(CIPARS) 2007 - Final Report

Table of Contents

Contributors to CIPARS 2007

Executive Summary

List of Figures

List of Tables

List of Boxes

Preamble

• About CIPARS
• What’s New in the 2007 Report
• Important Notes

Section One – Antimicrobial Resistance

• Humans
• Beef Cattle
• Chickens
• Pigs
• Turkeys
• Horses
• Feed and Feed Ingredients

Section Two – Antimicrobial Use

• Humans
• Animals

Section Three – Public Health Agency of Canada Research Collaborations

Appendix A – Methods

• A.1 Categorization of Antimicrobials Based on Importance in Human Medicine
• A.2 Sampling and Testing Methods in Humans
• A.3 Sampling and Testing Methods in the Agri-Food Sector
• A.4 Antimicrobial Resistance Data Analysis
• A.5 Antimicrobial Use Data Collection and Analysis

Appendix B – Additional Tables

• B.1 Antimicrobial Resistance in Humans
• B.2 Antimicrobial Resistance in the Agri-Food Sector
• B.3 Antimicrobial Use in Humans
• B.4 Summary Tables for Human and Agri-Food Data

Appendix C – Additional Information

• C.1 Abbreviations
• C.2 Glossary
• C.3 Demographic Information
• C.4 References

List of Figures

• Figure 1: Diagram of CIPARS surveillance components in 2007
• Figure 2: Temporal variation in resistance to selected antimicrobials in human isolates of Salmonella serovars Enteritidis, Heidelberg, and Newport; Surveillance of Human Clinical Isolates, 2003–2007
• Figure 3: Temporal variation in resistance to selected antimicrobials in human isolates of Salmonella serovars Paratyphi A and B, Typhi, Typhimurium, and “Other Serovars”; Surveillance of Human Clinical Isolates, 2003–2007
• Figure 4: Resistance to antimicrobials in Escherichia coli isolates from beef cattle; Abattoir Surveillance, 2007
• Figure 5: Temporal variation in resistance to selected antimicrobials in Escherichia coli isolates from beef cattle; Abattoir Surveillance, 2003–2007
• Figure 6: Resistance to antimicrobials in Escherichia coli isolates from beef; Retail Meat Surveillance, 2007
• Figure 7: Temporal variation in resistance to selected antimicrobials in Escherichia coli isolates from beef; Retail Meat Surveillance, 2003–2007
• Figure 8: Resistance to antimicrobials in Campylobacter isolates from beef cattle; Abattoir Surveillance, 2007
• Figure 9: Resistance to antimicrobials in Salmonella isolates from chickens; Abattoir Surveillance, 2007
• Figure 10: Temporal variation in resistance to selected antimicrobials in Salmonella isolates from chickens; Abattoir Surveillance, 2003–2007
• Figure 11: Resistance to antimicrobials in Salmonella isolates from chicken; Retail Meat Surveillance, 2007
• Figure 12: Temporal variation in resistance to selected antimicrobials in Salmonella isolates from chicken; Retail Meat Surveillance, 2003–2007.
• Figure 13: Resistance to antimicrobials in Escherichia coli isolates from chickens; Abattoir Surveillance, 2007
• Figure 14: Temporal variation in resistance to selected antimicrobials in Escherichia coli isolates from chickens; Abattoir Surveillance, 2003–2007
• Figure 15: Resistance to antimicrobials in Escherichia coli isolates from chicken; Retail Meat Surveillance, 2007
• Figure 16: Temporal variation in resistance to selected antimicrobials in Escherichia coli isolates from chicken; Retail Meat Surveillance, 2003–2007.
• Figure 17: Resistance to antimicrobials in Campylobacter isolates from chicken; Retail Meat Surveillance, 2007
• Figure 18: Resistance to antimicrobials in Campylobacter isolates from chicken, by Campylobacter species; Retail Meat Surveillance, 2007
• Figure 19: Temporal variation in resistance to selected antimicrobials in Campylobacter isolates from chicken; Retail Meat Surveillance, 2003–2007
• Figure 20: Resistance to antimicrobials in Enterococcus isolates from chicken, by province; Retail Meat Surveillance, 2007
• Figure 21: Resistance to antimicrobials in Enterococcuss isolates from chicken, by Enterococcus species; Retail Meat Surveillance, 2007
• Figure 22: Temporal variation in resistance to selected antimicrobials in Enterococcus isolates from chicken; Retail Meat Surveillance, 2003–2007
• Figure 23: Resistance to antimicrobials in Salmonella isolates from pigs; Farm Surveillance, 2007
