Informing Stewardship Measures in Canadian Food Animal Species through Integrated Reporting of Antimicrobial Use and Antimicrobial Resistance Surveillance Data-Part I, Methodology Development.

Agnes Agunos,David F Léger,Anne E Deckert,Grace Kuiper,Sheryl P Gow

doi:10.3390/pathogens10111492

Abstract

This study explores methodologies for the data integration of antimicrobial use (AMU) and antimicrobial resistance (AMR) results within and across three food animal species, surveyed at the farm-level by the Canadian Integrated Program for Antimicrobial Resistance Surveillance (CIPARS). The approach builds upon existing CIPARS methodology and principles from other AMU and AMR surveillance systems. Species level data integration involved: (1) standard CIPARS descriptive and temporal analysis of AMU/AMR, (2) synthesis of results, (3) selection of AMU and AMR outcomes for integration, (4) selection of candidate AMU indicators to enable comparisons of AMU levels between species and simultaneous assessment of AMU and AMR trends, (5) exploration of analytic options for studying associations between AMU and AMR, and (6) interpretation and visualization. The multi-species integration was also completed using the above approach. In addition, summarized reporting of internationally-recognized indicators of AMR (i.e., AMR adjusted for animal biomass) and AMU (mg/population correction unit, mg/kg animal biomass) is explored. It is envisaged that this approach for species and multi-species AMU–AMR data integration will be applied to the annual CIPARS farm-level data and progressively developed over time to inform AMU–AMR integrated surveillance best practices for further enhancement of AMU stewardship actions.

Highlights

Disease mitigation strategies, such as infection prevention and control (IPC), good management practices (GMP) and enhanced disease detection, are utilized in Canadian food animal species, including broiler chickens, grower-finisher (GF) pigs and turkeys
From this point forward, each subsection provides a brief description of the method used, the results from either exploratory analysis or expansion of current Canadian Integrated Program for Antimicrobial Resistance Surveillance (CIPARS) methodology and the rationale as to why a particular method or analysis was selected for further data integration
The correlation matrices analysis (Appendix D Table A6), regardless of the species, showed statistically significant high correlation between the two weight-based indicators, mg/PCU and mg/kg animal biomass and between the three dosebased indicators, nDDDvetCA/1000 animal-days at risk [TI1000 ], nDDDvetCA/PCU and nDDDvetCA/kg animal biomass. These results indicated alignment of the exploratory antimicrobial use (AMU) indicators with those routinely used by CIPARS for reporting and research

Summary

Introduction

Disease mitigation strategies, such as infection prevention and control (IPC), good management practices (GMP) and enhanced disease detection, are utilized in Canadian food animal species, including broiler chickens, grower-finisher (GF) pigs and turkeys. Managing the clinical and economic implications of these pathogens in animal production settings through IPC [7] or GMP, including biosecurity, in addition to enhanced monitoring and surveillance of AMU and AMR, are recommended to reduce the need for antimicrobials and the containment of AMR [7,8,9]. Analyzing, reporting and communication of surveillance data has advanced in the last decade This is, in part, due to the development of AMU metrics (technical units of measurements such as frequency of use, mg of antimicrobial active ingredients and number of defined daily doses in animals (DDDvet)) and AMU indicators (a metric in relation to a denominator, such as population and weight or days at risk) [11,12,13].

Objectives

Methods

Findings

Conclusion