Canadian Integrated Program for Antimicrobial Resistance Surveillance (CIPARS): About

The Canadian Integrated Program for Antimicrobial Resistance Surveillance (CIPARS) monitors and reports trends across Canada in:

1. The quantity of antimicrobials sold and/or used in people, terrestrial and aquatic animals, and plants/crops, and
2. Antimicrobial resistance (AMR) in select enteric and zoonotic bacteria from people, terrestrial animals, food, feed ingredients and mixed feeds, farm environment of sick animals, and water sources.

The program is based on several representative and methodologically unified surveillance components which can be integrated to evaluate links between AMR in bacteria found at different stages along the food chain, and between AMU and AMR. This information supports:

• The creation of evidence-based policies to control antimicrobial use in hospital, community, and agricultural settings, and thus prolong the effectiveness of these drugs, and
• The identification of appropriate measures to contain the emergence and spread of resistant bacteria between animals, food, and people in Canada.

CIPARS is a national integrated surveillance program that works in collaboration with federal, provincial and private industry partners. CIPARS is coordinated by:

• The Centre for Foodborne, Environmental and Zoonotic Infectious Diseases (CFEZID), Infectious Diseases and Vaccination Programs Branch (IDVPB), Public Health Agency of Canada (PHAC)
• The Bacterial Pathogens, AMR and Wastewater Division, and Division of Enteric Diseases, National Microbiology Laboratory Branch (NML), PHAC

CIPARS is operationally linked with FoodNet Canada (FNC), which is the integrated sentinel site surveillance network for enteric disease in Canada.

CIPARS objectives

• Provide an integrated approach to monitor trends in antimicrobial resistance (AMR) and antimicrobial use (AMU) in humans and animals.
• Help identify appropriate measures to contain the emergence and spread of resistant bacteria between animals, food, and people in Canada.
• Facilitate assessment of the public health impact of antimicrobials used in humans and agriculture to support the creation of evidence-based policies to control AMU in hospital, community, and agricultural settings.
• Provide timely analysis and dissemination of surveillance data to stakeholders, and facilitate knowledge translation via targeted communications products.
• Allow accurate comparisons with other countries that use similar surveillance systems such as the National Antimicrobial Resistance Monitoring System (NARMS) and the Danish Integrated Antimicrobial Resistance Monitoring and Research Programme (DANMAP).
• Provision of data for Health Canada's Veterinary Drugs Directorate for new antimicrobial drug approval processes and post-approval monitoring.

How to interact with the visualizations

Depending on the visualization, there may be different options for interacting including:

• Drop-down menus to select which information to display
• Check boxes or lists to add or remove information from the visualization
• Hover over fields for the individual data points in the visualization to display information including numerator and denominator data
• Hover over elements of the figure (lines, points) to display data in the legend
• Clicking on various aspects of the legend will add or remove the corresponding lines or bars from the visualization, which also allows an individual data series to be shown in isolation on the visualization
• Hovering over legend elements to highlight the data in the visualization
• Download data associated with the visualizations on the page

The visualizations also include (in text, footnotes and/or links) descriptions of CIPARS methods, needed context to interpret the data and an indication of limitations to the data, where appropriate. The important data details and footnotes may change with filter selections.

The CIPARS Infobase dashboard includes tabs for:

1. Key and integrated findings

   This tab provides an overview of CIPARS key and integrated findings. Integrated findings include AMR and/or AMU findings across different host species, bacterial species, antimicrobials and surveillance components.

2. Antimicrobial sales/use

   Veterinary antimicrobial sales reporting (VASR)

   The veterinary antimicrobial sales reporting (VASR) system is an online reporting system that was launched in January 2018 and is a joint surveillance activity between the Public Health Agency of Canada and Health Canada's Veterinary Drugs Directorate. Manufacturers, importers and compounders of antimicrobial products in Canada are required to report annually on the quantity of medically important antimicrobials sold that were intended for use in animals.

   The interactive data visualizations provide an overview of the quantity of medically important antimicrobials sold for use in animals since 2018, including:

   • sales by province/region
   • antimicrobial class
   • animal species
   • route of administration

   CIPARS AMU interactive data visualizations provide an overview of AMU on sentinel volunteer farms by:

   • animal species (for example, broiler chickens, turkeys, grower-finisher pigs)
   • region/province
   • route of administration (in feed, in water, by injection)
   • antimicrobial use metric
   • antimicrobial class
   • Category of importance in human medicine
3. Antimicrobial resistance

   CIPARS-FNC AMR interactive data visualizations provide an overview of AMR, bacterial subtype and recovery data by:

   • bacterial genus and subtype (Campylobacter species, Escherichia coli, or non-typhoidal Salmonella serovar)
   • sample type (host species or environment, for example, chicken)
   • surveillance component (for example, farm broiler chickens or surface water)
   • specific antimicrobial or antimicrobial grouping (for example, resistance to ciprofloxacin or resistance to 3 or more antimicrobial classes)
   • geographic region (for example, Atlantic)