Thematic description of factors linked with extended-spectrum beta-lactamase-producing Enterobacteriaceae in humans.

Background: Extended-spectrum beta-lactamase (ESBL)-producing Enterobacteriaceae are associated with serious antimicrobial-resistant infections in Canadians. Humans are exposed to ESBL-producing Enterobacteriaceae through many interconnected pathways. To better protect Canadians, it is important to generate an understanding of which sources and activities contribute most to ESBL exposure and infection pathways in Canada. Objective: The aims of this scoping review were to thematically describe factors potentially associated with ESBL-producing Enterobacteriaceae colonization, carriage and/or infection in humans from countries with a very high human development index and describe the study characteristics. Methods: Four databases (PubMed, CAB Direct, Web of Science, EBSCOhost) were searched to retrieve potentially relevant studies. Articles were screened for inclusion, and factors were identified, grouped thematically and described. Results: The review identified 381 relevant articles. Factors were grouped into 13 themes: antimicrobial use, animals, comorbidities and symptoms, community, demographics, diet and substance use, health care, household, occupation, prior ESBL colonization/carriage/infection, residential care, travel, and other. The most common themes reported were demographics, health care, antibiotic use and comorbidities and symptoms. Most articles reported factors in hospital settings (86%) and evaluated factors for ESBL-producing Enterobacteriaceae infections (52%). Conclusion: This scoping review provided valuable information about which factor themes have been well described (e.g., health care) and which have been explored less frequently (e.g., diet or animal contact). Themes identified spanned human, animal and environmental contexts and settings, supporting the need for a diversity of perspectives and a multisectoral approach to mitigating exposure to antimicrobial resistance.

Modelling the transmission of dengue, zika and chikungunya: a scoping review protocol.

INTRODUCTION: Aedes mosquitoes are the primary vectors for the spread of viruses like dengue (DENV), zika (ZIKV) and chikungunya (CHIKV), all of which affect humans. Those diseases contribute to global public health issues because of their great dispersion in rural and urban areas. Mathematical and statistical models have become helpful in understanding these diseases' epidemiological dynamics. However, modelling the complexity of a real phenomenon, such as a viral disease, should consider several factors. This scoping review aims to document, identify and classify the most important factors as well as the modelling strategies for the spread of DENV, ZIKV and CHIKV. METHODS AND ANALYSIS: We will conduct searches in electronic bibliographic databases such as PubMed, MathSciNet and the Web of Science for full-text peer-reviewed articles written in English, French and Spanish. These articles should use mathematical and statistical modelling frameworks to study dengue, zika and chikungunya, and their cocirculation/coinfection with other diseases, with a publication date between 1 January 2011 and 31 July 2023. Eligible studies should employ deterministic, stochastic or statistical modelling approaches, consider control measures and incorporate parameters' estimation or considering calibration/validation approaches. We will exclude articles focusing on clinical/laboratory experiments or theoretical articles that do not include any case study. Two reviewers specialised in zoonotic diseases and mathematical/statistical modelling will independently screen and retain relevant studies. Data extraction will be performed using a structured form, and the findings of the study will be summarised through classification and descriptive analysis. Three scoping reviews will be published, each focusing on one disease and its cocirculation/co-infection with other diseases. ETHICS AND DISSEMINATION: This protocol is exempt from ethics approval because it is carried out on published manuscripts and without the participation of humans and/or animals. The results will be disseminated through peer-reviewed publications and presentations in conferences.

Identifying Barriers and Pathways Linking Fish and Seafood to Food Security in Inuit Nunangat: A Scoping Review.

