Atlantic Health Organizations Meet to Address Antimicrobial Stewardship in Halifax

For immediate release

Atlantic Health Organizations Meet to Address Antimicrobial Stewardship in Halifax

June 8, 2017 (Halifax) – The National Collaborating Centre for Infectious Diseases (NCCID) and the Public Health Agency of Canada are pleased to greet representatives from across the Atlantic provinces today to discuss strategies for improving the use of antimicrobials such as antibiotics.

Physicians, pharmacists and public health staff will share information on successes and challenges in ensuring appropriate use of antibiotics and helping to reduce resistance to life-saving treatments. “We are really pleased to be part of the growing interest and momentum in effective and appropriate use of antimicrobials,” said Yoav Keynan, co-Scientific Director at the NCCID. “This event builds upon work we have been engaged in across the country for over a year. The Atlantic Region in particular has a strong role to play in leading the way for other parts of Canada.”

Antimicrobial resistance has been in the news more and more and is considered a significant threat to human health by the World Health Organization. It has been estimated that by 2050, annual deaths due to AMR could reach 10 million worldwide, overtaking deaths due to diabetes and cancer combined. And AMR is not just a human health threat; it is a complex issue that has animal, agricultural, environmental and economic implications.

Antimicrobial stewardship involves systems-wide organization and approaches to monitoring the most effective use of antimicrobials drugs, and promoting their appropriate use according to national and international guidelines. It is one of four pillars of the Government of Canada’s Federal Framework for Action on AMR, which identifies AMS as conserving the effectiveness of existing treatments through infection prevention and control guidelines, education and awareness, regulations, and oversight.

“The groundwork has been laid and there is considerable expertise in this country. Now our task is to reinforce and support AMS programs locally so that patients, practitioners and policy-makers are committed and involved”, said Margaret Haworth-Brockman, Senior Program Manager at the NCCID.

For more information on AMR and AMS, and to find additional resources, please contact NCCID at nccid@umanitoba.ca or 1-204-318-2591.

What can Big Data do for Public Health?

What can Big Data do for Public Health?

WEBINAR // May 17 @ 1 pm eastern

 >> REGISTER <<

The National Collaborating Centre for Infectious Diseases (NCCID) presents new information on the potential contributions of big data for infectious diseases surveillance and the investigation of foodborne outbreaks in Canada. Recognizing the potential for big data as a resource for public health planning and decision-making, NCCID commissioned a summary of evidence with the objectives of:

  1. Understanding big data resources related to infectious diseases surveillance;
  2. Exploring options and challenges in visualizing and analyzing the resulting information; and
  3. Highlighting examples of how big data have been applied to foodborne illnesses.

In this presentation, Dr. Cheryl Waldner, DVM, PhD (University of Saskatchewan) will give an overview of big data, its opportunities and limitations for public health, and describe examples related to foodborne illnesses.

Antimicrobial Stewardship in Long Term / Elder Care

Antimicrobial Stewardship in Long Term / Elder Care: The Case To Act, A Call To Leaders

Presented by: The National Collaborating Centre for Infectious Diseases (NCCID) and Do Bugs Need Drugs? Alberta Health Services

WEBINAR / 9 MARCH 2017

An archived version of this webinar is now available for viewing. Please email Harpa Isfeld-Kiely, NCCID Senior Project Manager, for access.

This March 9, 2017 webinar was developed for senior leaders, decision makers and innovators in long term care—administrators, medical directors, directors of care, or program managers—in provincial, private or voluntary sector organizations. Leads were asked to invite key staff who implement antimicrobial stewardship programs (e.g. infection prevention and control specialists, or nurse practitioners).

Program

The emergence of antimicrobial resistant (AMR) microorganisms in care facilities and their spread into the community places patients at risk and contributes to a major public health challenge. To respond effectively, leaders require knowledge of the challenges and opportunities to take action.

