7 Integrated national surveillance platforms: CIPARS

You have looked at local, national (including multinational) and global surveillance systems, so it is now time to discuss integrated systems.

Integrated systems aim to collect, analyse, and communicate trends in AMU and AMR for select bacteria from different sectors. Information from these integrated systems supports measures to contain the emergence and spread of resistant bacteria among animals, food and people, with the aim of prolonging the effectiveness of antimicrobials. One example of a comprehensive, national, integrated One Health AMR and AMU surveillance system is the Canadian Integrated Program for Antimicrobial Resistance Surveillance (CIPARS).

CIPARS monitors the trends in AMU of all antimicrobial agents and AMR in selected bacteria in humans, animals and food sources from all over Canada. Figure 10 shows the composition of the CIPARS surveillance approach. It is important to note that the CIPARS system shares similarities with EARS-NET and ReLAVRA in the key system components it relies on, e.g. sentinel sites, reference laboratories and epidemiology units in charge of collating, analysing and interpreting data.

At this point it is worth noting that AMR surveillance in animals can serve different purposes, depending on whether the end goal is to secure animal and/or human health, and its design (i.e. area surveyed, microbe – antimicrobial (or ‘bug-drug’) combinations and choice of standards) should be adapted accordingly – such considerations are covered in more depth in the AMR surveillance in animals and the Introducing a One Health approach to AMR modules.

Provision of data to an integrated surveillance system is made possible using standardised collection and testing procedures to ensure that results from different studies can be compared and contrasted. In this way trends in AMR, AMU and AMC in each sector and between sectors can be investigated. This allows for effective measures to reduce the emergence and spread of resistant organisms between people, animals, agricultural and animal produce to be developed.

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Figure 10 CIPARS surveillance components in 2016 (CIPARS, 2018).