Canadian Integrated Program for Antimicrobial Resistance Surveillance (CIPARS) 2018: 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) 2018 : 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: December 2020

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

Cat.: HP2-4/2018E-2-1-PDF
ISSN: 978-0-660-36795-8
Pub.: 200321

Suggested Citation:

Government of Canada. Canadian Integrated Program for Antimicrobial Resistance Surveillance (CIPARS) 2018: Integrated Findings. Public Health Agency of Canada, Guelph, Ontario, 2020.

On this page

• Overview of CIPARS activities
• 2018 Key findings
  • Antimicrobial use
  • Antimicrobial resistance
  • Integrated antimicrobial use and resistance data
• Integrated findings and discussion
  • Integrated antimicrobial use data
  • Integrated antimicrobial resistance data
  • Integrated antimicrobial use and resistance data
• What's new for CIPARS in 2018
  • Antimicrobial use
  • Antimicrobial resistance
• Glossary

Overview of CIPARS activities

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.

2018 key findings

Antimicrobial use

• Antimicrobial sales increased between 2017 and 2018.
• For broiler chickens, farm surveillance showed a reduction of use in 2018 compared to 2017 data, with some provincial variations.
• For pigs, AMU has significantly decreased overall and substantially in some provinces.
• For turkeys, AMU has increased overall with some provincial variations.

Antimicrobial resistance

Quinolone-resistant Salmonella Enteritidis

Quinolone (nalidixic acid) resistance in S. Enteritidis from agri-food sources is extremely rare, especially from chicken(s).

In 2018, nalidixic acid resistance in S. Enteritidis from chickens and chicken meat was detected at levels never observed before by CIPARS.

Highly drug resistant Salmonella

We observed the highest number of highly-resistant Salmonella isolates to-date across all human, animal, and food sources in 2018.

Additionally, we isolated highly-resistant Salmonella (serovar Infantis) from a chicken source for the first time.

Integrated antimicrobial use and resistance data

Chicken and people

The poultry industry initiative to eliminate the use of Category I antimicrobials (including the 3rd generation cephalosporins and fluoroquinolones) for disease prevention appears to reduce antimicrobial resistance in most scenarios.

Ceftiofur use and ceftriaxone resistance

• There has been no reported ceftiofur use in broiler chickens since 2015.
• In most scenarios, there has been a reduction in ceftriaxone (a 3rd generation cephalosporin) resistance in both E. coli and Salmonella recovered from chickens, and Salmonella isolates recovered from people.
• However, there was an increase in ceftriaxone-resistant Salmonella from chickens on farm.

Fluoroquinolone-resistant Campylobacter

• In 2018, fluoroquinolones were reported for treatment of sick chickens in a single flock in British Columbia.
• Similar to previous years, there were regional differences in the prevalence of fluoroquinolone-resistant Campylobacter from chicken and chicken meat.
• Resistance to ciprofloxacin (a fluoroquinolone) 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 data

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

• Category I: Very high importance
  Examples: cephalosporins (3rd and 4th generation), carbapenems, fluoroquinolones
• Category II: High importance
  Examples: macrolides, penicillins
• Category III: Medium importance
  Examples: tetracyclines
• Category IV: Low importance
  Examples: ionophores, flavophospholipids.

Medically important antimicrobials include Category I to III. 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 uncategorized 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?

• There are several different ways to collect, analyze, and report antimicrobial use data.
• No single approach is appropriate for all purposes. Certain metrics are better suited to looking at trends over time, while others may be more appropriate for comparing different regions or different host species, and others may be better for understanding relationships between use and resistance.

Comparing humans, animals, and crops

Figure 2. Human and animal population estimates with total kilograms of antimicrobials distributed and/or sold in 2018 - Text Description

Human and animal population estimates with total kilograms of antimicrobials distributed and/or sold in 2018

Population	Estimated number	Antimicrobials distributed and/or sold (kg)	Ratio
Humans	37,058,856	1 (4.55 %)	270,635
Animals	782,985,707	21 (95.45 %)	1,004,392

Of the antimicrobials distributed or sold* in 2018:

• 78% were intended for production animals
• 21% were intended for humans
• 1% were intended for companion animals
• <1% were intended for crops

* Animal distribution data currently do not account for quantities imported for own use, or as active pharmaceutical ingredients intended for further compounding; hence, these are underestimates of total quantities used.