The first in a series, this webinar invited leaders and decision makers in long term care to consider the evidence for AMR harms, leading practices relevant to LTC settings, and their own role in initiating and advancing antimicrobial stewardship programs. Key findings on common diagnoses in LTC for which antibiotics are prescribed, as well as campaigns and initiatives designed to address inappropriate prescribing and use of antimicrobials were presented. Future webinars will provide implementers with information on how to begin stewardship programs in LTC.

Featured speakers included Dr. John Conly, one of Canada’s foremost experts on antimicrobial resistance and stewardship programs. As well, other innovators in antimicrobial stewardship initiatives, Dr. Victor Leung and Dr. Gregory German, provided examples based on their work relevant to long term / elder care in Pacific and Atlantic regions, respectively.

The webinar included a live Q&A with the presenters. Participants had an opportunity to comment on challenges to implementing AMS programs, information needs of leaders and their teams, and their interest in a national network to help identify and spread leading practices in AMS for long term care settings.

About our Presenters

Dr. John Conly, Foothills Medical Centre, AB

John Conly MD is trained in internal medicine and infectious disease and is a Professor of Medicine at the University of Calgary. He currently serves as a member of the WHO Advisory Group on Integrated Antimicrobial Surveillance and the PHAC Expert Advisory Group on Antimicrobial Resistance. He was a past Chairman of the Board for the Canadian Committee on Antibiotic Resistance and previous Vice-Chair for the Canadian Expert Drug Advisory Committee. He has published over 300 papers and has received numerous career honours for clinical service, mentorship, teaching, research, and innovation.

Dr. Greg German, Queen Elizabeth Hospital, PEI

Greg German is the Medical Microbiologist and infectious disease consultant for P.E.I. He is the medical lead of Health PEI antibiotic stewardship efforts. Nationally, Greg serves on several AMR working groups, including co-chair for the antimicrobial resistance working group of the Canadian Public Health Laboratory Network. He co-developed and actively champions a program targeting LTC and UTI diagnostics that was created by the Association of Medical Microbiology and Infectious Disease Canada. In 2015 the Medical Society for P.E.I. awarded him the President’s Leadership award for his infection and antibiotic expertise.

Dr. Victor Leung, Providence Health Centre, BC

Victor Leung completed fellowships in Infectious Diseases and Medical Microbiology at McGill University.  He is currently the Medical Director for Infection Prevention and Control, and the Medical Lead for the Antimicrobial Stewardship Program at Providence Health Care in BC.  He is interested in implementing interventions to prevent nosocomial infections and optimize antimicrobial use.  He also wants to improve efficiency of surveillance systems for nosocomial infections.

Moderator: Simon Habegger, Alberta Health Services (AHS)

Simon leads Do Bugs Need Drugs?, a community education program on Antimicrobial Stewardship at AHS. He and his colleagues build on a twenty year history of stewardship program development in the province that has seen particular success working with long-term care administrators. Simon holds degrees in Biological Anthropology and International Health. He has worked as an educator in college-level nursing and science programs, as well as a coordinator with other community education outreach programs (HIV Edmonton, Canadian Diabetes Association).

Communicating the Risk of Infectious Diseases in a Changing Climate

Communicating the Risk of Infectious Diseases in a Changing Climate

Presented by: National Collaborating Centre for Infectious Diseases (NCCID) and National Collaborating Centre for Environmental Health (NCCEH)

WEBINAR / 8 March 2017

An archived version of this webinar is now available for viewing. Please email NCCID’s Elnaz Shadabi for access.

What means are available to public health practitioners for effectively communicating the risk of infectious diseases to the public? When a new outbreak emerges, how can public health convey facts and risks accurately to the public and to policy makers? How are risks interpreted by various audiences?

These are examples of some of the questions that public health professionals may grapple with during a new infectious disease outbreak or re-emergence of an existing one. To ensure that both the public and policy makers receive the most accurate information, the means and methods of communication utilized by healthcare providers must be effective. This March 8, 2017 webinar provided different perspectives on communicating risk in an “environment” of change: the intersection of climate change and infectious disease emergence and resurgence. The webinar had two main goals: to present a range of perspectives on good communication about risk for public health stakeholders; and, to allow for discussion on communication for public health, using examples that relate to emerging and resurging infectious diseases in the context of changing climate.

