Canadian Antimicrobial Resistance Surveillance System (CARSS): References and further reading
Established in 2015, the Canadian Antimicrobial Resistance Surveillance System (CARSS) serves as a national focal point for antimicrobial resistance (AMR) and antimicrobial use (AMU) surveillance, highlighting evidence and trends from PHAC and partners, and providing relevant, timely, accurate, and comprehensive information to stakeholders, to support research, policies and actions.
- Last updated: 2026-01-28
On this page
- Interactive AMR and AMU dashboards and reports
- Carbapenemase-producing Enterobacterales (CPE)
- Enterobacterales
- Pseudomonas aeruginosa
- Carbapenemase-producing Acinetobacter spp. (CPA)
- Candida auris
- Drug-resistant non-typhoidal Salmonella spp.
- Drug-resistant typhoidal Salmonella spp.
- Drug-resistant Campylobacter spp.
- Drug-resistant gonorrhea
- Drug-resistant Shigella
- Mycoplasma genitalium
- Invasive pneumococcal disease (IPD)
- Methicillin-resistant Staphylococcus aureus (MRSA)
- Vancomycin-resistant Enterococcus (VRE)
- Invasive group A Streptococcus (iGAS)
- Clostridioides difficile infection (CDI)
- Mycobacterium tuberculosis
- AMU - Community
- AMU - Hospital
- AMU - International
- Integrated AMR and AMU
Interactive AMR and AMU dashboards and reports
Consolidated overview of key surveillance initiatives and data platforms related to AMR and AMU in Canada. Together, these tools and programs provide a comprehensive, multi-sectoral surveillance system for antimicrobial resistance (AMR) and antimicrobial use (AMU) in Canada, enabling evidence-based policy development, antimicrobial stewardship initiatives, and One Health integration across the human, animal, and food sectors:
The AMRNet surveillance program collects antimicrobial resistance data submitted by Canadian laboratories.
This interactive data visualization tool, updated quarterly, highlights the quantity of antimicrobial doses dispensed to Canadians in the community over the last 72 months.
The CNISP summarizes trends in national incidence rates, antimicrobial resistance and molecular characterization for select healthcare-acquired infections and antimicrobial-resistant organisms.
Tracks culture-positive TB isolates from provincial/territorial laboratories across Canada. Provides critical data on trends in TB transmission, resistance, and supports public health efforts to control and prevent TB.
CIPARS AMR interactive data visualizations provide an overview of AMR data, including temporal trends in susceptibility, resistance and multidrug resistance, and bacterial subtypes and recovery among bacteria isolated from various host species.
An overview of antimicrobial use data from the CIPARS Farm Surveillance component.
The CIPARS key and integrated findings page highlights important AMR and AMU trends across bacterial species, antimicrobials, host species and surveillance components using text and interactive data visualizations.
The VASR system collects data on volumes of antimicrobials and quantity sold or compounded by animal species and by province/territory.
This interactive data tool explores the epidemiologic, antimicrobial use appropriateness, and laboratory data among Enhanced Surveillance of Antimicrobial-Resistant Gonorrhea System (ESAG) cases.
The Gonococcal Antimicrobial Surveillance Program — Canada (GASP-Canada) monitors antimicrobial resistance (AMR) in gonorrhea across Canada.
National Laboratory Surveillance of Invasive Streptococcal Disease (eSTREP)
Monitors trends in disease caused by invasive Streptococcus pneumoniae, Group A Streptococcus and neonatal Group B Streptococcus from provincial/territorial laboratories across Canada.
This dashboard presents integrated information from the PHAC-lead Canadian Antimicrobial Resistance Surveillance System (CARSS) which collects antimicrobial resistance data for priority pathogens.
This dashboard presents integrated information from the PHAC-lead Canadian Antimicrobial Resistance Surveillance System (CARSS) which monitors antimicrobial use data in humans and animals.
These initiatives collectively contribute to Canada's goal of evidence-informed action against AMR and AMU.