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

The relative quantity of cephalosporins and fluoroquinolones (Category I) intended for use in people is higher compared to animals (about 7 times and 25 times higher for people, respectively).

Tetracyclines (Category III) are used predominantly in production animals.

Figure 3 - Text Description

The proportions of total kilograms of antimicrobial classes distributed or sold in 2018 in humans, production animals, and companion animals

Humans		Companion Animals		Production Animals
Antimicrobial Class	%	Antimicrobial Class	%	Antimicrobial Class	%
B-lactams (penicillins)	52%	Cephalosporins	35%	Tetracyclines	57%
Cephalosporins	18%	B-lactams (penicillins)	33%	Other antimicrobials	12%
Trimethoprim and sulfonamides	7%	Timethoprim and sulfonamides	27%	B-lactams (penicillins)	11%
Fluoroquinolones and quinolones	6%	Lincosamides	2%	Macrolides	9%
Macrolides	5%	Fluoroquinolones	1%	Trimethoprim and sulfonamides	5%

The total quantities of antimicrobials distributed for sale for use in production animals increased. When measured in kilograms, the total quantities distributed increased by 6% compared to 2017. When total quantities were adjusted for biomass (mg/PCU), the increase was 5% compared to 2017.

Figure 4 - Text Description

Quantities of antimicrobials distributed for use in animals

Year	Total (kg)	Total (mg/PCU European weights)	Total (mg/PCU Canadian weights)
2009	1,141,213	160	142
2010	1,037,313	150	133
2011	1,121,715	168	150
2012Figure 4 footnote *	1,117,457	169	150
2013Figure 4 footnote *	1,118,097	170	150
2014Figure 4 footnote *	1,114,837	170	151
2015Figure 4 footnote *	1,187,136	183	163
2016Figure 4 footnote *	1,051,010	160	143
2017Figure 4 footnote *	934,873	142	126
2018Figure 4 footnote *	991,150	149	133
Figure 4 footnote * Indicates years where data exclude antimicrobials sold for use in companion animals. Return to Figure 4 footnote * referrer

Canada is the 6th highest country (in comparison to Europe) for quantities of antimicrobials sold (mg/PCU).

Figure 5 - Text Description

Quantities of antimicrobials used (mg/PCU) by Canada (2018) and countries participating in the European Surveillance of Veterinary Antimicrobial Consumption (ESVAC) network (2017)

European Countries (2017)	mg/PCU	Canada (2018) European weights	Median (of EU countries)	Canada (2018) Canadian weights
Austria	47	149	62	133
Belgium	131	149	62	133
Bulgaria	132	149	62	133
Croatia	72	149	62	133
Cyprus	423	149	62	133
Czech Republic	64	149	62	133
Denmark	39	149	62	133
Estonia	57	149	62	133
Finland	19	149	62	133
France	69	149	62	133
Germany	89	149	62	133
Greece	94	149	62	133
Hungary	191	149	62	133
Iceland	5	149	62	133
Ireland	47	149	62	133
Italy	274	149	62	133
Latvia	33	149	62	133
Lithuania	35	149	62	133
Luxembourg	35	149	62	133
Malta	121	149	62	133
Netherlands	56	149	62	133
Norway	3	149	62	133
Poland	165	149	62	133
Portugal	135	149	62	133
Romania	90	149	62	133
Slovakia	62	149	62	133
Slovenia	37	149	62	133
Spain	230	149	62	133
Sweden	12	149	62	133
Switzerland	40	149	62	133
United Kingdom	33	149	62	133

Comparing farm antimicrobial use data

Comparison of antimicrobial classes*

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.

