Resistance In Canada Research Articles

Salient Indigenous Acts of Resistance in Canada, 2010–2020: Current Trends

AbstractIndigenous peoples continue to challenge Canadian colonial policies through nonroutine acts of resistance. Sustained scholarly attention on the frequency and characteristics of Indigenous resistance has dropped precipitously, with the time span of this scholarship typically ending by the early 2000s. Research on more recent acts of resistance is directed to small-n case studies. This research note examines Indigenous resistance in Canada between 2010 and 2020 as reported by news articles from the Canadian Broadcasting Corporation (CBC) to identify key characteristics of salient Indigenous resistance: What issue areas were the subject of resistance movements? Which Indigenous communities or groups contributed to acts of resistance? What strategies were employed? The research note's findings suggest that salient acts of resistance rarely result in immediate policy change from the state; instead, resistance has transformative potential to develop Indigenous governance that departs from settler-colonial state processes.

Memory, Imagination, and Resistance in Canada’s Prison for Women

A group of women who were incarcerated at Canada’s first federal Prison for Women (P4W) have been fighting to create a memorial garden since the prison closed in 2000. In 2017, the prison was sold to a private developer who plans to convert the historic building and grounds into condos, retail, and office space. What does it mean to remember the dead, and to fight for the living, at a time when neoliberal common sense demands the efficient conversion of a place of suffering and death into a “heritage building” on “prime real estate”? How might a collective practice of radical imagination help to resist the commodification of memory into a tourist attraction or an aesthetic improvement of private property? And what is the relation between memory, healing, and accountability in a place where state violence, gender domination, and settler colonialism intersect?

The impact of COVID-19 on community antibiotic use in Canada: an ecological study

ObjectivesThe COVID-19 pandemic has had an effect on the incidence of infectious diseases and medical care. This study aimed to describe the impact of the COVID-19 pandemic on community-level antibiotic use. MethodsUsing national antibiotic dispensing data from IQVIA's CompuScript database, this ecological study investigated antibiotic dispensing through community retail pharmacies in Canada from November 2014 to October 2020. Analyses were stratified by age, sex, prescription origin and approximate indication. ResultsAdjusting for seasonality, the national rate of antibiotic dispensing in Canada decreased by 26.5% (50.4 to 37.0 average prescriptions per 1000 inhabitants) during the first 8 months of the Canadian COVID-19 period (March to October 2020), compared with the pre-COVID-19 period. Prescribing rates in children ≤18 years decreased from 43.7 to 12.2 prescriptions per 1000 inhabitants in males (–72%) and from 46.8 to 14.9 prescriptions per 1000 inhabitants in females (–68%) in April 2020. Rates in adults ≥65 decreased from 74.9 to 48.8 prescriptions per 1000 inhabitants in males (–35%) and from 91.7 to 61.3 prescriptions per 1000 inhabitants in females (–33%) in May 2020. Antibiotic prescriptions from family physicians experienced a greater decrease than from surgeons and infectious disease physicians. Prescribing rates for antibiotics for respiratory indications decreased by 56% in May 2020 (29.2 to 12.8 prescriptions per 1000 inhabitants), compared with prescribing rates for urinary tract infections (9.4 to 7.8 prescriptions per 1000 inhabitants; –17%) and skin and soft tissue infections (6.4 to 5.2 prescriptions per 1000 inhabitants; –19%). DiscussionThe first 8 months of the COVID-19 pandemic reduced community antibiotic dispensing by 26.5% in Canada, compared with the marginal decrease of 3% in antibiotic consumption between 2015 and 2019. Further research is needed to understand the implications and long-term effects of the observed reductions on antibiotic use on antibiotic resistance in Canada.

Knowledge Gaps in the Understanding of Antimicrobial Resistance in Canada.

