active ingredient)

There are important differences in the types and relative quantities of antimicrobials reported for use between food animal species, which is why we need ongoing surveillance across the food animal species.

Figure 7.1 The relative quantities of antimicrobial classes reported for use (mg/PCU) in animals in 2017: broiler chickens

Figure 7.1 The relative quantities of antimicrobial classes reported for use (mg/PCU) in broiler chickens, grower-finisher pigs, and turkeys in 2017. Text description follows.

Not shown: macrolides (1%), aminoglycosides (1%), lincosamides-aminocyclitols (<1%)

Figure 7.2 The relative quantities of antimicrobial classes reported for use (mg/PCU) in animals in 2017: grower-finisher pigs

Figure 7.2 Grower-finisher pigs. Text description follows.

Not shown: pleuromutilins (1%)

Figure 7.3 The relative quantities of antimicrobial classes reported for use (mg/PCU) in animals in 2017: turkeys

Figure 7.3 Turkeys. Text description follows.
Figure 7.1, 7.2, 7.3 - Text Description
The relative quantities of antimicrobial classes reported for use (mg/PCU) in animals in 2017
Broiler Chickens Grower-Finisher Pigs Turkeys
Antimicrobial Class % Antimicrobial Class % Antimicrobial Class %
Bacitracins 61% Tetracyclines 43% Bacitracins 54%
Trimethoprim and sulfonamides 13% Lincosamides 31% Streptogramins 21%
Streptogramins 10% Macrolides 12% Trimethoprim and sulfonamides 12%
Penicillins 7% Sulfonamides 7% Macrolides 11%
Orthosomycins 6% Penicillins 4% Tetracyclines 1%
Tetracyclines 2% Streptogramins 2%    

Not shown: penicillins (<1%)

Temporal trends in antimicrobial use

Broiler chickens

Farm surveillance showed a reduction in antimicrobial use in 2017 compared with 2016 data in broiler chickens.

When we accounted for the number and weight of chickens, the top reported antimicrobials were:

  1. Bacitracins
  2. Trimethoprim
  3. Streptogramins

When we accounted for the number of doses, the top reported antimicrobials were:

  1. Bacitracins
  2. Streptogramins
  3. Orthosomycins

Figure 8. Temporal trends in mg/PCU in broiler chickens in Canada, 2013 to 2017

Figure 8. Temporal trends in mg/PCU in broiler chickens in Canada, 2013 to 2017. Text description follows.
Figure 8 - Text Description
Temporal trends in mg/PCU in broiler chickens in Canada, 2013 to 2017
Year 2013 2014 2015 2016 2017
Number of flocks 99 143 136 136 138
Antimicrobial class
I Fluoroquinolones < 0.1 0 0 0 0
Third-generation cephalosporins < 0.1 < 0.1 0 0 0
II Aminoglycosides < 0.1 2 1 0.5 1
Lincosamides-aminocyclitols 0.1 0.1 0.2 0.1 0.1
Macrolides 7 11 7 3 1
Penicillins 11 19 14 5 8
Streptogramins 24 8 6 14 13
Trimethoprim and sulfonamides 20 24 26 14 16
III Bacitracins 75 79 74 82 77
Tetracyclines 5 3 8 0 2
IV Flavophospholipids 0.2 0 0.3 < 0.1 0.1
N/A Orthosomycins 0 7 10 11 8
Total 142 153 147 130 127

Figure 9. Temporal trends in nDDDvetCA/1000 chicken-days at risk in broiler chickens, 2013 to 2017