• Figure 24: Resistance to antimicrobials in Salmonella isolates from pigs; Abattoir Surveillance, 2007
• Figure 25: Temporal variation in resistance to selected antimicrobials in Salmonella isolates from pigs; Abattoir Surveillance, 2003–2007
• Figure 26: Resistance to antimicrobials in Escherichia coli isolates from pigs; Farm Surveillance, 2007
• Figure 27: Resistance to antimicrobials in Escherichia coli isolates from pigs; Abattoir Surveillance, 2007
• Figure 28: Temporal variation in resistance to selected antimicrobials in Escherichia coli isolates from pigs; Abattoir Surveillance, 2003–2007
• Figure 29: Resistance to antimicrobials in Escherichia coli isolates from pork, by province; Retail Meat Surveillance, 2007
• Figure 30: Temporal variation in resistance to selected antimicrobials in Escherichia coli isolates from pork; Retail Meat Surveillance, 2003–2007
• Figure 31: Resistance to antimicrobials in Enterococcus isolates from pigs; Farm Surveillance, 2007
• Figure 32: Total number of prescriptions and total cost per 1,000 inhabitants for oral antimicrobials dispensed by retail pharmacies in Canada, 2000–2007
• Figure 33: Percentages of total number of defined daily doses (DDDs) per 1,000 inhabitant-days for oral antimicrobials dispensed by retail pharmacies in Canada, 2007
• Figure 34: Temporal trends in percentages of total numbers of defined daily doses (DDDs) per 1,000 inhabitant-days for oral antimicrobials dispensed by retail pharmacies in Canada, 2000–2007
• Figure 35: Total consumption of oral macrolides (DDDs/1,000 inhabitant-days) dispensed by retail pharmacies in Canada, 2000–2007
• Figure 36: Total consumption (DDDs/1,000 inhabitant-days) of oral fluoroquinolones dispensed by retail pharmacies in Canada, 2000–2007
• Figure 37: Total consumption (DDDs/1,000 inhabitant-days) of oral antimicrobials dispensed by retail pharmacies in Canadian provinces, 2007
• Figure 38: Total consumption (DDDs/1,000 inhabitant-days) of oral ciprofloxacin dispensed by retail pharmacies in Canadian provinces, 2000–2007
• Figure 39: Total consumption (DDDs/1,000 inhabitant-days) of oral moxifloxacin dispensed by retail pharmacies in Canadian provinces, 2000–2007
• Figure 40: Total consumption (DDDs/1,000 inhabitant-days) of oral doxycycline dispensed by retail pharmacies in Canadian provinces, 2000–2007
• Figure 41: Total consumption (DDDs/1,000 inhabitant-days) of oral cefadroxil dispensed by retail pharmacies in Canadian provinces, 2000–2007
• Figure 42: Total consumption (DDDs/1,000 inhabitant-days) of oral cefixime dispensed by retail pharmacies in Canadian provinces, 2000–2007
• Figure 43: Total consumption (DDDs/1,000 inhabitant-days) of oral clindamycin dispensed by retail pharmacies in Canadian provinces, 2000–2007
• Figure 44: Antimicrobial consumption (DDDs/1,000 inhabitant-days) in 27 European countries and Canada; European Surveillance of Antimicrobial Consumption and CIPARS 2006.
• Figure 45: Number of sentinel swine herds (n = 100) with reported use of no antimicrobials, a single antimicrobial class, or multiple antimicrobial classes, by administration route; Farm Surveillance, 2007
• Figure 46: Number of sentinel swine herds (n = 100) with reported use of specific antimicrobial classes, by administration route; Farm Surveillance, 2007
• Figure 47: Number of sentinel swine herds (n = 100) with reported use of specific antimicrobial classes in feed, by weight category of pigs; Farm Surveillance, 2007
• Figure 48: Number of sentinel swine herds (n = 100) with reported use of specific antimicrobial classes in water, by weight category of pigs; Farm Surveillance, 2007
• Figure 49: Number of sentinel swine herds (n = 100) with reported use of specific antimicrobial classes in feed, by reason for use; Farm Surveillance, 2007
• Figure 50: Number of sentinel swine herds (n = 100) with reported use of specific antimicrobial classes in water, by reason for use; Farm Surveillance, 2007
• Figure 51: Numbers of breeding swine herds for which disease status (positive or negative) was reported, by disease; Farm Surveillance, 2007
• Figure 52: Number of grower-finisher swine herds for which disease status (positive or negative)was reported, by disease; Farm Surveillance, 2007
  