Current limitations in the understanding and control of antimicrobial resistance (AMR) in Canada are described through a comprehensive review focusing on: (1) treatment optimization; (2) surveillance of antimicrobial use and AMR; and (3) prevention of transmission of AMR. Without addressing gaps in identified areas, sustained progress in AMR mitigation is unlikely. Expert opinions and perspectives contributed to prioritizing identified gaps. Using Canada as an example, this review emphasizes the importance and necessity of a One Health approach for understanding and mitigating AMR. Specifically, antimicrobial use in human, animal, crop, and environmental sectors cannot be regarded as independent; therefore, a One Health approach is needed in AMR research and understanding, current surveillance efforts, and policy. Discussions regarding addressing described knowledge gaps are separated into four categories: (1) further research; (2) increased capacity/resources; (3) increased prescriber/end-user knowledge; and (4) policy development/enforcement. This review highlights the research and increased capacity and resources to generate new knowledge and implement recommendations needed to address all identified gaps, including economic, social, and environmental considerations. More prescriber/end-user knowledge and policy development/enforcement are needed, but must be informed by realistic recommendations, with input from all relevant stakeholders. For most knowledge gaps, important next steps are uncertain. In conclusion, identified knowledge gaps underlined the need for AMR policy decisions to be considered in a One Health framework, while highlighting critical needs to achieve realistic and meaningful progress.

Tuberculosis drug resistance in Canada: 2018.

Drug-resistant tuberculosis (TB) is a public health issue of global importance that poses a threat to TB control efforts. Canada conducts nationwide surveillance to monitor emerging drug resistance trends and document progress towards reaching the goal of TB elimination. To describe TB drug resistance trends across Canada from 2008-2018, with a focus on 2018, by drug resistance, geographic and demographic patterns. TB drug resistance data are captured through two independent surveillance systems managed by the Public Health Agency of Canada: Canadian Tuberculosis Laboratory Surveillance System (CTBLSS) and the Canadian Tuberculosis Reporting System (CTBRS). Data from these systems were analyzed and descriptive statistics were reported by resistance profile, place of residence (province), age groups, sex and country of birth. In 2018, 1,459 TB isolates underwent drug susceptibility testing, a 4.3% decrease from 2017. Resistance to any first-line drug was reported in 148 isolates (10.1%), compared to 123 (8.1%) in 2017. Of these, 121 were monoresistant, five were polyresistant, 21 were multidrug-resistant tuberculosis (MDR-TB) and one was extensively drug-resistant TB (XDR-TB). Drug resistance was reported in all provinces and territories except Prince Edward Island, Northwest Territories and Yukon. Among individuals younger than 15 years, very little TB drug resistance was detected. Among individuals aged 15 years and older, the distribution of TB drug resistance varied with no discernable trends. The proportion of drug resistance was slightly higher in females than in males. By origin, 10.7% of foreign-born TB cases reported between 2006 and 2016 were drug-resistant. Among the Canadian-born non-Indigenous cases, 9.3% were drug resistant; among Canadian-born Indigenous, 2.4% were drug resistant. In 2018, the proportion of isolates with TB drug resistance in Canada remained low and below global averages, with stable drug resistance, both geographically and demographically.

Tuberculosis drug resistance in Canada: 2018

Tuberculosis drug resistance in Canada: 2018

Extended-Spectrum β-Lactamase and AmpC β-Lactamase-Producing Escherichia coli Isolates from Chickens Raised in Small Flocks in Ontario, Canada.

Food-producing animals are recognized to play a role in the epidemiology of antimicrobial resistance in Canada. However, the presence of resistant organisms in particular groups of animals, such as chickens raised in small-holder flocks, has not been studied. The purpose of this study was, therefore, to identify and characterize Escherichia coli possessing broad-spectrum β-lactamase genes among a collection of third-generation cephalosporin-resistant isolates recovered from 205 small flocks in southern Ontario. Extended-spectrum β-lactamase (ESBL; CTX-M-1) positive strains were isolated from 26 out of 205 flocks (12.7%), whereas 39 strains possessing AmpC (CMY-2) were grown from 31 out of 205 flocks (15.1%). Pulsed-field gel electrophoresis (PFGE) revealed that the isolates were genetically heterogeneous. Further testing by multi-locus sequence typing confirmed that none of the PFGE-defined clusters belonged to ST131. Our results suggest that the dissemination of this resistance in bacteria isolated from chickens in small-holder flocks may be associated with the spread of plasmids rather than particular E. coli clones and that these isolates do not possess the ESBL types most commonly associated with human infections (CTX-M-15).

Viola Desmond’s Canada: A History of Blacks and Racial Segregation in the Promised Land

Book review of Graham Reynold's 2016 history of Black Canadians in Nova Scotia with an account of Anti-Black oppression and Black resistance in Canada.