Figure 9. Temporal trends in nDDDvetCA/1000 chicken- days at risk in broiler chickens, 2013 to 2017. Text description follows.
Figure 9 - Text Description
Temporal trends in nDDDvetCA/1000 chicken-days at risk in broiler chickens, 2013 to 2017
Year 2013 2014 2015 2016 2017
Number of flocks 99 143 136 136 138
Antimicrobial class
I Fluoroquinolones 0.04 0 0 0 0
Third-generation cephalosporins 1 0.1 0 0 0
II Aminoglycosides 0.0 2 2 1 1
Lincosamides-aminocyclitols 0.5 0.5 1 0.5 0.5
Macrolides 8 12 7 3 1
Penicillins 34 33 47 25 31
Streptogramins 237 83 63 139 128
Trimethoprim and sulfonamides 85 85 89 50 61
III Bacitracins 217 232 213 239 224
Tetracyclines 9 4 15 1 4
N/A Orthosomycins 0 72 98 117 79
Total 591 524 535 576 529
Grower-finisher pigs

A grower-finisher pig is a pig that is approximately 25 kilograms to market weight. Farm surveillance showed a reduction in antimicrobials used in feed in 2017 compared with 2016 data in grower-finisher pigs.

When we accounted for the number and weight of pigs, the top reported antimicrobials were:

  1. Tetracycline
  2. Lincosamides
  3. Macrolides

When we accounted for the number of doses, the top reported antimicrobials were:

  1. Lincosamides
  2. Tetracyclines
  3. Macrolides

Figure 10. Temporal trends in mg/PCU in grower-finisher pigs in Canada, 2009 to 2017

Figure 10. Temporal trends in mg/PCU in grower-finisher pigs in Canada, 2009 to 2017. Text description follows.
Figure 10 - Text Description
Temporal trends in mg/PCU in grower-finisher pigs in Canada, 2009 to 2017
Year 2009 2010 2011 2012 2013 2014 2015 2016 2017
Number of herds 95 90 93 87 89 95 85 91 82
Antimicrobial class
II Lincosamides 28.0 20.1 25.1 23.2 31.3 31.1 31.9 28.1 32.6
Macrolides 35.9 43.7 44.2 43.3 36.8 33.2 27.3 27.0 12.5
Penicillins 2.0 2.5 1.2 0.8 4.9 4.9 3.0 2.9 3.7
Streptogramins < 0.1 < 0.1 < 0.1 2.6 0.8 1.3 9.0 0.4 1.6
III Aminogylcosides 0.2 0.1 0.4 0.0 0.0 0.6 0.4 0.0 0.0
Bacitracins 0.0 0.8 0.0 0.0 0.8 0.0 0.0 0.0 0.0
Pleuromutilins < 0.1 1.7 1.8 2.1 3.2 6.0 4.7 1.9 1.5
Sulfonamides 3.3 0.8 0.9 0.5 2.3 2.7 2.7 3.5 7.3
Tetracyclines 87.5 73.0 83.6 83.1 66.3 84.7 97.0 51.6 44.9
IV Flavophospholipids 0.1 0.1 < 0.1 0.1 < 0.1 < 0.1 0.1 0.2 0.2
Total no data 157.1 142.9 157.2 155.7 146.4 164.6 176.3 115.5 104.3

Figure 11. Temporal trends in nDDDvetCA/1000 pig-days at risk in grower-finisher pigs, 2009 to 2017

Figure 11. Temporal trends in nDDDvetCA/1000 pig-days at risk in grower-finisher pigs, 2009 to 2017. Text description follows.
Figure 11 - Text Description
Temporal trends in nDDDvetCA/1000 pig-days at risk in grower-finisher pigs, 2009 to 2017
Year 2009 2010 2011 2012 2013 2014 2015 2016 2017
Number of herds 95 90 93 87 89 95 85 91 82
Antimicrobial
II Lincosamides 59 47 49 49 79 68 60 49 57
Macrolides 104 122 129 122 103 92 76 78 37
Penicillins 8 10 5 3 20 20 12 11 15
Streptogramins 0.1 0.1 0.3 7 2 4 24 1 4
III Aminocyclitols 2 1 4 0 0 6 4 0 0
Bacitracins 0 2 0 0 2 0 0 0 0
Pleuromutilins 0.1 3 4 4 6 11 9 4 0
Sulfonamides 7 2 2 1 5 5 5 7 15
Tetracyclines 87 64 73 72 58 72 82 44 38
Total 268 250 266 258 276 278 274 194 168
Turkeys

The overall reported antimicrobial use in turkeys was much lower than for broiler chickens and grower-finisher pigs in 2017.