BACKGROUND: Fish and seafood play an important role in improving food security in Inuit Nunangat. Therefore, this scoping review aims to explore (1) what topics and/or themes have been widely explored in the literature related to barriers and pathways linking fish and seafood to food security; (2) where research, policy, and action gaps exist; and (3) how fisheries currently contribute to food security. METHODS: A systematic search of peer-reviewed articles was conducted using six databases. Articles were screened by two independent reviewers. Eligible studies included primary research conducted in Inuit Nunangat that explored the roles of fish and seafood in food security. RESULTS: Thirty-one articles were included for review. Overall, we found that fisheries can influence food security through direct pathways (e.g., consuming fish for nutrition), and through indirect pathways such as increasing household purchasing power (e.g., through employment). Research indicated that policies relating to wildlife and fisheries management need to be integrated with food and health policies to better address food insecurity in Inuit Nunangat. CONCLUSION: Future research is needed to establish a more robust understanding of the explicit mechanisms that fish and seafood harvest and/or the participation in commercial fisheries alleviates household food insecurity.

Evidence needed for antimicrobial resistance surveillance systems.

One Health surveillance for antimicrobial resistance has been promoted by the scientific community and by international organizations for more than a decade. In this article, we highlight issues that need to be addressed to improve the understanding of the effectiveness of One Health surveillance for antimicrobial resistance. We also outline the evidence needed to support countries planning to increase the level of integration of their surveillance system. Based on experience in Canada and other countries, we argue that more effort is needed to understand and measure the added value of One Health for antimicrobial resistance surveillance and to identify the most effective integration strategies. To date, guidelines for the development of One Health surveillance have focused mainly on the types of data that should be integrated. However, it may be necessary to apply the concept of One Health to surveillance tasks beyond data integration to realize the full value of the approach. Integration can be enhanced across different surveillance activities (data collection, analysis, interpretation and dissemination), taking account of the different skills and perspectives of experts and stakeholders involved. More research is needed to investigate the mechanisms through which a One Health approach to surveillance can increase the performance of antimicrobial resistance surveillance and, ultimately, improve health outcomes.

Cela fait plus de dix ans que la communauté scientifique et les organisations internationales préconisent l'application de l'approche «Un monde, une santé¼ à la surveillance de la résistance aux antimicrobiens. Cet article souligne les éléments à considérer pour mieux comprendre l'efficacité d'une surveillance fondée sur cette approche. Nous y évoquons également les données requises pour éclairer les pays dans la définition de leurs plans nationaux afin d'améliorer le niveau d'intégration de leur système de surveillance. À partir de l'expérience du Canada et d'autres pays, nous estimons que des efforts doivent encore être faits pour comprendre et mesurer la véritable valeur ajoutée de l'approche «Un monde, une santé¼ dans le cadre de la surveillance de la résistance aux antimicrobiens et afin d'identifier les stratégies d'intégration les plus efficaces. À ce jour, les lignes directrices pour l'établissement d'une surveillance fondée sur cette approche se sont principalement axées sur les types de données qui devraient être intégrées. Néanmoins, pour exploiter toute la valeur de cette approche, il pourrait être utile d'appliquer le concept «Un monde, une santé¼ aux activités de surveillance au-delà de la simple intégration des données. Une meilleure intégration peut être obtenue au niveau des différentes activités de surveillance (collecte, analyse, interprétation et diffusion des données) en tenant compte des différentes compétences et des différents points de vue des experts et des parties prenantes. De nouvelles recherches sont nécessaires pour comprendre les mécanismes par lesquels l'approche «Un monde, une santé¼ appliquée à la surveillance peut améliorer les performances de la surveillance de la résistance aux antimicrobiens et, en fin de compte, améliorer les résultats de santé.