• Figure A.3.1: Example of sampling visits in regular and cohort swine herds over a calendar year

List of Tables

• Table 1: Summary of antimicrobial resistance surveillance findings for bacterial isolates from humans and the agri-food sector, 2007.
• Table 2: Resistance to antimicrobials in Salmonella Enteritidis isolates from humans, by province; Surveillance of Human Clinical Isolates, 2007.
• Table 3: Resistance to antimicrobials in Salmonella Heidelberg isolates from humans, by province; Surveillance of Human Clinical Isolates, 2007.
• Table 4: Resistance to antimicrobials in Salmonella Newport isolates from humans, by province; Surveillance of Human Clinical Isolates, 2007.
• Table 5: Resistance to antimicrobials in Salmonella Paratyphi A and S. Paratyphi B isolates from humans, by province; Surveillance of Human Clinical Isolates, 2007
• Table 6: Resistance to antimicrobials in Salmonella Typhi isolates from humans, by province;
  Surveillance of Human Clinical Isolates, 2007
• Table 7: Resistance to antimicrobials in Salmonella Typhimurium isolates from humans, by province; Surveillance of Human Clinical Isolates, 2007.
• Table 8: Resistance to antimicrobials in Salmonella “Other Serovars” isolates from humans, by province; Surveillance of Human Clinical Isolates, 2007.
• Table 9: Number of antimicrobials in resistance patterns of Salmonella isolates from humans, by province and serovar; Surveillance of Human Clinical Isolates, 2007
• Table 10: Number of antimicrobials in resistance patterns of Salmonella isolates from cattle, by serovar; Surveillance of Animal Clinical Isolates, 2007
• Table 11: Number of antimicrobials in resistance patterns of Campylobacter isolates from beef cattle, by Campylobacter species; Abattoir Surveillance, 2007.
• Table 12: Number of antimicrobials in resistance patterns of Salmonella isolates from chickens, by serovar; Abattoir Surveillance, 2007
• Table 13: Number of antimicrobials in resistance patterns of Salmonella isolates from chicken, by province and serovar; Retail Meat Surveillance, 2007
• Table 14: Number of antimicrobials in resistance patterns of Salmonella isolates from chickens, by serovar; Surveillance of Animal Clinical Isolates, 2007
• Table 15: Number of antimicrobials in resistance patterns of Campylobacter isolates from chicken, by province and Campylobacter species; Retail Meat Surveillance, 2007
• Table 16: Number of antimicrobials in resistance patterns of Enterococcus isolates from chicken, by Enterococcus species; Retail Meat Surveillance, 2007
• Table 17: Number of antimicrobials in resistance patterns of Salmonella isolates from pigs, by serovar; Farm Surveillance, 2007.
• Table 18: Number of antimicrobials in resistance patterns of Salmonella isolates from pigs, by serovar; Abattoir Surveillance, 2007
• Table 19: Number of antimicrobials in resistance patterns of Salmonella isolates from pigs, by serovar; Surveillance of Animal Clinical Isolates, 2007
• Table 20: Number of antimicrobials in resistance patterns of Enterococcus isolates from pigs, by Enterococcus species; Farm Surveillance, 2007.
• Table 21: Number of antimicrobials in resistance patterns of Salmonella isolates from turkeys, by serovar; Surveillance of Animal Clinical Isolates, 2007
• Table 22: Number of antimicrobials in resistance patterns of Salmonella isolates from horses, by serovar; Surveillance of Animal Clinical Isolates, 2007
• Table 23: Number of antimicrobials in resistance patterns of feed Salmonella isolates from animal feed, by serovar; Feed and Feed Ingredients, 2007.
• Table 24: Total number of prescriptions of oral antimicrobials dispensed by retail pharmacies per 1,000 inhabitants, 2000–2007
• Table 25: Defined daily doses (DDDs) per 1,000 inhabitant-days for oral antimicrobials dispensed by retail pharmacies in Canada, 2000–2007
• Table 26: Total cost per 1,000 inhabitants for oral antimicrobials dispensed by retail pharmacies in Canada, 2000–2007
• Table 27: Total consumption (DDDs/1,000 inhabitant-days) of oral antimicrobials dispensed by retail pharmacies in Canadian provinces, 2007.
• Table 28: Kilograms of antimicrobials in dosage form distributed in Canada for use in animals; Canadian Animal Health Institute, 2006 and 2007.
• Table 29: Number of sentinel swine herds (n = 100) with reported use of specific active antimicrobial ingredients, by administration route; Farm Surveillance, 2007