*The percentages are based on total kilograms of active ingredients intended for use in that host species.

The relative quantities of antimicrobial classes reported for use (mg/PCU) in broiler chickens, grower-finisher pigs, and turkeys in 2018

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

Not shown: streptogramins (1%)
**used in feed only.

Not shown: B-lactams (penicillins) (3%), orthomycins (1%), fluoroquinolones (<1%).

Figure 6.1, 6.2, 6.3 - Text Description

The relative quantities of antimicrobial classes reported for use (mg/PCU) in animals in 2018

Broiler Chickens		Grower-Finisher Pigs		Turkeys
Antimicrobial Class	%	Antimicrobial Class	%	Antimicrobial Class	%
Bacitracins	51%	Tetracyclines	57%	Bacitracins	53%
B-lactams (penicillins)	21%	Lincosamides	21%	Streptogramins	26%
Trimethoprim and sulfonamides	9%	Macrolides	13%	Trimethoprim and sulfonamides	7%
Streptogramins	5%	Sulfonamides	3%	Tetracyclines	6%
Orthosomycins	5%	Pleuromutilins	3%	Aminoglycosides	4%
Tetracyclines	4%	B-lactams (penicillins)	1%	no data	no data
Macrolides	4%	no data	no data	no data	no data

Temporal trends in antimicrobial use

Broiler chickens

Overall (nationally), farm surveillance showed a reduction in antimicrobial use in 2018 compared with 2017 data in broiler chickens. The two most commonly reported classes of antimicrobials used in broilers were bacitracins (Category III) and penicillins (Category II).

There were regional differences in the number of doses of antimicrobials administered. Compared to 2017:

• The Prairies and Ontario decreased their overall antimicrobial use (AMU).
• There was an increase in overall AMU in flocks from British Columbia and Québec.

Figure 7 - Text Description

Temporal trends in nDDDvetCA/1000 chicken-days at risk, 2013 to 2018

Year		2013	2014	2015	2016	2017	2018
Number of flocks		99	143	136	136	138	141
Antimicrobial class
I	Fluoroquinolones	< 0.1	0	0	0	0	< 0.1
	Third-generation cephalosporins	1	0.1	0	0	0	0
II	Aminoglycosides	< 0.1	2	2	1	1	1
	Lincosamides-aminocyclitols	1	1	1	0.5	0.5	2
	Macrolides	8	12	7	3	1	6
	Penicillins	34	33	47	25	31	116
	Streptogramins	237	83	63	139	128	63
	Trimethoprim and sulfonamides	85	85	89	50	61	49
III	Bacitracins	217	232	213	239	224	190
	Tetracyclines	9	4	15	1	4	8
N/A	Orthosomycins	0	72	98	117	79	58
Total		591	524	535	576	529	493

Figure 8 - Text Description

Temporal trends in nDDDvetCA/1000 chicken-days at risk, by province/region, 2014 to 2018

Year	2014	2015	2016	2017	2018
Number of broiler chicken flocks	141	135	136	137	141
Province/region
British Columbia	380	405	491	439	558
Prairies	450	419	595	568	410
Ontario	616	679	601	601	504
Québec	624	665	606	521	544
National	528	566	573	541	495

Grower-finisher pigs

Farm surveillance showed a decrease in antimicrobials used in feed (nDDDvetCA/1000 grower-finisher pig-days at risk) between 2014 and 2018. The most commonly reported classes of antimicrobials used in pigs included tetracyclines (Category III), lincosamides (Category II), and macrolides (Category II).

There were regional differences in the quantity and the number of doses of antimicrobials administered through feed over a grower-finisher feeding period. Compared to 2017:

• Québec and Ontario herds decreased their overall AMU in feed.
• There was an increase in overall AMU in feed in herds from the Prairies.

