Streptococcus and STI Section

The Streptococcus and STI Section provides surveillance, reference diagnostic services, and research on Streptococcus pneumoniae, Streptococcus pyogenes, Streptococcus agalactiae, Neisseria gonorrhoeae and Mycoplasma genitalium. The National Laboratory Surveillance of Invasive Streptococcal Disease in Canada (eSTREP) characterizes the types of Streptococcal cultures causing disease by serotypes, emm types and antimicrobial resistance (AMR) to monitor trends in disease. Data supports public health outbreak investigations and is used by the National Advisory Committee on Immunization to update vaccine guidelines. Surveillance reports are published in the Canadian Communicable Disease Report (CCDR) annually. In addition, the Streptococcus and STI Section participates in international and national surveillance programs such as the Canadian Ward Surveillance Study (CANWARD), the Immunization Monitoring Program Active (IMPACT) and International Circumpolar Surveillance (ICS).

The N. gonorrhoeae work includes the Gonococcal Antimicrobial Surveillance Program – Canada (GASP-Canada) which characterizes antimicrobial-resistant N. gonorrhoeae causing disease to monitor trends and support outbreak investigations. Gonococcal surveillance data is published in the Canadian Communicable Disease Report (CCDR) annually. A subset of GASP-Canada isolates are included in the Enhanced Surveillance of Antimicrobial-Resistant Gonorrhea (ESAG) system which links laboratory and epidemiological case data including gonorrhea treatment and risk factor data. In regions where N. gonorrhoeae cultures are not available, the NML is now able to predict antimicrobial resistance directly from clinical specimens, providing valuable AMR surveillance data to these jurisdictions. GASP-Canada and ESAG data improves the understanding of emerging gonorrhea antimicrobial resistance trends in Canada and are used by Canadian STI Treatment Guidelines to update treatment recommendations. With the global rise in resistance to first-line treatment antimicrobials, a treatment failure or ceftriaxone resistance case report form has been developed to ensure the tracking of these cases in Canada.

Research activities include the molecular characterization of antimicrobial resistance mechanisms using whole genome sequencing and continually updating the real-time PCR assays used to predict antimicrobial susceptibilities in clinical specimens. In recent years, there has been an increase in the number of STIs reported in Canada as well as the emergence of gonococcal strains with decreased susceptibility or resistance to 3rd generation cephalosporins and resistance to azithromycin. The M. genitalium program focuses on determining azithromycin and moxifloxacin antimicrobial resistance.