La comunidad científica y las organizaciones internacionales han promovido durante más de una década la vigilancia sanitaria de la resistencia a los antimicrobianos. En este artículo, destacamos las cuestiones que deben abordarse para mejorar la comprensión de la eficacia de la vigilancia de la resistencia a los antimicrobianos de One Health. También esbozamos las pruebas necesarias para apoyar a los países que planean aumentar el nivel de integración de su sistema de vigilancia. Basándonos en la experiencia de Canadá y de otros países, sostenemos que se necesitan más esfuerzos para comprender y medir el valor agregado de One Health para la vigilancia de la resistencia a los antimicrobianos y para identificar las estrategias de integración más eficaces. Hasta la fecha, las directrices para el desarrollo de vigilancia de One Health se han centrado principalmente en los tipos de datos que deben integrarse. Sin embargo, puede ser necesario aplicar el concepto de One Health a tareas de vigilancia que van más allá de la integración de datos para aprovechar todo el valor del enfoque. La integración puede mejorarse en las diferentes actividades de vigilancia (recopilación, análisis, interpretación y difusión de datos), teniendo en cuenta las diferentes competencias y perspectivas de los expertos y las partes interesadas. Se necesita más investigación para estudiar los mecanismos mediante los cuales un enfoque de vigilancia de One Health puede aumentar el rendimiento de la vigilancia de la resistencia a los antimicrobianos y, en última instancia, mejorar los resultados sanitarios.

Epidemiology of Antimicrobial Resistance in Escherichia coli Isolates from Raccoons (Procyon lotor) and the Environment on Swine Farms and Conservation Areas in Southern Ontario.

Antimicrobial resistance is a global threat to livestock, human and environmental health. Although resistant bacteria have been detected in wildlife, their role in the epidemiology of antimicrobial resistance is not clear. Our objective was to investigate demographic, temporal and climatic factors associated with carriage of antimicrobial resistant Escherichia coli in raccoons and the environment. We collected samples from raccoon paws and feces and from soil, manure pit and dumpsters on five swine farms and five conservation areas in Ontario, Canada once every five weeks from May to November, 2011-2013 and tested them for E. coli and susceptibility to 15 antimicrobials. Of samples testing positive for E. coli, resistance to ≥ 1 antimicrobials was detected in 7.4% (77/1044; 95% CI, 5.9-9.1) of raccoon fecal samples, 6.3% (23/365; 95% CI, 4.0-9.3) of paw samples, 9.6% (121/1260; 8.0-11.4) of soil samples, 57.4% (31/54; 95% CI, 43.2-70.8) of manure pit samples, and 13.8% (4/29; 95% CI, 3.9-31.7) of dumpster samples. Using univariable logistic regression, there was no significant difference in the occurrence of resistant E. coli in raccoon feces on conservation areas versus farms; however, E. coli isolates resistant to ≥ 1 antimicrobials were significantly less likely to be detected from raccoon paw samples on swine farms than conservation areas and significantly more likely to be detected in soil samples from swine farms than conservation areas. Resistant phenotypes and genotypes that were absent from the swine farm environment were detected in raccoons from conservation areas, suggesting that conservation areas and swine farms may have different exposures to resistant bacteria. However, the similar resistance patterns and genes in E. coli from raccoon fecal and environmental samples from the same location types suggest that resistant bacteria may be exchanged between raccoons and their environment.

Impact of Season, Demographic and Environmental Factors on Salmonella Occurrence in Raccoons (Procyon lotor) from Swine Farms and Conservation Areas in Southern Ontario.

Salmonella has been detected in the feces of many wildlife species, including raccoons (Procyon lotor), but little is known about the epidemiology of Salmonella in wildlife living in different habitat types. Our objective was to investigate demographic, temporal, and climatic factors associated with the carriage of Salmonella in raccoons and their environment on swine farms and conservation areas. Using a repeated cross-sectional study design, we collected fecal samples from raccoons and environmental samples (soil, manure pits, dumpsters) on 5 swine farms and 5 conservation areas in Ontario, Canada once every five weeks from May to November, 2011-2013. Salmonella was detected in 26% (279/1093; 95% CI 22.9-28.2) of raccoon fecal samples, 6% (88/1609; 95% CI 4.5-6.8) of soil samples, 30% (21/69; 95% CI 20.0-42.7) of manure pit samples, and 23% (7/31; 95% CI 9.6-41.0) of dumpster samples. Of samples testing positive for Salmonella, antimicrobial resistance was detected in 5% (14/279; 95% CI 2.8-8.3) of raccoon fecal, 8% (7/89; 95% CI 3.2-15.5) of soil, 10% (2/21; 95% CI 1.2-30.4) of manure pit, and 0/7 dumpster samples. Using multi-level multivariable logistic regression analyses, we found location type (swine farm or conservation area) was not a significant explanatory variable for Salmonella occurrence in raccoon feces or soil (p > 0.05). However, detection of Salmonella in raccoon feces was associated with rainfall, season, and sex with various interaction effects among these variables. We detected a variety of Salmonella serovars that infect humans and livestock in the feces of raccoons indicating that raccoons living near humans, regardless of location type, may play a role in the epidemiology of salmonellosis in livestock and humans in southwestern Ontario.