Carbapenemase-producing Enterobacterales (CPE)
Data source(s): Canadian Nosocomial Infection Surveillance Program (CNISP) and Canadian Integrated Program for Antimicrobial Resistance Surveillance (CIPARS)
- HAI and ARO rates: The Canadian Nosocomial Infection Surveillance Program (CNISP) — Canada.ca.
- Canadian Nosocomial Infection Surveillance Program. Healthcare-associated infections and antimicrobial resistance in Canadian hospitals, 2019-2023. Can Commun Dis Rep 2025;51:249–69 doi:rg/10.14745/ccdr.v51i67a04
- Ontario Health Agency of Health Protection and Promotion. Surveillance report: Carbapenemase-producing enterobacteriaceae in Ontario: 2022 annual summary. Toronto, ON: King's Printer for Ontario.
- Nikiforuk AM, Russell S, Lukac CD, et al. Shifting Epidemiology of Carbapenemase-Producing Organisms: Time Series Analysis of the Provincial Surveillance Program in British Columbia, Canada from 2014-2023. Lancet 2024 doi:10.2139/ssrn.4938032.
- Mitchell R, Mataseje L, Cayen J, et al. The evolving epidemiology of Carbapenemase-producing Enterobacterales in Canadian acute care facilities, 2010–2023. Antimicrobial Resistance & Infection Control 2025;14:88 doi:10.1186/s13756-025-01602-w.
- Mitchell R, Lee D, Bartoszko J, et al. Trends in healthcare-associated infections and antimicrobial-resistant organisms among adults in Canadian acute care hospitals: findings from four point prevalence surveys, 2002 to 2024. Infection Control & Hospital Epidemiology 2025:1–8 doi:10.1017/ice.2025.10259.
- Bonardi S, Pitino R. Carbapenemase-producing bacteria in food-producing animals, wildlife and environment: A challenge for human health. Ital J Food Safety 2019;8:7956 doi:10.4081/ijfs.2019.7956.
Enterobacterales
Data source(s): Canadian Integrated Program for Antimicrobial Resistance Surveillance (CIPARS) and Antimicrobial Resistance Network (AMRNet)
- CIPARS: Key and integrated findings — Canada.ca.
- Clinical data and reports: The Antimicrobial Resistance Network (AMRNet) - Canada.ca.
Pseudomonas aeruginosa
Data source(s): Antimicrobial Resistance Network (AMRNet)
- Clinical data and reports: The Antimicrobial Resistance Network (AMRNet) - Canada.ca.
Carbapenemase-producing Acinetobacter spp. (CPA)
Data source(s): Canadian Nosocomial Infection Surveillance Program (CNISP)
- HAI and ARO rates: The Canadian Nosocomial Infection Surveillance Program (CNISP) - Canada.ca.
- Canadian Nosocomial Infection Surveillance Program. Healthcare-associated infections and antimicrobial resistance in Canadian hospitals, 2019-2023. Can Commun Dis Rep 2025;51:249-69 doi:rg/10.14745/ccdr.v51i67a04.
Candida auris
Data source(s) : Canadian Nosocomial Infection Surveillance Program (CNISP)
- HAI and ARO rates: The Canadian Nosocomial Infection Surveillance Program (CNISP) - Canada.ca.
- Canadian Nosocomial Infection Surveillance Program. Healthcare-associated infections and antimicrobial resistance in Canadian hospitals, 2019-2023. Can Commun Dis Rep 2025;51:249-69.
- Public Health Agency of Canada (2024). Candida auris infection prevention and control in Canadian healthcare settings.
- De Luca DG, Alexander DC, Dingle T et al. Four genomic clades of Candida auris identified in Canada, 2012-2019. Med Mycol. 2022 Jan 10;60(1):myab079. doi: 10.1093/mmy/myab079.
Drug-resistant non-typhoidal Salmonella spp.
Data source(s): Canadian Integrated Program for Antimicrobial Resistance Surveillance (CIPARS)
Drug-resistant typhoidal Salmonella spp.
