Antimicrobial resistance occurs as a result of microbes, such as bacteria and viruses, changing in ways that reduce or eliminate the effectiveness of the drugs used to treat the infections they cause.
Antimicrobial resistance can develop from the use of antimicrobials in humans, animals, or plants (antimicrobials include antibacterial drugs, antibiotics, antivirals, antifungals and antiparisitic drugs). However, the overuse and/or inappropriate use of antimicrobials make the development and spread of resistance more likely. This is why the prudent use of antimicrobials is very important.
Once microbes become resistant, the drugs used to cure the infections they cause are less effective and may no longer work. Individuals infected with an antimicrobial resistant organism may be ill for a longer period of time, which also increases the chance for the illness to spread to other people.
Microbes are living organisms such as bacteria, viruses, fungi and parasites.
Antimicrobials are drugs, chemicals, or other substances that either kill or slow the growth of microbes. Among the antimicrobial agents are antibacterial drugs, antibiotics, antivirals, antifungals, and antiparisitic drugs.
Antibiotics are substances that can kill or inhibit the growth of bacteria. Antibiotics are commonly used to fight bacterial infections, but are not effective against infections caused by viruses.
Antibacterials are substances that kill or inhibit the growth of bacteria on human and environmental surfaces. These include substances that aid in proper hygiene like antibacterial cleansers and hand sanitizers.
Antivirals are substances that kill or inhibit the growth of viruses.
Some organisms are inherently resistant to some drugs. Microbes can also adapt, as a group, to their environment and resist the antimicrobials that are used to try to kill them. The microbes do this by changing their genetic make-up. Once these microbes mutate so they are resistant to an antimicrobial, this new genetic structure is carried on as the microbes grow and replicate.
Antimicrobial resistant organisms can develop from the use of antimicrobials in humans, animals, or plants. The overuse and/or inappropriate use of antimicrobials make the development and spread of resistance more likely. This is why the prudent use of antimicrobials is very important.
When infections are caused by organisms resistant to drugs like antibiotics, it means they are more difficult to treat. Individuals infected with an antimicrobial resistant organism may be ill for a longer period of time, which also increases the chance for the illness to spread to other people.
An infection caused by an antimicrobial resistant organism can be serious because the infection does not respond to conventional antimicrobial treatment. Some infections can cause severe illness leading to complications and even death. In addition, some people are more susceptible to complications from infections than others. The elderly, pregnant women, young children and people with weakened immune systems are groups that often are at higher risk of developing severe illness from an infection.
Antimicrobial resistance occurs everywhere in the world.
Healthcare facilities often deal with antimicrobial resistance, in part because of the frequent use of antimicrobials. These organisms can easily spread inside these institutions if proper infection prevention and control practices are not followed. Examples of health-care associated infections that are multi-drug resistant are Clostridium difficile (C. difficile) and Methicillin-Resistant Staphylococcus aureus (MRSA).
In the community, antimicrobial resistant infections can also spread from person to person. Examples of community associated infections that could show resistance include sexually transmitted infections (STIs), pneumonia, and skin and soft tissue infections.
If you become infected with an antimicrobial resistant organism, this does not necessarily mean your infection is untreatable. There are usually several types of antimicrobials that may be used to fight an infection. When an infection fails to respond to one type of antimicrobial treatment, another type may successfully fight the infection.
For infections caused by an antimicrobial resistant organism, as with all infections, patients should undergo treatment under the supervision of a physician. If you are infected with an antimicrobial resistant organism, your physician will determine the best treatment option. It is important to closely follow directions provided by your health care professional and to fully complete the course of treatment as prescribed.
The decision to use antimicrobials should be left to your healthcare provider. It is also important to remember that antibiotics are not effective against viral infections.
The following infections are some important examples of resistance to antimicrobials:
To prevent antimicrobial resistance, you and your healthcare provider should discuss the appropriate medicine for your illness to avoid overusing or misusing antimicrobials. You should take the full course of medication as prescribed and never take medication that was not prescribed for you.
Proper hand hygiene is one of the most effective ways to reduce the risk of acquiring an infection, including those that are resistant to antimicrobials. To decrease the risk of transmission of bacteria within healthcare settings, it is particularly important that staff and visitors wash their hands frequently with soap and water or use alcohol-based hand cleansers. Personal protective equipment, such as gloves and masks, when appropriately used and disposed of, can help prevent transmission of infections.
Antimicrobial resistance (AMR) is a serious concern to public health in Canada and around the world. The Public Health Agency of Canada recognizes antimicrobial use in any environment is an important driver in the development and spread of AMR. The Agency is committed to raising awareness and providing public health guidance on this issue to help reduce, limit, and control the emergence and spread of resistant organisms.
AMR continues to be a complex issue with implications for many different sectors that deal with human health care, public health, food safety, food production, and environmental protection. Together with our federal partners in the areas of health, pharmaceutical, and agriculture and food, the Agency works with the provinces and territories to encourage the careful use of antibiotics by healthcare professionals, pharmacists, patients, farmers, veterinarians and food producers, in a number of areas.
The Agency leads national surveillance initiatives to track antimicrobial use and antimicrobial resistance in healthcare and community settings, and in the food supply. This information is used by governments, health care professionals, veterinarians and farmers to reduce the emergence and spread of AMR.
The Agency’s Canadian Nosocomial Infection Surveillance Program (CNISP) collaborates with infectious disease specialists and the infection control community to collect surveillance data on selected healthcare-associated infections and antimicrobial resistant organisms in healthcare facilities. Additionally, the Agency leads the Canadian Integrated Program for Antimicrobial Resistance Surveillance (CIPARS). This national system monitors and analyzes antimicrobial use in food animal production sectors and in humans in community settings, as well as antimicrobial resistance in selected bacteria throughout the food-chain.
The Agency provides reference services to provincial and territorial public health laboratories and hospitals across the country on AMR issues through the National Microbiology Laboratory (NML). The NML also provides laboratory support for CIPARS and CNISP programs.
The Agency provides guidance on infection prevention and control practices for use by provinces and territories, health care facilities and health care personnel across Canada. These guidelines are designed to limit the spread of hospital acquired infections.
On the international front, the Agency collaborates with several international organizations. The World Health Organization (WHO) has designated the Agency’s NML as a collaborating centre for preparedness and response to enteric pathogens and related antimicrobial resistance.
Overall, the Agency believes that the most effective way to address this important and complex public health issue is by collaborating with our national and international partners in key areas such as surveillance, research, knowledge transfer and exchange, and identification of best practices.