Sampling strategies and biodiversity of influenza A subtypes in wild birds.

Wild aquatic birds are recognized as the natural reservoir of avian influenza A viruses (AIV), but across high and low pathogenic AIV strains, scientists have yet to rigorously identify most competent hosts for the various subtypes. We examined 11,870 GenBank records to provide a baseline inventory and insight into patterns of global AIV subtype diversity and richness. Further, we conducted an extensive literature review and communicated directly with scientists to accumulate data from 50 non-overlapping studies and over 250,000 birds to assess the status of historic sampling effort. We then built virus subtype sample-based accumulation curves to better estimate sample size targets that capture a specific percentage of virus subtype richness at seven sampling locations. Our study identifies a sampling methodology that will detect an estimated 75% of circulating virus subtypes from a targeted bird population and outlines future surveillance and research priorities that are needed to explore the influence of host and virus biodiversity on emergence and transmission.

Canada's inter-agency wild bird influenza survey.

Canada's Inter-agency Wild Bird Influenza Survey, which started in 2005, and is a collaborative effort among federal, provincial and territorial government agencies as well as non-governmental organizations and academic institutions, has two components: (i) a seasonal survey of live wild waterfowl species from selected geographic regions across Canada (to expand our understanding of the avian influenza viruses circulating in wild bird populations); and (ii) an ongoing survey of birds found dead that are submitted to a regional diagnostic laboratory (to enhance detection of highly pathogenic avian influenza strains). Combined swabs from the cloaca and oropharynx collected from each bird are screened using a real-time reverse transcriptase-polymerase chain reaction (RRT-PCR) that targets a unique segment of the influenza A M1 gene. If the M1 result is positive or inconclusive, RRT-PCR for gene segments of the H5 and H7 hemagglutinin subtypes are performed. All samples that are RRT-PCR positive for H5 or H7 are sent immediately for test confirmation and further characterization. All field and laboratory data are entered into a database developed and maintained by the Canadian Cooperative Wildlife Health Centre. Since the survey commenced in 2005, on average, 30% of all live ducks sampled, 5% of other species of live birds and 3% of birds found dead have tested positive for avian influenza, all of North American lineage and of low pathogenicity.

Obstacles to developing a multinational report card on antimicrobial resistance for Canada: an evidence-based review.

Many countries want to compare the results of their antimicrobial resistance programs to those of others nations to help gauge the effectiveness of their prevention and control practices. In our attempt to compare Canada with other nations, we encountered several challenges that must be addressed before meaningful multinational comparisons can be made. The fundamental barriers to comparison were the lack of shared targets for performance and predictive measures of success. Unique problems and policies within countries resulted in variations in goals, methods, pathogens, drugs, and priorities within and between jurisdictions. Other obstacles included: (1) lack of information on potential biases associated with different microbiological testing and sampling methods; (2) lack of information with which to conclude whether or not different programs examined comparable spectra of patients or outcomes; (3) inadequate description of the epidemiological rationale for sampling strategies; (4) use of aggregated national data that can hide regional or local variations; (5) rarity of studies designed explicitly for multinational comparison; and (6) lack of international agreement on methods, continuing education, and quality control needed to ensure program comparability. Comparison based on a country's ability to meet its internal goals for antimicrobial resistance control may be a more informative basis for a report card than specific resistance or drug use rates.