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

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

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.
   
citation Kohler P, Melano R G, Patel S N, Shafinaz S, Faheem A, Coleman B L, Green K, Armstrong I, Almohri H, Borgia S, Borgundvaag E, Johnstone J, Katz K, Lam F, Muller M P, Powis J, Poutanen S M, Richardson D, Rebbapragada A, Sarabia A, Simor A, McGeer A, 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)
date of publishing 9-2018
journal title Emerging Infect Dis (24/9)
ISSN electronic 1080-6059
pages 1674-1682
PubMed 30124197
DOI 10.3201/eid2409.180164