This study estimated the prevalence of Salmonella, Campylobacter, and Escherichia coli isolates in fresh retail grain-fed veal obtained in Ontario, Canada. The prevalence and antimicrobial resistance patterns were examined for points of public health significance. Veal samples (n = 528) were collected from February 2003 through May 2004. Twenty-one Salmonella isolates were recovered from 18 (4%) of 438 samples and underwent antimicrobial susceptibility testing. Resistance to one or more antimicrobials was found in 6 (29%) of 21 Salmonella isolates; 5 (24%) of 21 isolates were resistant to five or more antimicrobials. No resistance to antimicrobials of very high human health importance was observed. Ampicillin-chloramphenicolstreptomycin-sulfamethoxazole-tetracycline resistance was found in 5 (3%) of 21 Salmonella isolates. Campylobacter isolates were recovered from 5 (1%) of 438 samples; 6 isolates underwent antimicrobial susceptibility testing. Resistance to one or more antimicrobials was documented in 3 (50%) of 6 Campylobacter isolates. No Campylobacter isolates were resistant to five or more antimicrobials or category I antimicrobials. E. coli isolates were recovered from 387 (88%) of 438 samples; 1,258 isolates underwent antimicrobial susceptibility testing. Resistance to one or more antimicrobials was found in 678 (54%) of 1,258 E. coli isolates; 128 (10%) of 1,258 were resistant to five or more antimicrobials. Five (0.4%) and 7 (0.6%) of 1,258 E. coli isolates were resistant to ceftiofur and ceftriaxone, respectively, while 34 (3%) of 1,258 were resistant to nalidixic acid. Ciprofloxacin resistance was not detected. There were 101 different resistance patterns observed among E. coli isolates; resistance to tetracycline alone (12.7%, 161 of 1,258) was most frequently observed. This study provides baseline prevalence and antimicrobial resistance data and highlights potential public health concerns.
This study estimated the prevalence of Campylobacter, Salmonella, and Escherichia coli isolated from fresh retail turkey purchased at grocery stores in Ontario, Canada. The antimicrobial susceptibility patterns were determined and assessed for potential public health risk. From February 2003 to May 2004, 465 raw turkey meat samples were collected. Antimicrobial susceptibility testing was performed for Campylobacter isolates with a concentration gradient test and for Salmonella and E. coli isolates with a broth microdilution assay. Campylobacter isolates were recovered from 188 (46%) of 412 samples. The prevalence of resistance to one or more antimicrobials was 168 (81%) of 208. For antimicrobials of very high human health importance (category I of Health Canada's antimicrobial categorization), 12 (6%) of 208 Campylobacter isolates were ciprofloxacin resistant. Salmonella isolates were recovered from 95 (24%) of 397 samples. The prevalence of resistance to one or more antimicrobials was 50 (49%) of 102, and 13 (13%) of 102 samples were resistant to five or more antimicrobials. For category I antimicrobials, 14 (14%) of 102 and 1 (1%) of 102 isolates were resistant to ceftiofur and ceftriaxone, respectively. E. coli isolates were recovered from 392 (95%) of 412 turkey samples. The prevalence of resistance to one or more antimicrobials was 906 (71%) of 1,281, and 225 (18%) of 1,281 samples were resistant to five or more antimicrobials. For category I antimicrobials, 30 (2%) of 1,281 samples were resistant to ceftiofur. This study demonstrated that raw turkey pieces are a potential source of human exposure to enteric pathogens, including antimicrobial-resistant bacteria, if undercooked or improperly handled.
This study estimated the prevalence of Escherichia coli isolates in fresh retail milk-fed veal scallopini pieces obtained from grocery stores in Ontario, Canada. In addition, the prevalence and antimicrobial resistance patterns were examined for points of public health significance. One hundred fifty-three milk-fed veal samples were collected over the course of two sampling phases, January to May 2004 and November 2004 to January 2005. E. coli isolates were recovered from 87% (95% confidence interval, 80.54 to 91.83%) of samples, and antimicrobial susceptibility testing was conducted on 392 isolates. The prevalence of resistance to one or more antimicrobials was 70% (274 of 392), while the resistance to five or more antimicrobials was 33% (128 of 392). Resistance to ceftiofur (2.8%), ceftriaxone (3.6%), nalidixic acid (12%), and ciprofloxacin (3.8%) alone or in combination was observed. Eighty-five resistance patterns were observed; resistance to tetracycline only (7.4%) was observed most frequently. Individual antimicrobial resistance prevalence levels were compared with grain-fed veal and retail beef data from samples collected in Ontario. In general, resistance to individual antimicrobials was observed more frequently in E. coli isolates from milk-fed veal than in isolates from grain-fed veal and beef. Resistance to one or more antimicrobials and to five or more antimicrobials in E. coli isolates was more frequent in isolates from milk-fed veal than in isolates from grain-fed veal and beef. This study provides baseline data on the occurrence of resistance in E. coli isolates from milk-fed veal that can be compared with data for other commodities. Additionally, E. coli resistance patterns may serve as an indicator of antimicrobial exposure.