Figure 9 - Text Description

Temporal trends in nDDDvetCA/1000 grower-finisher pig-days at risk, 2009 to 2018

Year		2009	2010	2011	2012	2013	2014	2015	2016	2017	2018
Number of grower-finisher pig herds		95	90	93	87	89	95	85	91	82	97
Antimicrobial class
II	Lincosamides	59	47	49	49	79	68	60	49	57	46
	Macrolides	104	122	129	122	103	92	76	78	37	47
	Penicillins	14	17	8	5	35	34	21	20	25	11
	Streptogramins	0	0	0	7	2	4	24	1	4	2
III	Aminocyclitols	2	1	4	0	0	6	4	0	0	0
	Bacitracins	0	2	0	0	2	0	0	0	0	0
	Pleuromutilins	0	3	3	3	5	9	7	3	2	4
	Sulfonamides	7	2	2	1	5	5	5	7	15	6
	Tetracyclines	87	64	73	72	58	72	82	44	38	54
Total		274	257	269	259	289	290	281	202	178	171

Figure 10 - Text Description

Temporal trends in nDDDvetCA/1000 grower-finisher pig-days at risk for antimicrobials administered in feed, 2014 to 2018

Year	2014	2015	2016	2017	2018
Number of grower-finisher pig herds	95	85	91	82	97
Province/region
Prairies	308	268	217	177	193
Ontario	294	325	200	259	192
Québec	255	268	164	130	94
National	290	281	202	178	171

Turkeys

In 2018, the overall reported antimicrobial use in turkeys increased. The top reported classes of antimicrobials used in turkeys included streptogramins (Category II) and bacitracins (Category III). Compared to 2017:

• Ontario and Québec flocks decreased their overall antimicrobial use (AMU).
• There was an increase in overall AMU in flocks from the British Columbia.

Figure 11 - Text Description

Temporal trends in DDDvet per 1000 turkey-days at risk in Canada, 2016 to 2018

Year		2016	2017	2018
Number of turkey flocks		69	77	95
Antimicrobial class
I	Fluoroquinolones	0	< 0.1	0.1
	Third-generation cephalosporins	0	0	0
II	Aminoglycosides	1	0.3	13
	Macrolides	1	3	0
	Penicillins	2	1	3
	Streptogramins	48	52	60
	Trimethoprim and sulfonamides	5	13	7
III	Bacitracins	43	38	35
	Tetracyclines	4	0.4	14
Not applicable	Orthosomycins	0	0	2
Total		104	108	134

Figure 12 - Text Description

Temporal trends in DDDvet per 1000 turkey-days at risk in Canada, by province/region, 2016 to 2018

Year	2016	2017	2018
Number of turkey flocks	69	77	95
Province
British Columbia	86	125	186
Alberta	Not applicable	Not applicable	119
Ontario	152	143	110
Québec	66	117	89
National	104	131	137

Reasons for antimicrobial use

• In broiler chickens (Br. Chicken), turkeys, and grower-finisher pigs (G-F Pig), the predominant reason for administering antimicrobials was for disease prevention.
• In grower-finisher pigs, there continues to be reported use of antimicrobials for growth promotion.

Figure 13 - Text Description

Quantity of antimicrobials used (mg/PCU) by reason for use; CIPARS Farm 2014 to 2018

Year	2014		2015		2016			2017			2018
Sector	G-F Pig	Br. Chicken	G-F Pig	Br. Chicken	G-F Pig	Br. Chicken	Turkey	G-F Pig	Br. Chicken	Turkey	G-F Pig	Br. Chicken	Turkey
Number of Farms	95	143	85	136	91	136	72	82	138	74	97	141	95
Disease Treatment	26	43	16	31	4	14	3	4	18	6	2	25	10
Disease Prevention	88	106	90	116	77	115	58	54	108	56	81	101	47
Growth Promotion	50	5	70	1	35	0	0	46	1	1	28	0	0
Total	164	153	176	148	116	130	61	104	127	63	110	126	57

Note: 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 two resistance stories for 2018:

1. The detection of quinolone-resistant Salmonella Enteritidis from chicken.
2. The increase in highly drug-resistant Salmonella from human and agri-food sources.

In 2018, CIPARS tested for resistance to 7 classes of antimicrobials.

