Frontiers in Public Health (Oct 2021)
Knowledge Gaps in the Understanding of Antimicrobial Resistance in Canada
- Kayley D. McCubbin,
- Kayley D. McCubbin,
- R. Michele Anholt,
- Ellen de Jong,
- Ellen de Jong,
- Jennifer A. Ida,
- Diego B. Nóbrega,
- John P. Kastelic,
- John M. Conly,
- John M. Conly,
- John M. Conly,
- John M. Conly,
- John M. Conly,
- John M. Conly,
- John M. Conly,
- Matthias Götte,
- Tim A. McAllister,
- Karin Orsel,
- Karin Orsel,
- Ian Lewis,
- Ian Lewis,
- Leland Jackson,
- Leland Jackson,
- Graham Plastow,
- Hans-Joachim Wieden,
- Kathy McCoy,
- Kathy McCoy,
- Kathy McCoy,
- Myles Leslie,
- Myles Leslie,
- Myles Leslie,
- Myles Leslie,
- Joan L. Robinson,
- Lorian Hardcastle,
- Lorian Hardcastle,
- Lorian Hardcastle,
- Lorian Hardcastle,
- Aidan Hollis,
- Aidan Hollis,
- Aidan Hollis,
- Nicholas J. Ashbolt,
- Sylvia Checkley,
- Sylvia Checkley,
- Sylvia Checkley,
- Sylvia Checkley,
- Gregory J. Tyrrell,
- Gregory J. Tyrrell,
- André G. Buret,
- André G. Buret,
- André G. Buret,
- Elissa Rennert-May,
- Elissa Rennert-May,
- Elissa Rennert-May,
- Elissa Rennert-May,
- Elissa Rennert-May,
- Elissa Rennert-May,
- Ellen Goddard,
- Simon J. G. Otto,
- Simon J. G. Otto,
- Herman W. Barkema,
- Herman W. Barkema,
- Herman W. Barkema,
- Herman W. Barkema,
- Herman W. Barkema
Affiliations
- Kayley D. McCubbin
- Department of Production Animal Health, Faculty of Veterinary Medicine, University of Calgary, Calgary, AB, Canada
- Kayley D. McCubbin
- One Health at UCalgary, University of Calgary, Calgary, AB, Canada
- R. Michele Anholt
- One Health at UCalgary, University of Calgary, Calgary, AB, Canada
- Ellen de Jong
- Department of Production Animal Health, Faculty of Veterinary Medicine, University of Calgary, Calgary, AB, Canada
- Ellen de Jong
- One Health at UCalgary, University of Calgary, Calgary, AB, Canada
- Jennifer A. Ida
- Department of Production Animal Health, Faculty of Veterinary Medicine, University of Calgary, Calgary, AB, Canada
- Diego B. Nóbrega
- Department of Production Animal Health, Faculty of Veterinary Medicine, University of Calgary, Calgary, AB, Canada
- John P. Kastelic
- Department of Production Animal Health, Faculty of Veterinary Medicine, University of Calgary, Calgary, AB, Canada
- John M. Conly
- One Health at UCalgary, University of Calgary, Calgary, AB, Canada
- John M. Conly
- O'Brien Institute of Public Health, University of Calgary, Calgary, AB, Canada
- John M. Conly
- Snyder Institute for Chronic Diseases, University of Calgary, Calgary, AB, Canada
- John M. Conly
- Department of Microbiology, Immunology and Infectious Diseases, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
- John M. Conly
- Department of Pathology and Laboratory Medicine, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
- John M. Conly
- Department of Medicine, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
- John M. Conly
- Alberta Health Services, Calgary, AB, Canada
- Matthias Götte
- Department of Medical Microbiology and Immunology, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, AB, Canada
- Tim A. McAllister
- 0Agriculture and Agri-Food Canada, Lethbridge Research Centre, Lethbridge, AB, Canada
- Karin Orsel
- Department of Production Animal Health, Faculty of Veterinary Medicine, University of Calgary, Calgary, AB, Canada
- Karin Orsel
- One Health at UCalgary, University of Calgary, Calgary, AB, Canada
- Ian Lewis
- One Health at UCalgary, University of Calgary, Calgary, AB, Canada
- Ian Lewis
- 1Department of Biological Sciences, Faculty of Science, University of Calgary, Calgary, AB, Canada
- Leland Jackson
- One Health at UCalgary, University of Calgary, Calgary, AB, Canada
- Leland Jackson
- 1Department of Biological Sciences, Faculty of Science, University of Calgary, Calgary, AB, Canada
- Graham Plastow
- 2Department of Agricultural, Food and Nutritional Science, Faculty of Agricultural, Life and Environmental Sciences, University of Alberta, Edmonton, AB, Canada
- Hans-Joachim Wieden
- 3Department of Chemistry and Biochemistry, University of Lethbridge, Lethbridge, AB, Canada
- Kathy McCoy
- One Health at UCalgary, University of Calgary, Calgary, AB, Canada
