Informing Stewardship Measures in Canadian Food Animal Species through Integrated Reporting of Antimicrobial Use and Antimicrobial Resistance Surveillance Data—Part II, Application

Abstract

Using the methodology developed for integrated analysis and reporting of antimicrobial use (AMU) and antimicrobial resistance (AMR) data, farm-level surveillance data were synthesized and integrated to assess trends and explore potential AMU and AMR associations. Data from broiler chicken flocks (n = 656), grower–finisher pig herds (n = 462) and turkey flocks (n = 339) surveyed by the Canadian Integrated Program for Antimicrobial Resistance Surveillance (CIPARS) at the farm-level (2015–2019) were used. The analyses showed a reduction in mean flock/herd level number of defined daily doses using Canadian standards (nDDDvetCA) adjusted for kg animal biomass that coincided with the decline in % resistance in the three species. This was noted in most AMU-AMR pairs studied except for ciprofloxacin resistant Campylobacter where resistance continued to be detected (moderate to high levels) despite limited fluoroquinolone use. Noteworthy was the significantly negative association between the nDDDvetCA/kg animal biomass and susceptible Escherichia coli (multispecies data), an early indication that AMU stewardship actions are having an impact. However, an increase in the reporting of diseases in recent years was observed. This study highlighted the value of collecting high-resolution AMU surveillance data with animal health context at the farm-level to understand AMR trends, enable data integration and measure the impact of AMU stewardship actions.

Decrease in the prevalence of antimicrobial resistance in Escherichia coli isolates of Canadian turkey flocks driven by the implementation of an antimicrobial stewardship program

“…Step 2 was implemented at the end of 2018 and eliminated the preventive use of aminoglycosides, macrolides, penicillins, and streptogramins. Between 2019 and 2020, the incorporation of the Step 3 strategy ended the preventive use of bacitracin and tetracyclines [ 14 , 26 ]. It is important to note that the strategy does not include the prohibition of the use of these antimicrobials for treatment of disease under veterinary supervision in the face of an outbreak.…”

“…Previous research studies in Canada characterized AMR in indicator and foodborne bacteria from turkey flocks and retail turkey meats and found antimicrobial-resistant bacteria and AMR phenotypes that have potential food safety implications [20][21][22]. Similarly, other turkeyproducing countries have reported high levels of multidrug resistance (MDR) (resistance to �3 antimicrobial classes) in E. coli isolates and resistance to WHO's Highest Priority Critically Important Antimicrobials (HP-CIA) including beta-lactams, 3 rd , and 4 th generation cephalosporins, aminopenicillins, fluoroquinolones and polymyxins (colistin) [23][24][25][26][27]. Studies have also shown that the use of antimicrobials in turkey flocks was significantly associated with the development of resistance to the same or unrelated antimicrobials [26][27][28][29].…”

Canadian Collaboration to Identify a Minimum Dataset for Antimicrobial Use Surveillance for Policy and Intervention Development across Food Animal Sectors

“…CIPARS has advanced its farm-level analysis by developing the defined daily dose in animals using Canadian standards (DDDvetCA) [ 10 , 44 ]. Dose-based indicators were applied to the CIPARS Farm AMU Surveillance data for characterizing AMU trends between species and investigated for their utility for studying AMU–AMR linkages [ 45 ]. Additionally, the dose-based indicators were used for monitoring the impact of the changes in voluntary and regulatory AMU practices (i.e., from disease prevention to disease treatment or disease control, progressive elimination of certain classes of antimicrobials) [ 45 , 46 ].…”

“…Dose-based indicators were applied to the CIPARS Farm AMU Surveillance data for characterizing AMU trends between species and investigated for their utility for studying AMU–AMR linkages [ 45 ]. Additionally, the dose-based indicators were used for monitoring the impact of the changes in voluntary and regulatory AMU practices (i.e., from disease prevention to disease treatment or disease control, progressive elimination of certain classes of antimicrobials) [ 45 , 46 ]. Other sectors intending to develop their capacity for AMU surveillance could progressively improve their data collection and analytic capacity to enable the reporting of indicators relevant to their sector.…”

A scoping review of factors potentially linked with antimicrobial-resistant bacteria from turkeys (iAM.AMR Project)

“…However, these findings may have been impacted by criteria of this review that were shaped by the needs of the larger iAM.AMR project at this stage of model development, such as the pragmatic exclusion of continuous factors. The use of continuous quantitative AMU indicators in surveillance reporting provides additional granularity for understanding the impact of AMU (compared to categorical binary measurements), and the reporting of such indicators is becoming more common [ 31 , 58 ]. The research team plans to incorporate continuous quantitative AMU indicators, in particular, into future iterations of the iAM.AMR project's model structure.…”