When we accounted for the number and weight of turkeys, the top reported antimicrobials were:

  1. Bacitracins
  2. Streptogramins
  3. Trimethoprim and sulfonamides

When we accounted for the number of doses, the top reported antimicrobials were:

  1. Streptogramins
  2. Bacitracins
  3. Trimethoprim and sulfonamides

Figure 12. Temporal trends in mg/PCU in turkeys in Canada, 2016 to 2017

Figure 12. Temporal trends in mg/PCU in turkeys in Canada, 2016 to 2017. Text description follows.
Figure 12 - Text Description
Temporal trends in mg/PCU in turkeys in Canada, 2016 to 2017
Year 2016 2017
Number of flocks 72 74
Antimicrobial class
Flavophospholipids 0 1
Tetracyclines 5 1
Bacitracins 37 33
Trimethoprim and sulfonamides 2 8
Streptogramins 12 13
Penicillins 1 1
Macrolides 3 7
Aminoglycosides 0.4 0.2
Fluoroquinolones 0 0
Total 60.6 63.1

Figure 13. Temporal trends in nDDDvetCA/1000 turkey-days at risk in turkeys, 2016 to 2017

Figure 13. Temporal trends in nDDDvetCA/1000 turkey-days at risk in turkeys, 2016 to 2017. Text description follows.
Figure 13 - Text Description
Temporal trends in nDDDvetCA/1000 turkey-days at risk in turkeys, 2016 to 2017
Year 2016 2017
Number of flocks 72 74
Antimicrobial class
Tetracyclines 4 0
Bacitracins 43 38
Trimethoprim and sulfonamides 5 13
Streptogramins 48 52
Penicillins 2 1
Macrolides 1 3
Aminoglycosides 0 0
Fluoroquinolones 1 0
Total 103 108

Reasons for antimicrobial use

Figure 14. Quantity of antimicrobials used (mg/PCU) by reason for use; CIPARS Farm 2013 to 2017

Figure 14. Quantity of antimicrobials used (mg/PCU) by reason for use; CIPARS Farm 2013 to 2017. Text description follows.
Figure 14 - Text Description
Quantity of antimicrobials used (mg/PCU) by reason for use; CIPARS Farm 2013 to 2017
Year 2013 2014 2015 2016 2017
Sector G-F Swine Br. Chicken G-F Swine Br. Chicken G-F Swine Br. Chicken G-F Swine Br. Chicken Turkeys G-F Swine Br. Chicken Turkeys
Number of Farms 89 99 95 143 85 136 91 136 72 82 138 74
Disease Treatment 23 28 26 42 16 31 4 14 3 4 18 6
Disease Prevention 85 101 88 106 90 115 77 116 58 54 109 56
Growth Promotion 38 13 50 5 70 1 35 0 0 46 1 1
Total 146 142 164 152 176 147 116 130 61 104 127 63

Swine data are for antimicrobial use in feed only; chicken and turkey data include all routes of administration.

Integrated antimicrobial resistance data

In this section, we highlight 2 resistance stories: highly drug resistant Salmonella and fluoroquinolone-resistant Campylobacter.

The number of highly drug resistant isolates are increasing

Highly drug resistant Salmonella

Cattle
  • Sick cattle (clinical isolates)
  • Most of these have been S. Dublin and S. Typhimurium
Swine
  • Healthy pigs (farm and abattoir isolates)
  • Sick pigs (clinical isolates)
Human
  • All clinical isolates
  • Some isolates demonstrate resistance to all 7 classes of antimicrobials

Figure 15. Number of Salmonella isolates resistant to 6 or more antimicrobial classes from 2008 to 2017

