CIPARS

General

The Canadian Integrated Program for Antimicrobial Resistance Surveillance (CIPARS) of the Public Health Agency of Canada monitors AMU in animals, as well as AMR in select bacteria from humans, animals, and food. CIPARS has active surveillance of AMU on volunteer sentinel farms for grower-finisher pigs, broiler chickens, and turkeys, with AMU research underway in other animal species or production stages. Farm-level surveillance started in 2006 for grower-finisher pigs, expanded in 2013 for broiler chickens and includes a pilot project for turkeys.

Data collection

AMU data are collected from a sample of farms using a questionnaire. The number of farms sampled each year is approximately 100 for pigs, 140 for chickens, and 75 for turkeys.
Selection criteria:
Swine: Herds must be Canadian Quality Assurance (CQA®) validated, produce more than 2000 market pigs per year, and be representative of the characteristics and geographic distribution of herds in the veterinarian’s swine practice. Exclusion criteria include 1) being regarded as organic, 2) animals having been fed edible residual material or 3) the animals were raised on pasture.
Broiler chickens: The inclusion criteria involve being ‘Safe, Safer, Safest™’ compliant and a quota-holding broiler operation. Selected flocks are reflective of the veterinarian’s practice profile, representative of hatcheries supplying chicks, and representative of feed mills supplying feeds in the province/region. Exclusion criteria include being a pasture, backyard or small-sized farm. Inclusion and exclusion criteria are similar for turkeys.
Animal subcategories: AMU information for pigs is collected from the grower-finisher production stage and for chickens from the broiler stage of production; the questionnaire does also request information (if known) about AMU at the hatchery-level.
Input: Data are manually provided to CIPARS by the veterinarians who administer the questionnaire to the farmers. 

Analysis

Analysis is conducted using count-based, weight-based and dose-based units of measurement and indicators. Both Canadian and EMA[1] standards for the average daily dose are used. The animal weights to determine the kg animal at risk of treatment are from EMA[2] or specific to Canada, based on input from the Canadian industry.

Benchmarking & Reporting

CIPARS does not perform farm-level benchmarking at the moment.
Annual results are communicated to the farm industries and veterinarians. CIPARS hosts a multi-commodity stakeholder webinar during the Global Antibiotic Awareness Week each year. When emerging issues are identified, CIPARS communicates these findings via surveillance bulletins and/or holds ad hoc meetings with affected parties. CIPARS also presents findings at local, national, and international fora and publishes select findings in peer-reviewed journals.

Stewardship

CIPARS farm-level surveillance indicated that a change in antimicrobial use policy on broiler chicken farms across Canada appears to be having the desired goal of reducing use of critically important antimicrobials, in particular the use of 3rd generation cephalosporins (see figure below). 
Reduction in reported use of ceftiofur on farm and changing resistance to ceftriaxone in non‐typhoidal Salmonella from humans and chicken sources, Canada 2003‒2015

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