Moderator and Presenters

Dr. Christine Navarro has been an Associate Medical Officer of Health with Toronto Public Health since August 2014. While training as an epidemiologist, she worked with the Public Health Agency of Canada before getting her medical degree. Christine completed her specialty training in Public Health and Preventive Medicine at the University of Toronto in 2014. Her portfolio at Toronto Public Health focuses on Environmental Health.

Dr. Craig Stephen is a veterinary epidemiologist, professor in the Department of Veterinary Microbiology at the University of Saskatchewan, and clinical professor at the School of Population and Public Health at the University of British Columbia. He is the CEO of the Canadian Wildlife Health Cooperative. He has worked in Canada and internationally on ecohealth approaches to emerging infectious diseases.

Dr. Anne-Marie Nicol is a knowledge translation scientist at the National Collaborating Centre for Environmental Health. She holds a PhD in Epidemiology from UBC and a Masters of Environmental Studies from York University. Her area of research is risk communication and perception and the roles they play in risk management, particularly in public health. She also teaches health communication, as well as human health risk assessment, at Simon Fraser University as an Associate Professor.

Dr. Negar Elmieh is an interdisciplinary researcher who applies both quantitative and qualitative methods to complex health, environment, risk and policy issues. She will share lessons learned from past zoonotic outbreaks on how we can best communicate new threats and balance risk from infection versus potential interventions.

Newcomers and Vaccine Decision-Making Practices: Lessons from the Prairies

Newcomers and Vaccine Decision-Making Practices: Lessons from the Prairies

Presenter: Stephanie Kowal

This January 26, 2017 webinar focused on immunization information-gathering and decision-making practices in vulnerable refugee and immigrant populations in the city of Edmonton, Alberta. Ms. Stephanie Kowal presented key findings and recommendations from her study on the prairies focusing particularly on the potential impact that using cultural brokers can have on the success of creating access to immunization services and promoting immunization uptake. In addition, she discussed how nurses and physicians can best communicate with newly arrived families to ensure that immunization decisions are fully informed and are in the best interest of the patients.

For an archived version of this webinar, contact Zeeshan Qadar via Sheikh.Qadar@umanitoba.ca.

The Two Faces of Syphilis: A Call for Sustained, National and Coordinated Responses to Syphilis

The Two Faces of Syphilis: A Call for Sustained, National and Coordinated Responses to Syphilis

Montréal, 22–23 November 2016

Syphilis has re-emerged in Canada during the last decade with epidemics now rooted in both urban and rural settings. While gay men are still at the centre of the urban epidemics, there is now a transition in the epidemiological pattern with increasing numbers of cases identified among northern heterosexual Indigenous men and women with the reappearance of congenital syphilis cases.

To support responses to syphilis, NCCID, in partnership with the National Collaborating Centre for Aboriginal Health (NCCAH) and the Urban Public Health Network (UPHN), hosted a knowledge exchange forum in Montreal, November 22-23 2016. This forum brought together 42 public health specialists from across Canada. Practitioners, program coordinators, epidemiologists, researchers, policy makers, community-based partners and knowledge brokers gathered to share on ways to improve public health interventions on syphilis in Canada.

This forum created a space for participants to share on rural and urban perspectives, key challenges, gaps and new avenues and discuss relevant lessons for strengthening syphilis control and management at local, regional and national levels. Participants identified some hand-on and upstream strategies. Some presentations and a summary report will soon be available.

The goal was to provide information and ideas about promising practices with a focus on local contexts and affected populations. The specific objectives included:

  • To share the current state of syphilis outbreaks, highlighting what we know about the burden with an emphasis on what is new and what has changed recently.
  • To share innovative ways of surveillance to better tailor public health responses and inform public health strategies.
  • To share evidence-based, practice-based, and client-centered knowledge to improve public health interventions and partner notification activities.
  • To provide opportunities to discuss population-specific challenges and ways of adapting innovative and integrated public health strategies.