• Table A.1.1: Categorization of antimicrobial drugs based on importance in human medicine
• Table A.4.1: Breakpoints in antimicrobial susceptibility of Salmonella and Escherichia coli isolates, CMV1AGNF plate, 2007
• Table A.4.2: Breakpoints in antimicrobial susceptibility of Campylobacter isolates, CAMPY plate, 2007
• Table A.4.3: Breakpoints in antimicrobial susceptibility of Enterococcus isolates, CMV2AGPF plate, 2007
• Table A.5.1: List of antimicrobials from the Compu Script database for each ATC class
• Table B.1.1: Distribution of Salmonella isolates from humans, by patient age and province; Surveillance of Human Clinical Isolates, 2007
• Table B.1.2: Distribution of isolates of primary human Salmonella serovars from humans, by source; Surveillance of Human Clinical Isolates, 2007.
• Table B.1.3: Distribution of minimum inhibitory concentrations (MICs; μg/mL) for antimicrobials in Salmonella Enteritidis isolates from humans;
  Surveillance of Human Clinical Isolates, 2007
• Table B.1.4: Distribution of minimum inhibitory concentrations (MICs; μg/mL) for antimicrobials in Salmonella Heidelberg isolates from humans; Surveillance of Human Clinical Isolates, 2007
• Table B.1.5: Distribution of minimum inhibitory concentrations (MICs; μg/mL) for antimicrobials in Salmonella Newport isolates from humans; Surveillance of Human Clinical Isolates, 2007
• Table B.1.6: Distribution of minimum inhibitory concentrations (MICs; μg/mL) for antimicrobials in Salmonella Paratyphi A and S. Paratyphi B isolates from humans; Surveillance of Human Clinical Isolates, 2007
• Table B.1.7: Distribution of minimum inhibitory concentrations (MICs; μg/mL) for antimicrobials in Salmonella Typhi isolates from humans; Surveillance of Human Clinical Isolates, 2007
• Table B.1.8: Distribution of minimum inhibitory concentrations (MICs; μg/mL) for antimicrobials in Salmonella Typhimurium isolates from humans; Surveillance of Human Clinical Isolates, 2007
• Table B.1.9: Distribution of minimum inhibitory concentrations (MICs; μg/mL) for antimicrobials in Salmonella “Other Serovars” isolates from humans; Surveillance of Human Clinical Isolates, 2007.
• Table B.2.1: Distribution of minimum inhibitory concentrations (MICs; μg/mL) for antimicrobials in Salmonella isolates from cattle; Surveillance of Animal Clinical Isolates, 2007
• Table B.2.2: Distribution of minimum inhibitory concentrations (MICs; μg/mL) for antimicrobials in Escherichia coli isolates from beef cattle; Abattoir Surveillance, 2007.
• Table B.2.3: Distribution of minimum inhibitory concentrations (MICs; μg/mL) for antimicrobials in Escherichia coli isolates from beef, by province; Retail Meat Surveillance, 2007
• Table B.2.4: Distribution of minimum inhibitory concentrations (MICs; μg/mL) for antimicrobials in Campylobacter isolates from beef cattle, by Campylobacter species; Abattoir Surveillance, 2007.
• Table B.2.5: Distribution of minimum inhibitory concentrations (MICs; μg/mL) for antimicrobials in Salmonella isolates from chickens; Abattoir Surveillance, 2007
• Table B.2.6: Distribution of minimum inhibitory concentrations (MICs; μg/mL) for antimicrobials in Salmonella isolates from chicken, by province; Retail Meat Surveillance, 2007
• Table B.2.7: Distribution of minimum inhibitory concentrations (MICs; μg/mL) for antimicrobials in Salmonella isolates from chickens; Surveillance of Animal Clinical Isolates, 2007
• Table B.2.8: Distribution of minimum inhibitory concentrations (MICs; μg/mL) for antimicrobials in Escherichia coli isolates from chickens; Abattoir Surveillance, 2007
• Table B.2.9: Distribution of minimum inhibitory concentrations (MICs; μg/mL) for antimicrobials in Escherichia coli isolates from chicken, by province; Retail Meat Surveillance, 2007
• Table B.2.10: Distribution of minimum inhibitory concentrations (MICs; μg/mL) for antimicrobials in Campylobacter isolates from chicken, by Campylobacter species and province; Retail Meat Surveillance, 2007.
