232108 Use of ceftiofur and resistance in Salmonella and E. coli: Results from abattoir, retail, and diagnostic human and animal surveillance in Canada

Wednesday, November 10, 2010 : 9:10 AM - 9:30 AM

Rebecca Irwin, DVM, MSC , Laboratory for Foodborne Zoonosis, Public Health Agency of Canada, Guelph, ON, Canada
Lucie Dutil, DVM, MSc , Laboratory for Foodborne Zoonosis, Public Health Agency of Canada, St-Hyacinthe, QC, Canada
Rita Finley, MSc , Cfezid, Public Health Agency of Canada, Guelph, ON, Canada
Lai King Ng, PhD , National Microbiology Laboratory, Public Health Agency of Canada, Winnipeg, MB, Canada
Patrick Boerlin, DVM, PhD , University of Guelph, Ontario Veterinary College, Guelph, ON, Canada
Vanessa Allen, BA, MD , Public Health Laboratory, Ontario Agency for Health Protection and Promotion, Toronto, ON, Canada
Brent Avery, BSc, MSc , Laboratory for Foodborne Zoonosis, Public Health Agency of Canada, Guelph, ON, Canada
Anne-Marie Bourgault, MD , Laboratoire de santé publique du Québec, Institut National de Santé Publique, Ste-Anne-de-Bellevue, QC, Canada
Linda M. Cole, RT, MLT , Laboratory for Foodborne Zoonoses, Public Health Agency of Canada, Guelph, ON, Canada
Danielle Daignault, DVM, DES, Dipl ACVM , Laboratory for Foodborne Zoonoses, Public Health Agency of Canada, St. Hyacinthe, QC, Canada
Andrea Desruisseau, BSc , Laboratory for Foodborne Zoonoses, Public Health Agency of Canada, Guelph, ON, Canada
Walter Demczuk, BSc , National Microbiology Laboratory, Public Health Agency of Canada, Winnipeg, MB, Canada
Linda Hoang, MSc, MD , Bacteriology, Mycology and Enterics Program, British Columbia Center for Disease Control, Vancouver, BC, Canada
Greg B. Horsman, MD , Saskatchewan Public Health Laboratory, Saskatchewan Health, Regina, SK, Canada
Judy Isaac-Renton, MD, Dipl Public Health , Department of Pathology and Laboratory Medicine, UBC Centre for Disease Control, Vancouver, BC, Canada
Johanne Ismail, BSc , Laboratoire de sanét publique, Institut national de santé publique, Sainte-Anne-de-Bellevue, QC, Canada
Frances Jamieson, MD, FRCPC , Medical Microbiology, Central Public Health Laboratory, Ontario Agency for Health Protection and Promotion, Etobicoke, ON, Cameroon
Anne Maki , Public Health Laboratory, Ontario Agency for Health Protection and Promotion, Toronto, ON, Canada
Ana Pacagnella , Laboratory Services, BC Center for Disease Control, Vancouver, BC, Canada
Salmonella Heidelberg is one of the most common serovars in humans in Canada. It is often resistant to ceftiofur, a veterinary antimicrobial, and ceftriaxone, a closely related human antimicrobial important for treatment of pregnant women and children.

The Canadian Integrated Program for Antimicrobial Resistance Surveillance (CIPARS) highlighted a strong correlation (r=0.9, p<0.0001) at the ecologic level between ceftiofur-resistant S. Heidelberg (CRSH) in retail chicken and the incidence of CRSH infection in humans. Ceftiofur is not approved for use in chickens in Canada; however, in 2004, 75% of Québec broiler chicken flocks used ceftiofur in hatching eggs or day-old chicks to prevent E. coli related disease. No data were available for other Canadian provinces. Québec hatcheries voluntarily withdrew ceftiofur use in February 2005; in 2007 use was partially re-introduced. CIPARS observed the highest and lowest levels of ceftiofur resistance in retail chicken bacteria prior to and after the voluntary withdrawal in 2005 (S. Heidelberg, 62% and 7% respectively; E. coli, 34% and 6%); and increasing levels of resistance from 2007 to 2009 following reintroduction in 2007 (in 2009, ceftiofur resistance in S. Heidelberg was 22%; E. coli, 19%). Although there is no currently available data on the use of ceftiofur in animals in Canada, anecdotal information and the prevalence of ceftiofur resistance in chicken bacteria are consistent with common usage of ceftiofur in the Canadian broiler industry.

CIPARS data strongly suggest that reducing ceftiofur use in hatching eggs can limit the spread of cephalosporin-resistant S. Heidelberg from poultry to humans.

Learning Areas:
Public health or related research

Learning Objectives:
1. Describe three reasons explaining why resistance to third-generation cephalosporins in S. Heidelberg is a public health concern. 2. List three Salmonella serovars where ceftiofur resistance has been identified in Canada among healthy or diseased animals. 3. Describe the measure that preceded the rapid decrease in ceftiofur-resistance in S. Heidelberg and E. coli in Québec?

Keywords: Antibiotic Resistance, Zoonoses

Presenting author's disclosure statement:
Organization/institution whose products or services will be discussed: Resistance in Salmonella and E. coli from humans and chicken assciated to the OFF-LABEL use of third-generation cephalosporins in chicken eggs.

Qualified on the content I am responsible for because: I am the first author of a paper published in January 2010 in EID on the same topic. I am also the lead analyst for the Canadian Integrated Program for Antimicrobial Resistance Surveillance and have been following this issue since it was first identified in 2003.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.

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