Figure 15. Number of <em>Salmonella</em> isolates resistant to 6 or more antimicrobial classes from 2008 to 2017. Text description follows.
Figure 15 - Text Description
Number of Salmonella isolates resistant to 6 or more antimicrobial classes
Year Cattle Pigs Chicken Turkey Human (non-typhoidal)
2008 0 0 0 0 7
2009 0 0 0 0 10
2010 0 0 0 0 8
2011 5 2 0 2 10
2012 7 0 0 3 8
2013 26 2 0 3 16
2014 32 7 0 0 12
2015 39 16 0 0 25
2016 52 21 0 0 32
2017 31 8 0 1 36

Fluoroquinolone resistance in Campylobacter

Figure 16. Ciprofloxacin resistance in Campylobacter isolates from chicken over time and between regions; CIPARS 2011 to 2017

Figure 16. Ciprofloxacin resistance in <em>Campylobacter</em> isolates from chicken over time and between regions; CIPARS 2011 to 2017. Text description follows.
Figure 16 - Text Description
Ciprofloxacin resistance in Campylobacter isolates from chicken over time and between regions; CIPARS 2011 to 2017
Population Province Number of Isolates Year %
Retail Chicken British Columbia 71 2011 13%
73 2012 8%
57 2013 26%
43 2014 21%
46 2015 41%
65 2016 35%
74 2017 32%
Abattoir Chicken 39 2011 18%
47 2012 4%
43 2013 28%
46 2014 24%
52 2015 40%
44 2016 39%
47 2017 43%
Farm Chicken 27 2013 41%
26 2014 27%
25 2015 24%
31 2016 29%
44 2017 36%
HumanTable 16 footnote *,Table 16 footnote ** 222 2011 34%
276 2012 38%
232 2013 38%
222 2014 45%
Not applicable 2015 Not applicable
Not applicable 2016 Not applicable
28 2017 39%
Ciprofloxacin resistance in Campylobacter isolates from chicken over time and between regions; CIPARS 2011 to 2017 - Prairies
Population Province Number of Isolates Year %
Retail Chicken Prairies 25 2011 4%
40 2012 5%
25 2013 4%
67 2014 12%
65 2015 9%
16 2016 6%
10 2017 30%
Abattoir Chicken 21 2011 5%
33 2012 6%
21 2013 0%
36 2014 0%
24 2015 0%
20 2016 5%
34 2017 15%
Farm Chicken 15 2013 0%
11 2014 0%
46 2015 2%
28 2016 14%
30 2017 0%
HumanTable 16 footnote *,Table 16 footnote ** not applicable 2011 not applicable
not applicable 2012 not applicable
not applicable 2013 not applicable
not applicable 2014 not applicable
not applicable 2015 not applicable
29 2016 45%
69 2017 31%
Ciprofloxacin resistance in Campylobacter isolates from chicken over time and between regions; CIPARS 2011 to 2017 - Ontario
Population Province Number of Isolates Year %
Retail Chicken Ontario 71 2011 6%
88 2012 16%
84 2013 8%
76 2014 12%
39 2015 15%
46 2016 15%
29 2017 3%
Abattoir Chicken 29 2011 3%
41 2012 15%
43 2013 16%
62 2014 13%
42 2015 7%
67 2016 7%
40 2017 20%
Farm Chicken 20 2013 20%
35 2014 6%
36 2015 36%
26 2016 0%
36 2017 14%
HumanTable 16 footnote *,Table 16 footnote ** not applicable 2011 not applicable
not applicable 2012 not applicable
not applicable 2013 not applicable
not applicable 2014 not applicable
not applicable 2015 not applicable
106 2016 22%
18 2017 28%
Ciprofloxacin resistance in Campylobacter isolates from chicken over time and between regions; CIPARS 2011 to 2017 - Québec
Population Province Number of Isolates Year %
Retail Chicken Québec 57 2011 0%
79 2012 3%
58 2013 4%
54 2014 4%
49 2015 2%
49 2016 6%
52 2017 6%
Abattoir Chicken 9 2011 0%
23 2012 4%
11 2013 0%
12 2014 8%
8 2015 25%
17 2016 12%
9 2017 11%
Farm Chicken 19 2013 5%
21 2014 0%
10 2015 0%
8 2016 0%
12 2017 0%
HumanTable 16 footnote *,Table 16 footnote ** not applicable 2011 not applicable
not applicable 2012 not applicable
not applicable 2013 not applicable
not applicable 2014 not applicable
not applicable 2015 not applicable
not applicable 2016 not applicable
not applicable 2017 not applicable

