While there has been limited progress towards a comprehensive national program, some unique programs to address selected aspects of antimicrobial resistance have been developed and maintained. These programs include:
A community based public and professional education program promoting handwashing and responsible use of antibiotics to address the problem of antimicrobial resistance. Programs are available for physicians ("Bugs and Drugs" Antimicrobial Indications Handbook), pharmacists, nurses, occupational health nurses, teachers, schools, daycare centres, assisted living centres, parents, children and the public. This program was initially developed with government support in the province of Alberta, and subsequently introduced into a second province, British Columbia. Selected program components are also used in some other jurisdictions in Canada. Evaluation of the impact of the program or individual program components on community antimicrobial resistance has not, however, been reported.
This community, federal government, and academic partnership has used a public health approach to develop guidelines and teaching materials for prevention and management of CA-MRSA infections in isolated northern communities, many of which have a very high incidence of infections with these organisms. The program includes an interactive video game for schools, an educational tool, handwashing posters aimed at children, slide presentations, education podcasts, radio broadcasts in English and local Aboriginal languages, and CA-MRSA pamphlets for physicians offices and health centres in the relevant communities. Following the implementation of the program, a decrease in CA-MRSA infection in some of the program communities has been observed, but the extent to which this can be attributed to the program activities is not determined.
This partnership between AMMI-Canada (Association of Medical Microbiology and Infectious Diseases - Canada) and the Public Health Agency of Canada was initially established in 1994. It currently supports focused monitoring of healthcare acquired infections, including selected antimicrobial resistant organisms (including MRSA [3
], VRE [4
], C. difficile
, resistant gram negatives), at 37 sentinal hospitals - most of the Canadian tertiary care centres. Specific projects have described the prevalence, incidence, trends over time, and some impacts of antimicrobial resistant organisms in the Canadian Health Care system.
This program monitors trends in antimicrobial use and resistance for selected food borne bacterial organisms (E. coli 0157:H7, Salmonella spp, Campylobacter spp) isolated from humans, agricultural animals, and food sources across Canada. Surveillance includes results of cultures collected from abattoirs, animal clinical specimens, animal feed, human clinical specimens, on-farm, and retail, as well as of human and animal antimicrobial use. There are annual reports for 2002 - 2007, preliminary reports for 2008, 2009, and agrifood quarterly summaries of Salmonella spp (most recent Oct - Dec 2010).