The Canadian Integrated Program for Antimicrobial Resistance Surveillance (CIPARS) - Frequently Asked Questions

1. What is the Canadian Integrated Program for Antimicrobial Resistance Surveillance (CIPARS)?

CIPARS is a nationally integrated antimicrobial resistance surveillance program developed by the Public Health Agency of Canada in collaboration with Health Canada, the Canadian Food Inspection Agency and provincial partners. One of the key objectives of CIPARS is to monitor trends in the development of antimicrobial resistance (AMR) in the food chain.

To facilitate the comparison of data, CIPARS has been modelled after international initiatives such as the US National Antimicrobial Resistance Monitoring System (NARMS) and the Danish Integrated Antimicrobial Resistance Monitoring and Research Programme (DANMAP).

In March 2005, CIPARS released its Second Annual Report summarizing data collected during 2003 on antimicrobial resistance from human and animal samples.

2. What are antimicrobials and how does resistance develop?

The term antimicrobial refers to both natural and synthetic substances such as antibiotics and disinfectants that can kill or inhibit the growth of microorganisms. AMR occurs when an antimicrobial substance, or agent, is no longer effective in killing or inhibiting the growth of a particular microorganism. Cross-resistance to an antimicrobial drug may develop when bacteria associated with one drug develop resistance to other drugs of the same family.

3. Why are antimicrobials used in food-producing animals?

Antimicrobials are prescribed and used therapeutically for the treatment of diseases in both humans and animals. Antimicrobials are also added to the feed of food-producing animals to promote growth, to increase feed efficiency and to prevent infections, making for safer and more affordable food products.

4. What is Health Canada doing with data provided in the Second Annual CIPARS Report?

AMR surveillance is a key element of Health Canada's strategy to build a solid evidence base for developing overarching policies on antimicrobial use. Health Canada's approach to addressing the reported prevalence of resistance includes supporting the expansion of ongoing retail surveillance, strengthening our efforts to encourage prudent use of antimicrobial drugs in food-producing animals, while continuing our support for AMR research, and monitoring AMR trends.

The data collected must be interpreted in the context of a broader initiative to develop measures to control the spread of AMR in Canada. There are still evidence gaps and we will continue to monitor the emergence and persistence of AMR in food-borne pathogens isolated from food-producing animals in all Canadian provinces in order to have a nationally representative surveillance system.

5. Does this report indicate any resistance problems?

Efforts have been made to identify resistance to specific antimicrobials that are of highest human health importance. For example, since ceftiofur (which is used in animals) is of the same class of drugs as ceftriaxone (which is used in human medicine), there is a concern that resistance to ceftiofur may have an impact on human health. Results point to a need for further investigation and assessment of risk in order to determine if any remedial actions are warranted.

6. Why are there differences between the data collected from provinces?

It is difficult to identify why there are differences between the prevalence of resistance to specific antimicrobials in Quebec and Ontario, since we are still in the initial stage of data collection/analysis. Current surveillance data will need to be studied more closely to evaluate these differences. Health Canada will need to engage respective provincial partners to further evaluate and minimize the risk factors for emergence of resistance to antimicrobials that are of importance to human health and to animal health.

7. Why is Health Canada concentrating its attention on the agri-food sector? Is it the major source of AMR?

CIPARS was designed to provide the scientific data needed to better understand the relative importance of the agri-food sector's contribution to this complex issue. Health Canada recognizes that the use of antimicrobial drugs in the agri-food industry is only one of many factors contributing to the development and spread of resistance among human pathogens.

8. Does CIPARS have plans to expand their program?

Planning is underway regarding future work. Expansion is being considered in terms of partnerships, geographic locations, commodities, and bacterial species being evaluated.

9. Is food produced from animals treated with antibiotics safe for humans?

Antibiotics are used in food-producing animals to provide safe and affordable food products. Canada's food system is one of the safest in the world and efforts will continually be made to minimize the development and spread of resistance from agri-food sources. The findings reported in the CIPARS reports are very useful in the ongoing risk assessment of antimicrobial drugs. This is part of a broad initiative aimed at developing comprehensive Canadian policies on antimicrobial resistance and the use of antimicrobial drugs in humans as well as in animals.

To help prevent bacterial contamination in food, please refer to this Web site link for safe food handling tips:
Salmonella Prevention

10. What can I do to prevent AMR and maintain the usefulness of antibiotics currently available for the treatment of human infections?

AMR is recognized as a global public health issue requiring urgent and concerted action by individuals, governments, physicians, veterinarians, farmers, pharmaceutical industries, as well as national and international public health organizations and governments. Individuals also have a role to play, and can take some of the following precautions:

When treating animals,

• Follow label instructions for the use and disposal of animal medications (for farm animals or companion animals).
• Farmers are encouraged to improve on-farm hygiene to minimize the need to use antibiotics or other antimicrobials.

In human medicine,

• Be aware that antibiotics are not effective for everything. For example, 90 percent of colds and flus, and the accompanying coughs, sore throats, aches and pains are caused by viruses. Antibiotics won't help.
• Take drugs only as directed by your doctor or pharmacist. Don't stop taking a drug part way through the course of treatment, unless you are having an adverse reaction, without first discussing it with your doctor. Always take all of the prescribed antibiotics: sometimes symptoms disappear earlier, but the bacteria may not be gone. The surviving bacteria can recover and will be stronger and more resistant to the antibiotic.
• Don't share your prescriptions with anyone else. Don't use a prescription for any other purpose other than what it is prescribed for. Using an inappropriate drug can make the resistance problem worse.
• Do not flush out-of-date or unused medication down the toilet, pour it down the sink, or put it in the garbage. Disposing of medication using any one of these methods means that the active ingredients could end up in the water table. This could increase resistance. Ask your pharmacist if there is a drug recycling program. Many pharmacies provide a service to dispose of unused drugs in an environmentally safe manner.

In everyday living,

• Avoid use of antibacterial soap and "bacteria-fighting" household cleaning products. They are proven to be no more effective than regular soap and can lead to antimicrobial resistance. In fact, they also kill the 'good' germs that are needed to fight bad germs, aid in digestion, etc.
• Wash your hands regularly with plain soap and water for at least 20 seconds. It is the most effective way of preventing any type of infection.
• Store, handle and prepare food safely. When you're preparing food, be sure to wash cutting boards and knives with soap and water. Thoroughly wash all fruits and vegetables that will be eaten raw.

For more information, please see "AMR: Debunking the Myths".

For more information, please refer to this Web site link for frequently asked questions on AMR:
For Your Information: Antimicrobial Resistance.