Although there is no international standard for defining highly resistant isolates, CIPARS considers isolates which have resistance to 6 or more classes of antimicrobials to be highly drug resistant.

Detection of quinolone resistance in Salmonella Enteritidis from chicken

In 2018, a clear increase in nalidixic acid (a quinolone) resistance among S. Enteritidis from chickens occurred across several surveillance components from multiple provinces.

Retail

• 1 isolate from a chicken burger in British Columbia (FoodNet Canada)

Retail

• 1 isolate from Alberta
• Not previously observed

Abattoir

• 2 isolates from Ontario and Québec
• Not previously observed

Clinical cases

• 2 isolates from Ontario (sick chicken)
• Previously observed in a single isolate in Manitoba (2010)

The majority of S. Enteritidis from animal and food sources were susceptible to all antimicrobials tested.

From 2003 to 2018, nalidixic acid resistance was only observed in a single isolate from a sick chicken (clinical isolate) from Manitoba in 2010.

Most S. Enteritidis from people were susceptible to all antimicrobials tested. When resistance did occur, it was most commonly to nalidixic acid and these human cases may be related to travel outside of Canada.

This may be a new source of human exposure to nalidixic acid-resistant S. Enteritidis in Canada. This unprecedented and sudden increase in chickens and chicken meat will be monitored closely by CIPARS.

Highly drug-resistant Salmonella

• The number of highly resistant Salmonella isolates have increased substantially since 2008 in both human and animal sources.
• 2018 was the first time where highly resistant Salmonella were isolated from a chicken source.
• Despite a slight decrease in 2017, a substantial increase in the number of highly resistant Salmonella occurred in 2018 to levels not previously observed by CIPARS.

In 2018, 132 Salmonella isolates were identified as highly drug resistant from the following sources:

Chicken

• All highly resistant isolates from chicken were from retail samples (from chicken burgers) from British Columbia, the Prairies, and Ontario.
• All isolates were S. Infantis.

Cattle

• Sick cattle (clinical isolates).
• Most isolates were S. Dublin.

Swine

• Sick pigs (clinical isolates).
• Some isolates demonstrate resistance to all 7 classes of antimicrobials tested.
• Four serovars were detected.

Human

• Only clinical isolates tested.
• Most isolates were S. Infantis, S. Newport, and S. Typhimurium.

Figure 14 - Text Description

Number of Salmonella isolates resistant to 6 or more antimicrobial classes from 2008 to 2018

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	26
2016	52	21	0	0	37
2017	31	8	0	1	41
2018	62	10	3	0	57

Integrated antimicrobial use and resistance data

In this section, we highlight two integrated antimicrobial use and resistance stories for 2018:

1. Fluoroquinolone-resistant Campylobacter
2. Ceftriaxone resistance in non-typhoidal Salmonella and generic E. coli

Fluoroquinolone resistance in Campylobacter

• In 2018, one flock from British Columbia reported using a fluoroquinolone for disease treatment. Since 2014, there was no reported fluoroquinolone use on sentinel broiler chicken farms.
• In general, the highest proportion of ciprofloxacin-resistant Campylobacter continued to be from British Columbia. However, resistance from chicken(s) continued to vary over time and across regions.
  • In British Columbia, ciprofloxacin-resistant Campylobacter from chickens on farm decreased to 17% (8 out of 46 isolates were resistant).
  • In Québec, ciprofloxacin-resistant Campylobacter from chickens on farm increased to 50% (8 out of 16 isolates were resistant).

Figure 15 - Text Description

Ciprofloxacin resistance in Campylobacter isolates over time and between regions; CIPARS 2011 to 2018

The temporal trends of the percentage of Campylobacter isolates being resistant to ciprofloxacin are depicted in this figure by year (2011 to 2018) and by province (British Columbia, Ontario, and Québec) or region (Prairies). For each province or region, the temporal trends are represented by 4 series corresponding to 4 Campylobacter data sources as listed here:

1. chicken from retail (green line and round marker)
2. chicken from abattoir (purple line and diamond marker)
3. chicken from farm (blue line and triangle marker)
4. human origin*/** (orange line and square marker).