Integrated antimicrobial use and resistance data

Ceftriaxone resistance in non-typhoidal Salmonella and generic E. coli

Ceftriaxone is a Category I antimicrobial (very high importance to human medicine) that is used to treat a variety of human infections. They are the preferred option for the treatment of serious, potentially life-threatening human infections.

Although ceftriaxone is not used in animals, a similar drug (ceftiofur) is used to treat a range of animal infections. In most situations, if an organism is resistant to one of these drugs, it will also be resistant to the other.

Because Category I antimicrobials are those considered most important to human health, the poultry industry took steps to reduce their use. In mid-2014, the poultry industry implemented a national ban on the use of Category I antimicrobials for disease prevention purposes.

Subsequent data have shown no reported use of ceftiofur in sentinel broiler chicken flocks since 2015 as well as reduced resistance in both E. coli and Salmonella from chickens and chicken meat.

Figure 17. Reduction in reported use of ceftiofur on farm and changing resistance to ceftriaxone in non-typhoidal Salmonella and E. coli from humans and chicken sources between 2013 and 2017

Figure 17. Reduction in reported use of ceftiofur on farm and changing resistance to ceftriaxone in non-typhoidal <em>Salmonella</em> and <em>E. coli</em> from humans and chicken sources between 2013 and 2017. Text description follows.
Figure 17 - Text Description
Reduction in reported use of ceftiofur on farm and changing resistance to ceftriaxone in non-typhoidal Salmonella and E. coli from humans and chicken sources between 2013 and 2017
Year 2013 2014 2015 2016 2017
Component Isolates resistant to ceftriaxone
Retail chicken Salmonella 26% 21% 13% 7% 6%
Human non-typhoidal Salmonella 6% 6% 5% 4% 4%
Retail chicken E. coli 28% 19% 17% 9% 6%
Percentage of flocks reporting the use of ceftiofur
Broiler chicken flocks on farm 31% 6% 0% 0% 0%

The reduction in use of ceftiofur and associated reduction in ceftriaxone resistance in chickens and humans is a good example of a successful intervention to limit antimicrobial resistance that CIPARS continues to follow.

Glossary

Antimicrobial class Antimicrobials are grouped into the same class if they have a common chemical structure and method to kill or stop the growth of bacteria. CIPARS uses the Clinical and Laboratory Standards Institute to define antimicrobial class.
Biomass and Population Correction Unit (PCU) The PCU accounts for the size of the population, including the number and weight (biomass) of animals or people in the population. CIPARS adjusts (or corrects) for the "size" of populations to interpret antimicrobial use, consumption or sales data using methods reported by the European Surveillance of Veterinary Antimicrobial Consumption.
DDDvet This is an acronym for the "Defined Daily Dose for animals". The amount of antimicrobials given during a treatment (dose) will vary depending on the antimicrobial, how the antimicrobial is given (e.g. by injection, through water or feed) and the population treated (cattle, chickens, pigs). CIPARS uses this metric to adjust for this variation and help interpret antimicrobial use data.
mg/PCU An antimicrobial use metric that adjusts the quantity (milligram/mg) of antimicrobial used, consumed or distributed by the size of the population.
nDDDvet/1000 animal-days An antimicrobial use metric that adjusts for both variation in the amount of antimicrobial given during a treatment (DDDvet), and the length of time that an animal or group of animals are treated to help interpret antimicrobial use data.

CIPARS will continue to monitor and communicate the impact of changing antimicrobial use practices on the occurrence of antimicrobial resistance to preserve the effectiveness of antimicrobials in animals and humans.

CIPARS analysts are working to develop new ways of identifying emerging issues and integrating data across various host species, bacterial species, and across regions.

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