The study objectives were to identify potential associations between reported antimicrobial use (AMU) practices and antimicrobial resistance (AMR) of fecal and environmental Salmonella spp. isolates (n = 322 isolates) recovered from 60 Alberta finishing swine farms, and to estimate the amount of pen and farm level variation in AMR. The AMU data were collected through a questionnaire. Separate multilevel logistic regression models were built for six antimicrobials with prevalence of resistance >or=5% using the Generalized Linear Latent and Mixed Model (GLLAMM) procedure. In-feed use of tylosin in finishers was associated with increased odds of resistance in Salmonella isolates to ampicillin (OR = 61.56), streptomycin (OR = 11.70), and multiple antimicrobials (OR = 4.90). Injectable penicillin use in growers was associated with decreased odds of resistance in Salmonella isolates to streptomycin (OR = 0.06), kanamycin (OR = 0.03), and multiple antimicrobials (OR = 0.12). Injectable penicillin use in finishers was associated with decreased odds of resistance in Salmonella isolates to ampicillin (OR = 0.007) and chloramphenicol (OR = 0.04). Overall, these results indicate that AMU in pig production is inconsistently associated with AMR in Salmonella from finishing swine. Variation in AMR prevalence of Salmonella isolates of swine was moderate to high at pen and farm levels for most antimicrobials suggesting that interventions at the pen and farm levels might be beneficial in reducing the emergence of AMR Salmonella in swine populations.
The impact of livestock farming on the incidence of human Shiga toxin-producing Escherichia coli (STEC) infection was assessed by using several livestock density indicators (LDI) that were generated in a systematic approach. A total of 80 LDI were considered suitable proxy measures for livestock density. Multivariate Poisson regression identified several LDI as having a significant spatial association with the incidence of human STEC infection. The strongest associations with human STEC infection were the ratio of beef cattle number to human population and the application of manure to the surface of agricultural land by a solid spreader and by a liquid spreader. This study demonstrates the value of using a systematic approach in identifying LDI and other spatial predictors of disease.
To assess provincial-level predictors among socioeconomic and influenza rate data for the use of different macrolide antimicrobials in Canada from 2000 to 2006.
Multivariable models were developed to describe macrolide defined daily doses per capita.
Use was highest during October to March for all macrolides. Investigated yearly and provincial patterns differed considerably among the macrolide agents. Associations with socioeconomic variables were similar between clarithromycin and erythromycin, while azithromycin consumption showed some differences in its association with these variables. Consistently, the rate of influenza was significantly associated with increased macrolide use. The influenza rate interacted with socioeconomic variables in some models; as the influenza rate increased, the greatest increase in demand for macrolides occurred in populations with high percentages of low-income individuals, high unemployment levels and low percentages of individuals with bachelor's degrees.
The impact of associations among macrolide consumption, influenza and socioeconomic factors may reflect inappropriate use of these agents to treat viral infections and/or prescribing for secondary infections, and knowledge of the virus versus bacteria problem and accessibility of healthcare. Further research surrounding differences in access to antimicrobial prescriptions and treatment options between advantaged and disadvantaged populations is suggested to further understand the dynamics of antimicrobial use in Canada.
This exploratory study used participatory methods to identify, characterize, and rank climate-sensitive health priorities in Nunatsiavut, Labrador, Canada.
A mixed method study design was used and involved collecting both qualitative and quantitative data at regional, community, and individual levels. In-depth interviews with regional health representatives were conducted throughout Nunatsiavut (n?=?11). In addition, three PhotoVoice workshops were held with Rigolet community members (n?=?11), where participants took photos of areas, items, or concepts that expressed how climate change is impacting their health. The workshop groups shared their photographs, discussed the stories and messages behind them, and then grouped photos into re-occurring themes. Two community surveys were administered in Rigolet to capture data on observed climatic and environmental changes in the area, and perceived impacts on health, wellbeing, and lifestyles (n?=?187).
Climate-sensitive health pathways were described in terms of inter-relationships between environmental and social determinants of Inuit health. The climate-sensitive health priorities for the region included food security, water security, mental health and wellbeing, new hazards and safety concerns, and health services and delivery.
