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Guidance: Infection Prevention and Control

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Guidance: Infection Prevention and Control CANADIAN ANTIMICROBIAL RESISTANCE SURVEILLANCE SYSTEM – REPORT 2016 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 2016 To obtain additional copies, please contact: 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, 2016 Publication date: September 2016 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.: HP37-21E-PDF ISSN: 2369-0712 Pub.: 160112 I | CANADIAN ANTIMICROBIAL RESISTANCE SURVEILLANCE SYSTEM – REPORT 2016 CANADIAN ANTIMICROBIAL RESISTANCE SURVEILLANCE SYSTEM – REPORT 2016 Data to 2014 II | CANADIAN ANTIMICROBIAL RESISTANCE SURVEILLANCE SYSTEM – REPORT 2016 Table of contents Glossary .................................................................................................................................................... III Message from the Chief Public Health Officer and the President of the Public Health Agency of Canada ........................................................................................................................................................... 1 Executive Summary ................................................................................................................................... 2 Introduction ...................................................................................................................................... 2 Antimicrobial resistance and antimicrobial use ................................................................................ 3 Antimicrobial resistance ......................................................................................................... 3 Antimicrobial use in humans .................................................................................................. 4 Antimicrobial use in animals ................................................................................................... 6 AMR priority organisms..................................................................................................................... 7 Organisms transmitted in healthcare settings ........................................................................ 9 Organisms transmitted in community settings.....................................................................10 Organisms transmitted in animals ........................................................................................11 Surveillance data gaps .....................................................................................................................12 Next steps/conclusion .....................................................................................................................14 Technical annex.......................................................................................................................................15 Antimicrobial resistance and antimicrobial use ..............................................................................15 Antimicrobial resistance in Canada .................................................................................................16 Clostridium difficile ...............................................................................................................16 Multidrug-resistant Enterobacteriaceae and Acinetobacter ................................................21 Methicillin-resistant Staphylococcus aureus .........................................................................30 Vancomycin-resistant Enterococci ........................................................................................38 Drug-resistant Streptococcus ................................................................................................42 Neisseria gonorrhoeae ..........................................................................................................46 Drug-resistant Salmonella Typhi ...........................................................................................49 Drug-resistant Non-typhoidal Salmonella ............................................................................52 Drug-resistant Tuberculosis ..................................................................................................56 Resistance in foodborne bacteria ...................................................................................................62 Generic Escherichia coli ........................................................................................................62 Campylobacter species .........................................................................................................67 Salmonella spp. .....................................................................................................................71 Antimicrobial use in Canada ............................................................................................................74 Antimicrobial use in humans ................................................................................................74 Antimicrobial use in animals .................................................................................................97 References ............................................................................................................................................106 III | CANADIAN ANTIMICROBIAL RESISTANCE SURVEILLANCE SYSTEM – REPORT 2016 Glossary AMR Antimicrobial resistance AMU Antimicrobial use AST Antimicrobial susceptibility testing BCCDC British Columbia Centre for Disease Control BSI Bloodstream infection CA Community-associated CAHI Canadian Animal Health Institute CA-MRSA Community-associated methicillin-resistant Staphylococcus aureus CARA Canadian Antimicrobial Resistance Alliance CARSS Canadian Antimicrobial Resistance Surveillance System CDI Clostridium difficile infection CIDSC Communicable and Infectious Disease Steering Committee CIPARS Canadian Integrated Program for Antimicrobial Resistance Surveillance CNDSS Canadian Notifiable Disease Surveillance System CNISP Canadian Nosocomial Infection Surveillance Program CPHLN Canadian Public Health Laboratory Network CPO Carbapenemase-producing organisms CRA Carbapenem-resistant Acinetobacter CRE Carbapenem-resistant Enterobacteriaceae CTBLSS Canadian Tuberculosis Laboratory Surveillance System DDD Defined daily doses DID Daily doses per 1000 inhabitants per day EARS-NET European Antimicrobial Resistance Surveillance Network EIP Emerging Infections Program ESAC-Net European Surveillance of Antimicrobial Consumption Network ESAG Enhanced Surveillance of Antimicrobial Resistant Gonorrhea ESBL Extended-spectrum ß-lactamase ESVAC European Surveillance of Veterinary Antimicrobial Consumption GAS Group A Streptococcus GNB Gram-negative Bacilli HA Healthcare-associated HA-CDI Healthcare-associated Clostridium difficile infection HA-MRSA Healthcare-associated methicillin-resistant Staphylococcus aureus HO-CDI Hospital-onset Clostridium difficile infection HUS Hemolytic Uremic Syndrome ICU Intensive Care Unit iGAS Invasive Group A streptococcal diseases IV | CANADIAN ANTIMICROBIAL RESISTANCE SURVEILLANCE SYSTEM – REPORT 2016 INH Isoniazid IPD Invasive pneumococcal disease IV Intravenous KPC Klebsiella pneumoniae carbapenemase MDR Multidrug-resistant MDR-TB Multidrug-resistant Tuberculosis MIC Minimum inhibitory concentration MRSA Methicillin -resistant Staphylococcus aureus MSM Men who have sex with men NARMS National Antimicrobial Resistance Monitoring System for Enteric Bacteria NHS National Health Service NHSN National Healthcare Safety Network NIHB Non-Insured Health Benefits NML National Microbiology Laboratory PCR Polymerase chain reaction PCU Population Correction Unit PCV13 13-valent pneumococcal conjugate vaccine PFGE Pulsed-field gel electrophoresis PHAC Public Health Agency of Canada PHN Public Health Network RMP Rifampin SSTI Skin and soft tissue infection STI Sexually transmitted infection TB Tuberculosis TMP-SMX Trimethoprim-sulfamethoxazole US CDC United States Centers for Disease Control and Prevention UTI Urinary tract infections VRE Vancomycin-resistant Enterococci VRSA Vancomycin-resistant Staphylococcus aureus WHO World Health Organization XDR-TB Extensively drug-resistant TB 1 | CANADIAN ANTIMICROBIAL RESISTANCE SURVEILLANCE SYSTEM – REPORT 2016 Message from the Chief Public Health Officer and the President of the Public Health Agency of Canada Antimicrobial resistance (AMR) continues to be a serious public health issue in Canada and internationally. Common and treatable infections may once again become deadly. This reality is illustrated by the recent detection of the mcr-1
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