Knowledge Gaps in the Understanding of Antimicrobial Resistance in Canada

Frontiers in Public Health

Tim A. McAllister¹  Nicholas J. Ashbolt²  André G. Buret³  Ian Lewis³  Leland Jackson³  Sylvia Checkley⁴  Graham Plastow⁶  Hans-Joachim Wieden⁷  Gregory J. Tyrrell⁸  Kathy McCoy⁹  Ellen Goddard^1,10  Herman W. Barkema^1,11  Elissa Rennert-May^1,11  Myles Leslie^1,13  Simon J. G. Otto^1,14  Joan L. Robinson^1,15  Lorian Hardcastle^1,16  Aidan Hollis^1,17  John M. Conly^1,18  Matthias Götte^1,19  Jennifer A. Ida^2,23  John P. Kastelic^2,23  Diego B. Nóbrega^2,23  Karin Orsel^2,25  R. Michele Anholt^2,25  Kayley D. McCubbin^2,25  Ellen de Jong^2,25 

[1] 0Agriculture and Agri-Food Canada, Lethbridge Research Centre, Lethbridge, AB, Canada;0Faculty of Science and Engineering, Southern Cross University, Lismore, NSW, Australia;1Department of Biological Sciences, Faculty of Science, University of Calgary, Calgary, AB, Canada;1Department of Ecosystem and Public Health, Faculty of Veterinary Medicine, University of Calgary, Calgary, AB, Canada;2Alberta Precision Laboratories, Alberta Health Services, Calgary, AB, Canada;2Department of Agricultural, Food and Nutritional Science, Faculty of Agricultural, Life and Environmental Sciences, University of Alberta, Edmonton, AB, Canada;3Department of Chemistry and Biochemistry, University of Lethbridge, Lethbridge, AB, Canada;3Department of Laboratory Medicine and Pathology, Faculty of Medicine and Dentistry, University of Alberta, Calgary, AB, Canada;4Department of Physiology and Pharmacology, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada;4Department of Resource Economics and Environmental Sociology, Faculty of Agriculture, Life and Environmental Science, University of Alberta, Edmonton, AB, Canada;5Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada;5HEAT-AMR Research Group, School of Public Health, University of Alberta, Edmonton, AB, Canada;6School of Public Policy, University of Calgary, Calgary, AB, Canada;6Thematic Area Lead, Healthy Environments, Centre for Healthy Communities, School of Public Health, University of Alberta, Edmonton, AB, Canada;7Department of Pediatrics, Faculty of Medicine, University of Alberta, Edmonton, AB, Canada;8Faculty of Law, University of Calgary, Calgary, AB, Canada;9Department of Economics, Faculty of Arts, University of Calgary, Calgary, AB, Canada;Alberta Health Services, Calgary, AB, Canada;Department of Medical Microbiology and Immunology, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, AB, Canada;Department of Medicine, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada;Department of Microbiology, Immunology and Infectious Diseases, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada;Department of Pathology and Laboratory Medicine, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada;Department of Production Animal Health, Faculty of Veterinary Medicine, University of Calgary, Calgary, AB, Canada;O'Brien Institute of Public Health, University of Calgary, Calgary, AB, Canada;One Health at UCalgary, University of Calgary, Calgary, AB, Canada;Snyder Institute for Chronic Diseases, University of Calgary, Calgary, AB, Canada;

关键词: antimicrobial resistance;    One Health;    antimicrobial stewardship;    knowledge gaps;    policy;    Canada;   

DOI  :  10.3389/fpubh.2021.726484

来源: DOAJ

【 摘 要 】

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.

【 授权许可】

Unknown