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Antimicrobial resistance in Canada
1Centre for Antimicrobial Resistance, University of Calgary, Alta. jconly@ucalgary.ca
Abstract:
Antibiotic resistance has increased rapidly during the last decade, creating a serious threat to the treatment of infectious diseases. Canada is no exception to this worldwide phenomenon. Data from the Canadian Nosocomial Infection Surveillance Program have revealed that the incidence of methicillin-resistant Staphylococcus aureus, as a proportion of S. aureus isolates, increased from 1% in 1995 to 8% by the end of 2000, and vancomycin-resistant enterococcus has been documented in all 10 provinces since the first reported outbreak in 1995. The prevalence of nonsusceptible Streptococcus pneumoniae in Canada in 2000 was found to be 12%. Human antimicrobial prescriptions, adjusted for differences in the population, declined 11% based on the total number of prescriptions dispensed between 1995 and 2000. There was also a 21% decrease in beta-lactam prescriptions during this same period. These data suggest that systematic efforts to reduce unnecessary prescribing of antimicrobials to outpatients in Canada, beginning after a national consensus conference in 1997, may be having an impact. There is, however, still a need for continued concerted efforts on a national, provincial and regional level to quell the rising tide of antibiotic resistance.
Insights
Antibiotic resistance is a growing global threat, with rising rates of resistant bacteria like MRSA and VRE in Canada. Declining antimicrobial prescriptions suggest interventions may be working, but continued efforts are crucial.
Area of Science:
- Public Health
- Infectious Diseases
- Microbiology
Background:
- Antibiotic resistance poses a significant threat to global health.
- Canada is experiencing an increase in antibiotic-resistant pathogens, including methicillin-resistant Staphylococcus aureus (MRSA) and vancomycin-resistant enterococcus (VRE).
- Nonsusceptible Streptococcus pneumoniae prevalence was 12% in Canada in 2000.
Purpose of the Study:
- To analyze trends in antibiotic resistance and antimicrobial prescribing in Canada.
- To evaluate the potential impact of interventions aimed at reducing antimicrobial use.
Main Methods:
- Analysis of data from the Canadian Nosocomial Infection Surveillance Program (CISIP).
- Examination of antimicrobial prescription data from 1995 to 2000.
- Assessment of changes in the incidence of specific resistant bacterial strains.
Main Results:
- MRSA incidence increased from 1% to 8% between 1995 and 2000.
- Vancomycin-resistant enterococcus has been documented nationwide.
- Total antimicrobial prescriptions decreased by 11%, with a 21% decrease in beta-lactam prescriptions from 1995 to 2000.
Conclusions:
- Systematic efforts to reduce unnecessary outpatient antimicrobial prescribing, initiated after a 1997 consensus conference, appear to be impacting resistance trends.
- Continued national, provincial, and regional efforts are necessary to combat rising antibiotic resistance.