- Kathy McCoy
- Snyder Institute for Chronic Diseases, University of Calgary, Calgary, AB, Canada
- Kathy McCoy
- 4Department of Physiology and Pharmacology, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
- Myles Leslie
- One Health at UCalgary, University of Calgary, Calgary, AB, Canada
- Myles Leslie
- O'Brien Institute of Public Health, University of Calgary, Calgary, AB, Canada
- Myles Leslie
- 5Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
- Myles Leslie
- 6School of Public Policy, University of Calgary, Calgary, AB, Canada
- Joan L. Robinson
- 7Department of Pediatrics, Faculty of Medicine, University of Alberta, Edmonton, AB, Canada
- Lorian Hardcastle
- One Health at UCalgary, University of Calgary, Calgary, AB, Canada
- Lorian Hardcastle
- O'Brien Institute of Public Health, University of Calgary, Calgary, AB, Canada
- Lorian Hardcastle
- 5Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
- Lorian Hardcastle
- 8Faculty of Law, University of Calgary, Calgary, AB, Canada
- Aidan Hollis
- One Health at UCalgary, University of Calgary, Calgary, AB, Canada
- Aidan Hollis
- O'Brien Institute of Public Health, University of Calgary, Calgary, AB, Canada
- Aidan Hollis
- 9Department of Economics, Faculty of Arts, University of Calgary, Calgary, AB, Canada
- Nicholas J. Ashbolt
- 0Faculty of Science and Engineering, Southern Cross University, Lismore, NSW, Australia
- Sylvia Checkley
- One Health at UCalgary, University of Calgary, Calgary, AB, Canada
- Sylvia Checkley
- O'Brien Institute of Public Health, University of Calgary, Calgary, AB, Canada
- Sylvia Checkley
- Department of Microbiology, Immunology and Infectious Diseases, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
- Sylvia Checkley
- 1Department of Ecosystem and Public Health, Faculty of Veterinary Medicine, University of Calgary, Calgary, AB, Canada
- Gregory J. Tyrrell
- 2Alberta Precision Laboratories, Alberta Health Services, Calgary, AB, Canada
- Gregory J. Tyrrell
- 3Department of Laboratory Medicine and Pathology, Faculty of Medicine and Dentistry, University of Alberta, Calgary, AB, Canada
- André G. Buret
- One Health at UCalgary, University of Calgary, Calgary, AB, Canada
- André G. Buret
- Snyder Institute for Chronic Diseases, University of Calgary, Calgary, AB, Canada
- André G. Buret
- 1Department of Biological Sciences, Faculty of Science, University of Calgary, Calgary, AB, Canada
- Elissa Rennert-May
- One Health at UCalgary, University of Calgary, Calgary, AB, Canada
- Elissa Rennert-May
- O'Brien Institute of Public Health, University of Calgary, Calgary, AB, Canada
- Elissa Rennert-May
- Snyder Institute for Chronic Diseases, University of Calgary, Calgary, AB, Canada
- Elissa Rennert-May
- Department of Medicine, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
- Elissa Rennert-May
- Alberta Health Services, Calgary, AB, Canada
- Elissa Rennert-May
- 5Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
- Ellen Goddard
- 4Department of Resource Economics and Environmental Sociology, Faculty of Agriculture, Life and Environmental Science, University of Alberta, Edmonton, AB, Canada
- Simon J. G. Otto
- 5HEAT-AMR Research Group, School of Public Health, University of Alberta, Edmonton, AB, Canada
- Simon J. G. Otto
- 6Thematic Area Lead, Healthy Environments, Centre for Healthy Communities, School of Public Health, University of Alberta, Edmonton, AB, Canada
- Herman W. Barkema
- Department of Production Animal Health, Faculty of Veterinary Medicine, University of Calgary, Calgary, AB, Canada
- Herman W. Barkema
- One Health at UCalgary, University of Calgary, Calgary, AB, Canada
- Herman W. Barkema
- O'Brien Institute of Public Health, University of Calgary, Calgary, AB, Canada
- Herman W. Barkema
- Snyder Institute for Chronic Diseases, University of Calgary, Calgary, AB, Canada
- Herman W. Barkema
- 5Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
- DOI
- https://doi.org/10.3389/fpubh.2021.726484
- Journal volume & issue
-
Vol. 9
Abstract
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.
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