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Canadian Antimicrobial Resistance Surveillance System Report

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Canadian Antimicrobial Resistance Surveillance System Report CANADIAN ANTIMICROBIAL RESISTANCE SURVEILLANCE SYSTEM 2017 REPORT CANADIAN ANTIMICROBIAL RESISTANCE SURVEILLANCE SYSTEM – REPORT 2016 TO PROMOTE AND PROTECT THE HEALTH OF CANADIANS THROUGH LEADERSHIP, PARTNERSHIP, INNOVATION AND ACTION IN PUBLIC HEALTH. —Public Health Agency of Canada Également disponible en français sous le titre: Système canadien de surveillance de la résistance aux antimicrobiens – rapport de 2017 To obtain additional information, please contact: Public Health Agency of Canada Address Locator 0900C2 Ottawa, ON K1A 0K9 Tel.: 613-957-2991 Toll free: 1-866-225-0709 Fax: 613-941-5366 TTY: 1-800-465-7735 E-mail: [email protected] This publication is available in alternative formats upon request. © Her Majesty the Queen in Right of Canada, as represented by the Minister of Health, 2017 Publication date: November 10th, 2017 This publication may be reproduced for personal or internal use only without permission provided the source is fully acknowledged. However, multiple copy reproduction of this publication in whole or in part for purposes of resale or redistribution requires the prior written permission from the Minister of Public Works and Government Services Canada, Ottawa, Ontario K1A 0S5 or [email protected]. Cat.: ISSN: Pub.: CANADIAN ANTIMICROBIAL RESISTANCE SURVEILLANCE SYSTEM – 2017 REPORT 3 Glossary AMR Antimicrobial resistance AMU Antimicrobial use BSI Bloodstream infection CA-CDI Community-associated Clostridium difficile Infections CAHI Canadian Animal Health Institute CCS Canadian CompuScript CA-MRSA Community-associated methicillin-resistant Staphylococcus aureus CARSS Canadian Antimicrobial Resistance Surveillance System CCHS Canadian Community Health Survey CDH Canadian Drugstore and Hospital CDI Clostridium difficile infection CDTI Canadian Disease and Therapeutic Index CIDSC Communicable and Infectious Disease Steering Committee CIPARS Canadian Integrated Program for Antimicrobial Resistance Surveillance CNISP Canadian Nosocomial Infection Surveillance Program CPE Carbapenemase-producing Enterobacteriaceae CPO Carbapenamase-producing organisms CRE Carbapenem-resistant Enterobacteriaceae CTBRS Canadian Tuberculosis Reporting System DDD Defined Daily Dose ESAC-Net European Surveillance of Antimicrobial Consumption Network ESAG Enhanced Surveillance for Antimicrobial Resistant Gonorrhea ESBL Extended-spectrum ß-lactamase ESVAC European Surveillance of Veterinary Antimicrobial Consumption GLASS Global Antimicrobial Resistance Surveillance System GNB Gram-negative Bacilli HA-CDI Healthcare-associated Clostridium difficile infection HA-MRSA Healthcare-associated methicillin-resistant Staphylococcus aureus kg Kilogram MDR Multidrug-resistant MDR-TB Multidrug-resistant Tuberculosis mg/L Milligrams per liter MIA Medically important antimicrobials MIC Minimum Inhibitory Concentration MRSA Methicillin-resistant Staphylococcus aureus MSM Men who have sex with men NAAT Nucleic Acid Amplification Test NML National Microbiology Laboratory NIHB Non-Insured Health Benefits OIE World Organisation for Animal Health PCU Population Correction Unit PHAC Public Health Agency of Canada TB Tuberculosis VRE Vancomycin-resistant enterococci WHO World Health Organisation XDR-TB Extensively drug-resistant tuberculosis 4 Table of Contents Glossary ................................................................................................................................................................................................................. 4 Table oF Contents .............................................................................................................................................................................................. 5 Message from the Chief Public Health Officer and the President of the Public Health Agency of Canada ........... 6 Introduction ........................................................................................................................................................................................................ 7 EXECUTIVE SUMMARY ..................................................................................................................................................................................... 8 Antimicrobial resistance and antimicrobial use .............................................................................................................................................. 8 Antimicrobial resistance ................................................................................................................................................................................. 8 Antimicrobial use in humans ........................................................................................................................................................................ 11 Antimicrobial use in the community ............................................................................................................................................................. 12 Antimicrobial use in the hospital setting ...................................................................................................................................................... 13 Antimicrobial use in Food-producing and companion animals ..................................................................................................................... 14 Addressing surveillance data gaps ................................................................................................................................................................ 15 Next steps and conclusion ............................................................................................................................................................................ 16 TECHNICAL ANNEX .......................................................................................................................................................................................... 17 Antimicrobial resistance and use ....................................................................................................................................................................... 17 Clostridium difficile ....................................................................................................................................................................................... 20 Carbapenem-resistant Enterobacteriaceae and Acinetobacter spp. ............................................................................................................ 25 Staphylococcus aureus.................................................................................................................................................................................. 29 Enterococcus spp. ......................................................................................................................................................................................... 32 Streptococcus pyogenes and pneumoniae .................................................................................................................................................... 34 Neisseria gonorrhoeae .................................................................................................................................................................................. 36 Mycobacterium tuberculosis......................................................................................................................................................................... 40 Salmonella enterica serovars Typhi and Paratyphi ....................................................................................................................................... 43 Non-typhoidal Salmonella enterica .............................................................................................................................................................. 44 Resistance in Enteric Bacteria From Animal and Food Sources ..................................................................................................................... 46 Antimicrobial use in Canada .............................................................................................................................................................................. 59 Human antimicrobial use.............................................................................................................................................................................. 59 National Antimicrobial Use ........................................................................................................................................................................... 61 National Pharmacy Dispensing ..................................................................................................................................................................... 61 Provincial / Territorial Pharmacy Dispensing ................................................................................................................................................ 65 Prescribing Practices by Specialization ......................................................................................................................................................... 66 Antimicrobial use in Indigenous and non-Indigenous Populations ............................................................................................................... 68 Antimicrobial
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