Data source(s): Canadian Integrated Program for Antimicrobial Resistance Surveillance (CIPARS)
Drug-resistant Campylobacter spp.
Data source(s): Canadian Integrated Program for Antimicrobial Resistance Surveillance (CIPARS) and FoodNet Canada (FNC)
Drug-resistant gonorrhea
Data source(s): Gonococcal Antimicrobial Surveillance Program of Canada (GASP-Canada) and the Enhanced Surveillance of Antimicrobial-Resistant Gonorrhea (ESAG)
- Overview: Gonococcal Antimicrobial Surveillance Program - Canada (GASP-Canada) - Canada.ca.
- About: Enhanced Surveillance of Antimicrobial-Resistant Gonorrhea System (ESAG) - Canada.ca.
- Sawatzky P, Thorington R, Barairo N, et al. Antimicrobial susceptibilities of Neisseria gonorrhoeae in Canada, 2022, CCDR 51(4). Can Commun Dis Rep 2025;51:129-36 doi:rg/10.14745/ccdr.v51i04a03.
- Ministère de la Santé et des Services sociaux du Québec. Premier cas d'échec de traitement à la ceftriaxone 500 mg IM pour une infection à Neisseria gonorrhoeae [CNPHI Public Health Alert (PHA) SA-006043]. 24 September 2025.
- National Advisory Committee on Sexually Transmitted and Blood-Borne Infections (2025). Interim Guidance for the Treatment of Uncomplicated Gonorrhea Infections. Ottawa: Public Health Agency of Canada.
- Public Health Agency of Canada (2025). Gonorrhea guide: Treatment and follow-up.
- Lefebvre B, Martin I, Thorington R, et al. Extensively Drug-Resistant Neisseria gonorrhoeae Strain, Canada - Volume 31, Number 7-July 2025 - Emerging Infectious Diseases journal - CDC 2025;31:1446-9 doi:10.3201/eid3107.250023.
- Windsor-Essex County Health Unit. (2023). Multi-drug Resistant Neisseria Gonorrhea Infection in Ontario.
- Bodie M, Gale-Rowe M, Alexandre S, et al. Addressing the rising rates of gonorrhea and drug-resistant gonorrhea: There is no time like the present. Canada Communicable Disease Report 2019;45:54-62 doi:10.14745/ccdr.v45i23a02.
Drug-resistant Shigella
- Windsor-Essex County Health Unit. (2023). XDR Shigella sonnei.
- Chow Q. (2024). Study highlights rise in severe Shigella infections among people experiencing homelessness.
- Stefanovic A, Alam ME, Matic N, et al. Increased Severity of Multidrug-Resistant Shigella sonnei Infections in People Experiencing Homelessness. Clin Infect Dis 2025;80:339 doi:10.1093/cid/ciae575.
- Public Health Ontario. Surveillance Report: Shigella Antimicrobial Resistance. Public Health Ontario:1-15.
- Centers for Disease Control and Prevention (CDC). (2025). Health alert network (HAN) - 00486 | increase in extensively drug-resistant shigellosis in the united states (2025).
- Caldera JR, Shaw B, Uslan DZ, et al. Cluster of extensively drug-resistant Shigella sonnei carrying blaCTX-M-15 in Los Angeles, California, 2023 to 2024. American Journal of Infection Control 2025;53:524-6 doi:10.1016/j.ajic.2024.12.005.
Mycoplasma genitalium
Data source(s) : National Microbiology Laboratory (NML)
- Lê A, Labbé A, Fourmigue A, et al. Mycoplasma genitalium among gay, bisexual and men who have sex with men, CCDR 49(11/12). Can Commun Dis Rep 2023;49:477-86 doi:10.14745/ccdr.v49i1112a03.
