Emergence of Carbapenemase-Producing Enterobacteriaceae, South-Central Ontario, Canada

Publication

Emergence of Carbapenemase-Producing Enterobacteriaceae, South-Central Ontario, Canada

Journal Paper/Review - Sep 1, 2018

Kohler Philipp, Lam Freda, Muller Matthew P, Powis Jeff, Poutanen Susan M, Richardson David, Rebbapragada Anu, Sarabia Alicia, Simor Andrew, McGeer Allison, Katz Kevin, Johnstone Jennie, Borgundvaag Emily, Melano Roberto G, Patel Samir N, Shafinaz Shumona, Faheem Amna, Coleman Brenda L, Green Karen, Armstrong Irene, Almohri Huda, Borgia Sergio, Toronto Invasive Bacterial Diseases Network (TIBDN)

Citation

Kohler P, Lam F, Muller M, Powis J, Poutanen S, Richardson D, Rebbapragada A, Sarabia A, Simor A, McGeer A, Katz K, Johnstone J, Borgundvaag E, Melano R, Patel S, Shafinaz S, Faheem A, Coleman B, Green K, Armstrong I, Almohri H, Borgia S, Toronto Invasive Bacterial Diseases Network (TIBDN). Emergence of Carbapenemase-Producing Enterobacteriaceae, South-Central Ontario, Canada. Emerging Infect Dis 2018; 24:1674-1682.

Type

Journal Paper/Review (English)

Journal

Emerging Infect Dis 2018; 24

Publication Date

Sep 1, 2018

Issn Electronic

1080-6059

Pages

1674-1682

Brief description/objective

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.