• Table B.2.11: Distribution of minimum inhibitory concentrations (MICs; μg/mL) for antimicrobials in Enterococcus isolates from chicken, by Enterococcus species and province; Retail Meat Surveillance, 2007.
• Table B.2.12: Distribution of minimum inhibitory concentrations (MICs; μg/mL) for antimicrobials in Salmonella isolates from pigs; Farm Surveillance, 2007
• Table B.2.13: Distribution of minimum inhibitory concentrations (MICs; μg/mL) for antimicrobials in Salmonella isolates from pigs; Abattoir Surveillance, 2007
• Table B.2.14: Distribution of minimum inhibitory concentrations (MICs; μg/mL) for antimicrobials in Salmonella isolates from pigs; Surveillance of Animal Clinical Isolates, 2007
• Table B.2.15: Distribution of minimum inhibitory concentrations (MICs; μg/mL) for antimicrobials in Escherichia coli isolates from pigs; Farm Surveillance, 2007
• Table B.2.16: Distribution of minimum inhibitory concentrations (MICs; μg/mL) for antimicrobials in Escherichia coli isolates from pigs; Abattoir Surveillance, 2007
• Table B.2.17: Distribution of minimum inhibitory concentrations (MICs; μg/mL) for antimicrobials in Escherichia coli isolates from pigs, by province; Retail Meat Surveillance, 2007
• Table B.2.18: Distribution of minimum inhibitory concentrations (MICs; μg/mL) for antimicrobials in Enterococcus isolates from pigs, by Enterococcus species; Farm Surveillance, 2007
• Table B.2.19: Distribution of minimum inhibitory concentrations (MICs; μg/mL) for antimicrobials in Salmonella isolates from turkeys; Surveillance of Animal Clinical Isolates, 2007
• Table B.2.20: Distribution of minimum inhibitory concentrations (MICs; μg/mL) for antimicrobials in Salmonella isolates from horses; Surveillance of Animal Clinical Isolates, 2007
• Table B.2.21: Distribution of minimum inhibitory concentrations (MICs; μg/mL) for antimicrobials in Salmonella isolates from feed; Surveillance of Feed and Feed ingredients, 2007
• Table B.3.1: Total volume of active ingredients of oral antimicrobials dispensed by retail pharmacies in Canada, 2000–2007
• Table B.4.1: Summary of selected resistance patterns involving multiple antimicrobials in bacterial isolates from humans and the agri-food sector; CIPARS, 2007
• Table B.4.2: Summary of antimicrobial resistance in the most common isolates of Salmonella serovars from humans and the agri-food sector; CIPARS, 2007
• Table B.4.3: Recovery rates for bacterial species of isolates from various surveillance components of the agri-food sector; CIPARS, 2002–2007
• Table B.4.4: Distribution of animal isolates of Salmonella, by province; Surveillance of Animal Clinical Isolates, 2007
• Table C.3.1: Population demographics and availability of health care.
• Table C.3.2: Characteristics, production, and per-capita consumption of Canadian livestock.
• Table C.3.3: Number of births, slaughtered animals, international imports and exports, and farm deaths of Canadian cattle, pigs, and sheep, 2007.

List of Boxes

• Box 1: Prevalence and antimicrobial susceptibility of Salmonella and generic Escherichia coli isolated from liquid whole egg in Ontario
• Box 2: Application of analytic models to ciprofloxacin minimum inhibitory concentrations of enteric Campylobacter jejuni isolates from human patients in Saskatchewan, 1999–2005
• Box 3: Environmental household study
• Box 4: Retail meat sampling in Alberta – A pilot research project
• Box 5: The effect of intramammary antimicrobial therapy at dry off on antimicrobial resistance in commensal fecal Escherichia coli and Enterococcus spp. on commercial dairy farms
• Box 6: Antimicrobial resistance and aquaculture
• Box 7: Association between antimicrobial resistance and antimicrobial usage in mastitis treatment and control
• Box 8: Evaluation of the risks of shedding salmonellae and other potential pathogens by therapy dogs fed raw meat diets
• Box 9: CIPARS Retail Meat Surveillance in the Maritimes, 2007