Invasive pneumococcal disease (IPD)
Data source(s): National Laboratory Surveillance of Invasive Streptococcal Disease (eSTREP)
- Griffith A, Golden AR, Lefebvre B, et al. Invasive pneumococcal disease surveillance in Canada, 2021-2022. Canada communicable disease report 2024;50(5):121-34 doi:10.14745/ccdr.v50i05a02.
Methicillin-resistant Staphylococcus aureus (MRSA)
Data source(s): Canadian Nosocomial Infection Surveillance Program (CNISP) and Antimicrobial Resistance Network (AMRNet)
- HAI and ARO rates: The Canadian Nosocomial Infection Surveillance Program (CNISP) - Canada.ca.
- Clinical data and reports: The Antimicrobial Resistance Network (AMRNet) - Canada.ca.
- Canadian Nosocomial Infection Surveillance Program. Healthcare-associated infections and antimicrobial resistance in Canadian hospitals, 2019-2023. Can Commun Dis Rep 2025;51:249-69.
- Loewen K, Schreiber Y, Kirlew M, et al. Community-associated methicillin-resistant Staphylococcus aureus infection: Literature review and clinical update. Canadian Family Physician 2017;63:512-20.
- Public Health Agency of Canada. Canadian Antimicrobial Resistance Surveillance System (CARSS) Report 2022 2022 doi:10.58333/e241022.
Vancomycin-resistant Enterococcus (VRE)
Data source(s): Canadian Nosocomial Infection Surveillance Program (CNISP) and Antimicrobial Resistance Network (AMRNet)
- HAI and ARO rates: The Canadian Nosocomial Infection Surveillance Program (CNISP) - Canada.ca.
- Clinical data and reports: The Antimicrobial Resistance Network (AMRNet) - Canada.ca.
- Canadian Nosocomial Infection Surveillance Program. Healthcare-associated infections and antimicrobial resistance in Canadian hospitals, 2019-2023. Can Commun Dis Rep 2025;51:249-69.
- Pfister TR, Chow B, Shen Y, et al. The associated impact of standardized admission screening on vancomycin-resistant Enterococci bloodstream infections. Infection Control & Hospital Epidemiology 2023;44:1289-93 doi:10.1017/ice.2022.239.
- Johnstone J, Shing E, Saedi A, et al. Discontinuing Contact Precautions for Vancomycin-Resistant Enterococcus (VRE) Is Associated With Rising VRE Bloodstream Infection Rates in Ontario Hospitals, 2009-2018: A Quasi-experimental Study. Clin Infect Dis 2020;71:1756-9 doi:10.1093/cid/ciaa009.
- Ayobami O, Willrich N, Reuss A, et al. The ongoing challenge of vancomycin-resistant Enterococcus faecium and Enterococcus faecalis in Europe: an epidemiological analysis of bloodstream infections. Emerging Microbes & Infections 2020;9:1180-93 doi:10.1080/22221751.2020.1769500.
- Buetti N, Wassilew N, Rion V, et al. Emergence of vancomycin-resistant enterococci in Switzerland: a nation-wide survey. Antimicrobial Resistance & Infection Control 2019;8:16 doi:10.1186/s13756-019-0466-x.
Invasive group A Streptococcus (iGAS)
Data source(s): National Laboratory Surveillance of Invasive Streptococcal Disease (eSTREP)
- Golden AR, Griffith A, Tyrell GJ, et al. Invasive group A streptococcal disease in Canada, 2021-2022. Canada communicable disease report 2024;50(5):135-43 https://doi.org/10.14745/ccdr.v50i05a03.
- Golden AR, Griffith A, Tyrrell GJ, et al. Invasive Group A Streptococcus Hypervirulent M1UK Clone, Canada, 2018-2023 - Volume 30, Number 11-November 2024 - Emerging Infectious Diseases journal - CDC. Emerging Infectious Diseases 2024;30:2409-13 doi:10.3201/eid3011.241068.
- Otis D. (2024). Record number of invasive strep A infections in Canada, 6 children dead in Ontario.