You can view the full agenda here.

Data Management/Coordination & Refugee Health: Experience of Hamilton Public Health Services

NCCID’s series of public health podcasts and webinars on refugee health continued with this November 16, 2016 presentation about one Ontario city’s recent experience with data management/coordination. The City of Hamilton Public Health Services team was responsible for creating a strategy on the fly, working with several agencies to collect, collate and share such basic data as the names, ages, sex and location/address of refugees, but also vaccination status, health assessment status and dental screening results.

An archived copy of this webinar is available upon request. Please email qadarsmz@umanitoba.ca.

Refugee Oral Health: Interim Federal Health Plan (IFHP) Coverage

Refugee Oral Health: Interim Federal Health Plan (IFHP) Coverage

In this October 18, 2016 presentation, our two presenters delved into refugee oral health, both in children and adults. Content covered key findings from Manitoba and Saskatchewan, including the oral health needs of immigrants and refugees in Winnipeg and the coverage offered by IFHP (Interim Federal Health Program), and a large scale refugee oral health program offered by the University of Saskatchewan.

For an archived version of this webinar, contact NCCID Project Manager Zeeshan Qadar at qadarsmz@umanitoba.ca.


SPEAKERS

Dr. Robert Schroth

Dr. Schroth, DMD, MSc, PhD, is an Tenure Associate Professor and Clinician-Scientist, Department of Preventive Dental Science and Department of Pediatrics and Child Health, Associate Professor, Department of Oral Biology, Department of Community Health Sciences, Max Rady College of Medicine, University of Manitoba. In addition, he is a member of the Children’s Hospital Research Institute of Manitoba (CHRIM) and also presently holds a CIHR embedded clinician researcher. His main research interests include Early Childhood Caries (ECC) and the role that nutrition and prenatal factors have on infants and preschool oral health. Two major studies investigating the relationship between vitamin D deficiencies and both enamel hypoplasia and ECC in an urban Aboriginal population. He has also been involved in other ECC epidemiological work involving Aboriginal, rural, and Hutterite preschool populations. Dr. Schroth is a key participant in the Healthy Smile Happy Child Project (The Manitoba Collaborative Project for the Prevention of Early Childhood Tooth Decay), a Manitoba Health grant funded project guided by the pillars of community development, oral health promotion/education, and research/evaluation.

Dr. Alyssa Hayes

Dr. Hayes, BDENT (HONS), MSC, FRCD(C), is an Assistant Professor in the College of Dentistry at the University of Saskatchewan. During her work as Dental Officer in rural New South Wales (NSW) she worked closely with dental assistants, dental therapists and students (both locally and foreign-trained) to deliver care to marginalized populations. She had been active in Community Dental Health Services Research Unit (CDHRSU) in Toronto. She is also the recipient of the Canada Health Infoway Faculty Inter-professional E-Health Award.

Note: Funding for the series was provided by the Public Health Agency of Canada. The opinions expressed are those of the speaker(s) and do not necessarily reflect the official views of the Agency or NCCID.

Canadian Roundtable on Antimicrobial Stewardship

Canadian Roundtable on Antimicrobial Stewardship

June 16-17, 2016; Toronto, ON

Co-hosts: NCCID and HealthCareCAN

Facilitator:  Dorothy Strachan, Strachan-Tomlinson

Summary: Over 50 “Champions of Change”—experts, key influencers and stakeholders in the fields of antimicrobial stewardship and resistance—gathered to help build a national action plan for antimicrobial stewardship (AMS). (A draft action plan will be posted soon). Discussion began with certain assumptions about what would make for an effective AMS action plan. That is, the plan should align with global and federal AMS efforts, cross institutional and community settings, and aim for better cooperation among human health, animal health and environmental initiatives. Because antimicrobial resistance is a serious threat to public health, participants called for concrete and actionable steps.

Over the day and a half, Roundtable participants outlined many concrete steps that can be taken to develop, implement and monitor AMS programs in communities and in hospitals in Canada. The event encouraged consensus on basic priorities, identified opportunities for collaboration and specific commitments, and explored potential funding sources, governance options, and policy levers that could support more coordinated AMS efforts in Canada. See the meeting report for more details.