Quiet struggles: Migrant farmworkers, informal labor, and everyday resistance in Canada

Utilizing James C. Scott’s germinal concept of everyday resistance, we examine the subtle, daily acts of resistance carried out by Mexican and Jamaican migrant farmworkers in the Okanagan Valley, British Columbia. We argue that despite finding themselves in situations of formidable constraint, migrant farmworkers utilize a variety of “weapons of the weak” that undermine the strict regulation of their employment by employers and state authorities. We also argue that everyday forms of resistance are important political acts and as such, they warrant inclusion in scholarly examinations. Indeed, by reading these methods neither as “real” resistance nor as political, we risk reproducing the same systems of power that de-legitimize the actions, agency, and political consciousness of subaltern and oppressed peoples. After a brief discussion on the concept of everyday resistance, we provide an overview of Canada’s Seasonal Agricultural Worker Program (SAWP), establishing the conditions that drive migrant workers to resist and drawing connections between the regulatory framework of the SAWP, the informality of the agricultural sector, and migrant labor. Finally, we examine specific instances of resistance that we documented over 3 recent years through ethnographic fieldwork and as community organizers with a grassroots migrant justice organization. We assert the importance of situating migrants’ everyday acts of resistance at the center of conceptualizations of the broader movement for migrant justice in Canada and worldwide.

Tuberculosis drug resistance in Canada: 2017

Tuberculosis drug resistance in Canada: 2017

Tuberculosis drug resistance in Canada: 2017.

Drug-resistant tuberculosis (TB) is a global public health issue. To monitor this in Canada, surveillance systems have been in place for the last 20 years. To describe drug resistance patterns among TB isolates in Canada in 2017 by type of resistance as well as geographic location, demographic data and origin and to compare current data to those of the previous 10 years. Data were derived and analyzed from two sources. The Canadian Tuberculosis Laboratory Surveillance System (CTBLSS) is an isolate-based laboratory surveillance system and was used to obtain information on the results of drug susceptibility testing (DST) as well as province or territory, sex and age of the individual from which the sample originated. The Canadian Tuberculosis Reporting System (CTBRS) is a case-based surveillance system with information on active and retreatment TB cases in Canada and was used to derive origin data, which is defined as either foreign-born, Canadian-born Indigenous or Canadian-born non-Indigenous. Analysis was descriptive and compared with data from these two sources for 2007-2016. In 2017, 1,515 TB isolates were tested for resistance to anti-TB drugs, with 123 (8.1%) demonstrating resistance to any first-line anti-TB drug. Of these, 103 were monoresistant, six were polyresistant and 14 were multidrug-resistant tuberculosis (MDR-TB). No extensively drug-resistant tuberculosis (XDR-TB) isolates were reported. Drug resistance was reported in seven provinces/territories (British Columbia, Alberta, Saskatchewan, Manitoba, Ontario, Quebec and New Brunswick). There were 63 isolates from females with drug resistance (9.5%) and 60 isolates from males with drug resistance (7.0%). Drug resistance was found in a greater percentage of isolates among those aged 25-34 (n=29, 23.6%). By origin, 1,072 (11%) foreign-born TB cases reported between 2005 and 2015 were drug-resistant. Among the Canadian-born non-Indigenous and Canadian-born Indigenous TB cases, 143 (9%) and 54 (2%) were drug-resistant, respectively. Compared with previous years, the number of isolates tested increased slightly (from 1,267 to 1,515); however, there was a decrease in the percentage of isolates with reported drug resistance (from 10.5% in 2007 to 8.1% in 2017). In 2017, TB drug resistance rates remained low in Canada.

Factors potentially linked with the occurrence of antimicrobial resistance in selected bacteria from cattle, chickens and pigs: A scoping review of publications for use in modelling of antimicrobial resistance (IAM.AMR Project).