Clostridioides difficile infection (CDI)
Data source(s): Canadian Nosocomial Infection Surveillance Program (CNISP)
- HAI and ARO rates: The Canadian Nosocomial Infection Surveillance Program (CNISP) - Canada.ca.
- Canadian Nosocomial Infection Surveillance Program. Healthcare-associated infections and antimicrobial resistance in Canadian hospitals, 2019-2023. Can Commun Dis Rep 2025;51:249-.
- Du T, Choi KB, Silva A, et al. Characterization of Healthcare-Associated and Community-Associated Clostridioides difficile Infections among Adults, Canada, 2015-2019 - Volume 28, Number 6-June 2022 - Emerging Infectious Diseases journal - CDC 2022 doi:10.3201/eid2806.212262.
Mycobacterium tuberculosis
Data source(s): Canadian Tuberculosis Laboratory Surveillance System (CTBLSS) and Canadian Tuberculosis Reporting System (CTBRS)
- Public Health Agency of Canada. Tuberculosis Disease in Canada, 2023 (infographic).
- Public Health Agency of Canada. Tuberculosis in Canada: 2012-2021. Public Health Agency of Canada 2024:1-98.
- World Health Organization (WHO). (2024). Global tuberculosis report 2024.
AMU - Community
Data sources(s): Surveillance of Human Antimicrobial Use (SHAMU)
*: The statements, findings, conclusions, views, and opinions expressed in this report are based in part on data obtained under license from IQVIA Solutions Canada Inc. concerning the following information service(s): Compuscript, from March, 2019 to March, 2025. All Rights Reserved. The statements, findings, conclusions, views, and opinions expressed herein are not necessarily those of IQVIA Inc. or any of its affiliated or subsidiary entities.
AMU - Hospital
Data source(s): Canadian Nosocomial Infection Surveillance Program (CNISP) and National Antimicrobial Prescribing Survey (NAPS)
- Antimicrobial usage: The Canadian Nosocomial Infection Surveillance Program (CNISP) - Canada.ca.
- National Antimicrobial Prescribing Survey (NAPS™)*
*: Hospital NAPS™ appropriateness definitions, Melbourne Health. Adapted with permission for use in the Canadian National Antimicrobial Prescribing Survey. NAPS™ is a trademark of Melbourne Health.
AMU - International
Data sources(s): Surveillance of Human Antimicrobial Use (SHAMU), OECD and WHO GLASS
- Antimicrobial use (AMU) in the Canadian community sector - Canada.ca*.
- Organisation for Economic Co-operation and Development (OECD). (2025). Prescribing in primary care.
- World Health Organization (WHO). (2025). Global AMU data - WHO Global Antimicrobial Resistance and Use (GLASS).
*: The statements, findings, conclusions, views, and opinions expressed in this report are based in part on data obtained under license from IQVIA Solutions Canada Inc. concerning the following information service(s): Compuscript, from March, 2019 to March, 2025. All Rights Reserved. The statements, findings, conclusions, views, and opinions expressed herein are not necessarily those of IQVIA Inc. or any of its affiliated or subsidiary entities.
Integrated AMR and AMU
Data source(s): Canadian Integrated Program for Antimicrobial Resistance (CIPARS) and Fisheries and Oceans Canada.
- CIPARS: Antimicrobial Resistance - Canada.ca.
- CIPARS-Farm Antimicrobial Use in Canada - Canada.ca.
- CIPARS-VASR: Veterinary Antimicrobial Sales in Canada - Canada.ca.
- National Aquaculture Public Reporting Data - Open Government Portal.
- Bosman AL, Uhland F, Agunos A, Carson CA. One Health surveillance of antimicrobial resistance and use by the Canadian Integrated Program for Antimicrobial Resistance Surveillance (CIPARS). Can Vet J. 2024 Oct;65(10):1081-1085. PMID: 39355704; PMCID: PMC11411476.
- Health Canada (2009). Categorization of Antimicrobial Drugs Based on Importance in Human Medicine.
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