When the colistin-resistant gene, mcr-1
, was first found in China in 2015, health officials around the world knew the gene would inevitably appear in their countries. It has since been detected in other parts of Asia, Europe, and North America, including Canada, which just released a 2016 report
from their Canadian Antimicrobial Resistance Surveillance System (CARSS).
This new report is the second annual compilation of data from nine Public Health Agency of Canada (PHAC) surveillance systems and laboratory services, tasked with tracking and providing information for their Federal Action Plan on the state of antimicrobial resistance (AMR) and antimicrobial use (AMU) in the country. With antibiotic-resistant bacteria plaguing healthcare systems around the world, the report aims to support decision making by Canada’s health professionals and policy makers. “This year’s report demonstrates the Government of Canada’s continued commitment to leading activities to prevent, limit and control the emergence and spread of AMR as described in Antimicrobial Resistance and Use in Canada: A Federal Framework for Action,” states the report.
The World Health Organization
says that antimicrobial resistance is a global problem threatening the effectiveness of current treatment and the prevention of dangerous illnesses such as tuberculosis. Hard-to-treat infections caused by bacteria such as Staphylococcus aureus
, Escherichia coli
, and Klebsiella pneumoniae
drive up medical costs and can lead to lengthy hospital stays. With over-prescription of antibiotic medications contributing to the growing problem of “superbugs
,” the Canadian report states that the country’s volume of those prescriptions has remained relatively stable over the last 13 years. In 2014, Canadians dispensed 23 million prescriptions of antibiotics, putting the country 12th in a list of 31 countries for antibiotic use. The annual overall expenditure on antimicrobials in Canada is $786 million, with community dispensing accounting for 87% and hospital purchases accounting for 13% of this amount.
The good news out of this year’s report is that for select antimicrobial-resistant bacteria, the recent surveillance shows generally stable rates of resistance and, in some cases, a decline in infection rates for certain bacteria. Canada’s rates of hospitalization for methicillin-resistant Staphylococcus aureus
, a common cause of healthcare-associated infections, have dropped by 25% since 2008, with rates of vancomycin-resistant Enterococci infections down, too. Likewise, with Clostridium difficile
infections remaining an issue for hospitals and other health facilities, rates in Canada declined in 2014 from 5.2 cases per 1,000 patient admissions to 3.4 cases per 1,000 patient admissions, after a decade of increasing rates. While those infection rates still remain higher than 2007 levels, the new numbers indicate that Canada is stemming the problem of at least some drug-resistant bacteria.