* For British Columbia from 2011 to 2014: Data from antimicrobial resistance Trends in the province of British Columbia - 2014 Report, British Columbia Centre for Disease Control (BCCDC).
** All other human data are from Foodnet Canada.

Integrated antimicrobial use and resistance data

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

Since 2015, there has been no reported ceftiofur use in sentinel broiler chicken flocks, as well as reduced ceftriaxone resistance in both E. coli and Salmonella from chickens and chicken meat in most scenarios.

Previously, ceftriaxone-resistant Salmonella in humans were primarily serovar Heidelberg isolates. However, in 2018, the majority of resistant isolates were serovar Infantis, followed by serovar Heidelberg.

In 2018, ceftriaxone resistance in S. Infantis decreased to 15%, compared to 17% in 2017. Ceftriaxone resistance in S. Heidelberg also decreased to 7% compared to 12% in 2017.

Overall, ceftriaxone resistance in Salmonella and E. coli isolates from chicken sources remained relatively stable or decreased after the 2014 initiative to eliminate the use of Category I antimicrobials for disease prevention. Most Salmonella isolates were S. Kentucky, followed by S. Heidelberg and S. Infantis.

However, there were some increases in ceftriaxone resistance in 2018 compared to 2017 data. This is most notable in Salmonella isolated from chickens at the farm level.

Figure 16 - Text Description

Reduction in reported use of ceftiofur on sentinel farms and changing resistance to ceftriaxone in non-typhoidal Salmonella from humans and chicken sources between 2013 and 2018

Year	2013	2014	2015	2016	2017	2018
Component
Percentage of isolates resistant to ceftriaxone
Farm chicken Salmonella	23%	12%	13%	7%	6%	13%
Retail chicken Salmonella	26%	21%	13%	7%	6%	10%
Human non-typhoidal Salmonella	6%	6%	5%	4%	4%	3%
Percentage of flocks reporting the use of ceftiofur
Broiler chicken flocks on farm	31%	6%	0%	0%	0%	0%

The reduction in ceftiofur use and associated decrease in ceftriaxone resistance compared to pre-2014 data in chickens and humans is a good example of a successful intervention to limit antimicrobial resistance.

What's New for CIPARS in 2018

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 2018 data, we will be releasing 4 documents:

• Executive Summary
• Figures and Tables (summarized information with little accompanying text)
• Design and Methods
• Integrated Findings

Antimicrobial Use

• Data collected under legislation by Health Canada from veterinary pharmaceutical manufacturers, importers, and compounders for 2018 is currently being analyzed. Results will be released as a separate report in Spring of 2020.
• In 2018, grower-finisher pig quantitative antimicrobial use metrics were reported for the first time for antimicrobial use in water and injectables.
• As of 2018, the antimicrobial use metric nDDDvet/PCU was no longer be reported.

Antimicrobial Resistance

• There was no placement broiler chicken sampling conducted in 2018.
• For farm surveillance, sampling in turkeys was initiated in Alberta.
• Only a partial year of retail sampling was conducted in Ontario and the Prairies, and no sampling occurred in the Atlantic region; therefore, no temporal retail data from these regions are presented in 2018.

In addition to the changes described above, we launched two sentinel farm surveillance activities in feedlot and dairy cattle with our stakeholders.

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. It includes both the number and weight (biomass) of animals or people in the population. CIPARS uses the PCU to interpret the antimicrobial use and consumption data, using the same approach as the European Surveillance of Veterinary Antimicrobial Consumption Project.

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.

Grower-finisher pig

A pig that is approximately 25 kilograms to market weight.

Medically important antimicrobials

Antimicrobials deemed to be of very high importance (Category I), high importance (Category II), or medium importance (Category III) in human medicine.

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.

Non-typhoidal Salmonella

All Salmonella serovars, excluding S. Typhi, and Paratyphi A and B.

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

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.