Antimicrobial resistance is a complex issue with a large volume of published literature, and there is a need for synthesis of primary studies for an integrated understanding of this topic. Our research team aimed to have a more complete understanding of antimicrobial resistance in Canada (IAM.AMR Project) using multiple methods including the literature reviews and quantitative modelling. To accomplish this goal, qualitative features of publications (e.g., geographical location, study population) describing potential relationships between the occurrence of antimicrobial resistance and factors (e.g., antimicrobial use; management system) were of particular interest. The objectives of this review were to (a) describe the available peer-reviewed literature reporting potential relationships between factors and antimicrobial resistance; and (b) to highlight data gaps. A comprehensive literature search and screening were performed to identify studies investigating factors potentially linked with antimicrobial resistance in Campylobacter species, Escherichia coli and Salmonella enterica along the farm-to-fork pathway (farm, abattoir (slaughter houses) and retail meats) for the major Canadian livestock species (beef cattle, broiler chicken and pigs). The literature search returned 14,966 potentially relevant titles and abstracts. Following screening of titles, abstracts and full-text articles, the qualitative features of retained studies (n=28) were extracted. The most common factors identified were antimicrobial use (n=13 studies) and type of farm management system (e.g., antibiotic-free, organic; n=8). Most studies were conducted outside of Canada and involved investigations at the farm level. Identified data gaps included the effect of vaccination, industry-specific factors (e.g., livestock density) and factors at sites other than farm along the agri-food chain. Further investigation of these factors and other relevant industry activities are needed for the development of quantitative models that aim to identify effective interventions to mitigate the occurrence of antimicrobial resistance along the agri-food chain.

Tuberculosis drug resistance in Canada: 2006–2016

Tuberculosis drug resistance in Canada: 2006–2016

Tuberculosis drug resistance in Canada: 2006-2016.

Drug-resistant strains of tuberculosis (TB) pose a serious threat to TB prevention and control efforts. The Canadian Tuberculosis Laboratory Surveillance System (CTBLSS) was created in 1998 to monitor emerging trends and patterns in TB drug resistance in Canada. To present a descriptive overview of TB drug resistance data collected through the CTBLSS for the years 2006 to 2016 in Canada, with a focus on 2016. The CTBLSS is an isolate-based surveillance system designed to collect data on TB drug resistance across Canada. Each year, data are collected and analyzed by the Public Health Agency of Canada (PHAC) and then validated by the submitting laboratory. In 2016, anti-tuberculosis drug susceptibility test results were reported for 1,452 isolates. The proportion of TB drug-resistant strains remained relatively stable with 108 (7.4%) of the isolates classified as monoresistant, five (0.3%) isolates as polyresistant and 17 (1.2%) as multidrug-resistant TB (MDR-TB) strains. In 2016, there were no extensively drug-resistant TB (XDR-TB) isolates identified. Males accounted for 792 (54.5%) of all reported isolates and 64 (49.2%) of the resistant strains and females accounted for 11 (64.7%) of the MDR-TB strains. Between 2006 and 2016, individuals between 15 and 44 years of age comprised 47.4% of all reported isolates, 54.0% of isolates showing any resistance and 72.3% of MDR-TB strains. TB drug resistance levels have been relatively low and stable over the past 11 years and have remained below the global average since national surveillance began. However, with growing worldwide concern about drug resistance and the emergence of XDR-TB, the CTBLSS will remain vital to the monitoring of TB drug resistance in Canada.

What are Canadian primary care physicians prescribing for the treatment of gonorrhea?

Cases of Neisseria gonorrhea are on the rise in Canada, which-if undetected or undertreated-can lead to morbidity and infertility. In addition, the number of antimicrobial resistant strains is also increasing creating the risk that N. gonorrhea may become untreatable. In 2013, the Public Health Agency of Canada (PHAC) released Canadian recommendations for the management and treatment of gonorrhea that identified the need for combination therapy to address and minimize antimicrobial resistance. However, the level of awareness and uptake of these guidelines is not well-known. To assess primary care physicians' prescribing practices for the management and treatment of gonorrhea. After validity testing, two online cross-sectional surveys were conducted with a convenience sample of Canadian physicians. Physicians answered true/false statements and open-ended questions relating to three clinical scenarios: 1) suspected anogenital infection drawing from a population of men who have sex with men (MSM); 2) suspected anogenital infection drawing from a non-MSM population; and, 3) suspected pharyngeal infection drawing from any population. Frequencies of responses were calculated for the statements. Open-ended responses were recoded into treatment categories and frequencies were calculated for each scenario. A total of 625 physicians completed the survey. Most physicians (60%-95%) accurately identified knowledge statements regarding pharmaceutical management, partner notification and public health reporting. For all clinical scenarios, 30%-35% of physicians did not provide any treatment information, approximately 30% indicated treating with cephalosporin monotherapy, 20%-25% indicated they would prescribe a cephalosporin and azithromycin and a minority of physicians identified other treatment options. When physicians were asked about the purpose of the second antibiotic, azithromycin, 49% indicated it was to provide presumptive treatment for gonorrhea and chlamydia. Forty-one percent indicated it was to provide presumptive treatment for chlamydia only. This convenience sample suggests that although knowledge of pharmaceutical management, partner notification, and public health reporting is high, the use of combination therapy to deter the development of antimicrobial resistant gonorrhea may not be widespread among primary care physicians. In light of both the growing incidence of N. gonorrhea and the rising rates of antimicrobial resistance in Canada, consideration on how to improve awareness and update of best prescribing practices in primary care may be indicated.

