AMR surveillance in Canada: Insights from the 2025 Priority Pathogen List

Area of Science:

• Public Health
• Infectious Disease Epidemiology
• Health Surveillance

Background:

• Antimicrobial resistance (AMR) poses a significant global health threat.
• Canada's 2025 updated AMR Priority Pathogen List reflects current resistance trends and surveillance advancements.
• Previous AMR prioritization in Canada occurred in 2015.

Purpose of the Study:

• To qualitatively analyze the 2025 AMR prioritization results.
• To evaluate Canadian AMR surveillance systems' strengths and limitations in detecting high-risk pathogens.
• To identify data integration gaps in national surveillance.

Main Methods:

• Utilized a multi-criteria decision analysis (MCDA) framework for pathogen prioritization.
• Assessed 29 AMR pathogens based on nine weighted criteria, including health equity.
• Conducted qualitative analysis of surveillance system coverage for prioritized pathogens.

Main Results:

• Identified Candida auris, drug-resistant Neisseria gonorrhoeae, and Mycoplasma genitalium as emerging high-priority threats.
• Found that national surveillance systems can potentially cover 90% of prioritized pathogens.
• Highlighted persistent surveillance gaps for pathogens lacking routine diagnostics and disproportionate impacts on marginalized populations.

Conclusions:

• Canada has advanced integrated and equity-informed AMR surveillance.
• Continued investment and collaboration are crucial for addressing data gaps and improving public health actions.
• Enhanced national systems integrate laboratory and epidemiologic data for over half of prioritized pathogens.