학술논문
Emergence of Carbapenemase-Producing Enterobacteriaceae, South-Central Ontario, Canada1 .
Document Type
Journal Article
Author
Kohler, Philipp P.; Melano, Roberto G.; Patel, Samir N.; Shafinaz, Shumona; Faheem, Amna; Coleman, Brenda L.; Green, Karen; Armstrong, Irene; Almohri, Huda; Borgia, Sergio; Borgundvaag, Emily; Johnstone, Jennie; Katz, Kevin; Lam, Freda; Muller, Matthew P.; Powis, Jeff; Poutanen, Susan M.; Richardson, David; Rebbapragada, Anu; Sarabia, Alicia
Source
Subject
*ENTEROBACTERIACEAE
*CARBAPENEMASE
*MEDICAL care
*KLEBSIELLA
*INFECTION
*CROSS infection prevention
*PREVENTION of communicable diseases
*MEDICAL records
*PUBLIC health surveillance
*RESEARCH funding
*TRAVEL
*DISEASE incidence
*ENTEROBACTERIACEAE diseases
*
*
*
*
*
*
*
*
*
*
*
*
Language
ISSN
1080-6040
Abstract
We analyzed population-based surveillance data from the Toronto Invasive Bacterial Diseases Network to describe carbapenemase-producing Enterobacteriaceae (CPE) infections during 2007-2015 in south-central Ontario, Canada. We reviewed patients' medical records and travel histories, analyzed microbiologic and clinical characteristics of CPE infections, and calculated incidence. Among 291 cases identified, New Delhi metallo-β-lactamase was the predominant carbapenemase (51%). The proportion of CPE-positive patients with prior admission to a hospital in Canada who had not received healthcare abroad or traveled to high-risk areas was 13% for patients with oxacillinase-48, 24% for patients with New Delhi metallo-β-lactamase, 55% for patients with Klebsiella pneumoniae carbapenemase, and 67% for patients with Verona integron-encoded metallo-β-lactamase. Incidence of CPE infection increased, reaching 0.33 cases/100,000 population in 2015. For a substantial proportion of patients, no healthcare abroad or high-risk travel could be established, suggesting CPE acquisition in Canada. Policy and practice changes are needed to mitigate nosocomial CPE transmission in hospitals in Canada. [ABSTRACT FROM AUTHOR]