Roundtable objectives:

  1. Gather the information required to inform the development of a Canadian Action Plan;
  2. Link domestic and international AMS efforts;
  3. Identify key leaders and related accountabilities for the AMS post-Roundtable Action Plan, including commitments to new benchmarks and targets; and
  4. Continue to build community awareness and a common language in support of implementing the AMS Action Plan.

Speakers:

  • Gregory Taylor, Chief Public Health Officer for Canada
  • Andrew Morris, Director ASP, Mount Sinai Hospital ‐ University Health Network
  • David Patrick, Medical and Epidemiology Lead, AMR and Do Bugs Need Drugs Program, BC Centre for Disease Control
  • John Conly, Lead for the Alberta Health Services Regional AMS Program
  • Arjun Srinivasan, Associate Director for Healthcare‐Associated Infection Prevention Programs, Centers for Disease Control and Prevention
  • Stephan Harbarth, Section Head, Infection Control Programme, University Hospitals of Geneva

Background / further reading:

Sexually-transmitted Infections & Nursing in Indigenous Communities

Clarence Frenchman & Albert McLeod

The National Collaborating Centre for Infectious Diseases, together with the Aboriginal Nurses Association of Canada, hosted a Google Hangout On-Air about culturally-safe nursing practices and STBBIs in Indigenous communities. The 1-hour webinar was co-led by Clarence Frenchman, a Nurse Manager/HIV Case Coordinator at the Ahtahkakoop Health Centre in Saskatchewan, and Albert McLeod, a cross-cultural consultant/trainer whose work includes a focus on Aboriginal peoples and HIV/AIDS.

For video copies of the webinar, please email us.

Forward Thinking on Syphilis: An Information Exchange on Innovative Approaches to Syphilis, Focused on MSM

Forward Thinking on Syphilis: An Information Exchange on Innovative Approaches to Syphilis, Focused on MSM

In support of renewed public health efforts to control the recent outbreaks of syphilis in Canadian cities, NCCID brought together public health practitioners from several health regions, community-based organizations, and researchers September 29-30, 2014 in Winnipeg Manitoba. The goal was to provide an opportunity to share information and ideas from other jurisdictions on innovative, integrative and community-informed public health strategies with demonstrated or promising effectiveness in reducing the burden of syphilis, particularly among men who have sex with men (MSM).

Specific objectives included:

  • Share current knowledge on syphilis outbreaks, highlighting what we know about the burden of syphilis and dynamics of transmission among MSM;
  • Share evidence-based, practice-based, and client-centred knowledge that can contribute to an understanding of features of effective public health interventions for MSM;
  • Identify opportunities to bridge disease-specific silos and sectors, to build more upstream, integrated and community-informed approaches to syphilis.
  • Strategize on ways to advance innovative strategies to control syphilis among MSM.

Along with presentations, participants discussed relevant lessons and the implications for forward thinking about strategies and interventions at local, regional and national levels.

Related publications

Rethinking Chlamydia: How can public health STI teams manage the overwhelming caseload?

Rethinking Chlamydia: How can public health STI teams manage the overwhelming caseload?

Dr. Heejune Chang
MD, MHP, CCMF, FRCPC

Today, the sheer volume of Chlamydia cases has made it unrealistic for many urban public health STI teams to follow up with everyone via case-and-contact. And with the incidence of Chlamydia cases only rising every year, some now wonder whether their efforts are even making a difference. Rather than try to find ways to see more cases, however, the reality is that public health STI teams must ultimately reduce their Chlamydia caseloads, or risk sacrificing more urgently needed follow-up for other STIs or outreach activities to high risk groups. In this webinar, Dr. Heejune Chang walked through the ways some public health STI teams have tried to prioritize cases or reduce their workloads in the face of overwhelming Chlamydia case volumes.

An archived version of this webinar, including the ensuing discussion with Dr. Chang, is now available for viewing. Please email us to request access.