The results highlight several climate-sensitive health priorities that are specific to the Nunatsiavut region, and suggest approaching health research and adaptation planning from an EcoHealth perspective.
Enteric pathogens are an important cause of illness, however, little is known about their community-level risk factors (e.g., socioeconomic, cultural and physical environmental conditions) in the Northwest Territories (NWT) of Canada. The objective of this study was to undertake ecological (group-level) analyses by combining two existing data sources to examine potential community-level risk factors for campylobacteriosis, giardiasis and salmonellosis, which are three notifiable (mandatory reporting to public health authorities at the time of diagnosis) enteric infections.
The rate of campylobacteriosis was modeled using a Poisson distribution while rates of giardiasis and salmonellosis were modeled using a Negative Binomial distribution. Rate ratios (the ratio of the incidence of disease in the exposed group to the incidence of disease in the non-exposed group) were estimated for infections by the three major pathogens with potential community-level risk factors.
Significant (p=0.05) associations varied by etiology. There was increased risk of infection with Salmonella for communities with higher proportions of 'households in core need' (unsuitable, inadequate, and/or unaffordable housing) up to 42% after which the rate started to decrease with increasing core need. The risk of giardiasis was significantly higher both with increased 'internal mobility' (population moving between communities), and also where the community's primary health facility was a health center rather than a full-service hospital. Communities with higher health expenditures had a significantly decreased risk of giardiasis. Results of modeling that focused on each of Giardia and Salmonella infections separately supported and expanded upon previous research outcomes that suggested health disparities are often associated with socioeconomic status, geographical and social mobility, as well as access to health care (e.g. facilities, services and professionals). In the campylobacteriosis model, a negative association was found between food prices in communities and risk of infection. There was also a significant interaction between trapping and consumption of traditional foods in communities. Higher rates of community participation in both activities appeared to have a protective effect against campylobacteriosis.
These results raise very interesting questions about the role that traditional activities might play in infectious enteric disease incidence in the NWT, but should be interpreted with caution, recognizing database limitations in collection of case data and risk factor information (e.g. missing data). Given the cultural, socioeconomic, and nutritional benefits associated with traditional food practices, targeted community-based collaborative research is necessary to more fully investigate the statistical correlations identified in this exploratory research. This study demonstrates the value of examining the role of social determinants in the transmission and risk of infectious diseases.
Cites: Aust J Rural Health. 1999 Nov;7(4):229-3610732513
Hospital-based infection control in veterinary medicine is emerging and the role of the environment in hospital-acquired infections (HAI) in veterinary hospitals is largely unknown. This study was initiated to determine the recovery of Escherichia coli and selected veterinary and zoonotic pathogens from the environments of 101 community veterinary hospitals. The proportion of hospitals with positive environmental swabs were: E. coli--92%, Clostridium difficile--58%, methicillin-resistant Staphylococcus aureus (MRSA)--9%, CMY-2 producing E. coli--9%, methicillin-resistant Staphylococcus pseudintermedius--7%, and Salmonella--2%. Vancomycin-resistant Enterococcus spp., canine parvovirus, and feline calicivirus were not isolated. Prevalence of antimicrobial resistance in E. coli isolates was low. Important potential veterinary and human pathogens were recovered including Canadian epidemic strains MRSA-2 and MRSA-5, and C. difficile ribotype 027. There is an environmental reservoir of pathogens in veterinary hospitals; therefore, additional studies are required to characterize risk factors associated with HAI in companion animals, including the role of the environment.
In Ontario, infectious gastrointestinal illness (IGI) reporting can be represented by a linear model of several sequential steps required for a case to be captured in the provincial reportable disease surveillance system. Since reportable enteric data are known to represent only a small fraction of the total IGI in the community, the objective of this study was to estimate the under-reporting rate for IGI in Ontario.
A distribution of plausible values for the under-reporting rate was estimated by specifying input distributions for the proportions reported at each step in the reporting chain, and multiplying these distributions together using simulation methods. Input distributions (type of distribution and parameters) for the proportion of cases reported at each step of the reporting chain were determined using data from the Public Health Agency of Canada's National Studies on Acute Gastrointestinal Illness (NSAGI) initiative.
For each case of enteric illness reported to the province of Ontario, the estimated number of cases of IGI in the community ranged from 105 to 1,389, with a median of 285, and a mean and standard deviation of 313 and 128, respectively.
Each case of enteric illness reported to the province of Ontario represents an estimated several hundred cases of IGI in the community. Thus, reportable disease data should be used with caution when estimating the burden of such illness. Program planners and public health personnel may want to consider this fact when developing population-based interventions.