Surveillance programs watching for colistin-resistant infections

If the recently discovered MCR-1 gene led to colistin resistance in Canada, it would be pinpointed quickly, say leaders of Canada’s surveillance programs for antimicrobial resistance. First found in China last November, MCR-1 confers colistin resistance in bacteria such as Escherichia coli . Its

North of the Color Line: Migration and Black Resistance in Canada, 1870–1955

North of the Color Line: Migration and Black Resistance in Canada, 1870–1955

A summary of tuberculosis drug resistance in Canada, 2003−2013

Drug-resistant strains of tuberculosis (TB) pose a serious threat to prevention and control efforts. In response to this growing worldwide concern, the Public Health Agency of Canada (PHAC) established and maintains the Canadian Tuberculosis Laboratory Surveillance System (CTBLSS) in partnership with the Canadian Tuberculosis Laboratory Technical Network (CTLTN) and participating laboratories. To report on national trends and patterns in anti-tuberculosis drug resistance in Canada for the years 2003 to 2013. At the beginning of each calendar year, participating laboratories submit to PHAC reports on the results of anti-tuberculosis drug susceptibility testing for all isolates tested during the preceding year. These data are then analyzed by PHAC and the results are validated by supplying laboratories. The results are published annually as the Tuberculosis Drug Resistance in Canada series. In 2013, anti-tuberculosis drug susceptibility test results for 1,380 isolates were reported to PHAC. Of these, 762 (54%) were reported as Mycobacterium tuberculosis complex (MTBC) where the species was known. Two thirds (68%) of all the reported isolates originated from the three largest provinces, British Columbia, Ontario and Quebec. Overall, of the laboratory results received, 112 (8.1%) showed resistance to at least one first-line drug and, of these, the majority (93 or 83%) were monoresistant. TB drug resistance observed in Canada remains well below the global average. Over the last 10 years, the percentage of isolates with resistance to one or more of the first-line medications has decreased from 10.5% in 2003 to 8.1% in 2013.

A summary of tuberculosis drug resistance in Canada, 2003−2013

A summary of tuberculosis drug resistance in Canada, 2003−2013

New resources to address antibiotic resistance are just a click away.

Antibiotic resistance is a complex issue with multiple causes, and there are many roles to play in addressing it. As part of its response, the Public Health Agency of Canada is launching a pilot antibiotic awareness campaign for Canadian families and health care professionals. Coinciding with Antibiotic Awareness Week, starting on November 17, 2014, the goal of this campaign is to improve knowledge and awareness of antibiotic resistance in Canada. To achieve this, the Agency has developed a suite of resources for both Canadian families and health care providers featuring a variety of key messages explaining antibiotic resistance, why it is important, and how to reduce the risks associated with it. Resources for Canadian families include an online informational video, an educational brochure, and infographics for both adults and children. Resources for health care professionals include two online Continuing Medical Education Modules, a letter that physicians can sign and provide to parents explaining why an antibiotic was not prescribed, and two webinars to present trends in antimicrobial resistance (AMR) and antimicrobial use. Health professionals will also receive an electronic postcard and a bilingual campaign poster. Promoting the campaign messages and using these campaign resources will support health professionals in discussions about antibiotic resistance with their patients or clients, and in their continuing efforts to be part of the solution in addressing this important global health challenge.