Characterization of Extensively Drug-Resistant (XDR) Carbapenemase-Producing Enterobacterales (CPE) in Canada from 2019 to 2020
ABSTRACT Data regarding the epidemiology of extensively drug-resistant (XDR) carbapenemase-producing Enterobacterales (CPE) in Canada are scarce. Among CPE patients identified by the Canadian Nosocomial Infection Surveillance Program, the following were each significantly associated with XDR status:...
| Main Authors: | , , , , |
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| Format: | Article |
| Language: | English |
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American Society for Microbiology
2022-08-01
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| Series: | Microbiology Spectrum |
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| Online Access: | https://journals.asm.org/doi/10.1128/spectrum.00975-22 |
| _version_ | 1811337780662370304 |
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| author | Jessica J. Bartoszko Robyn Mitchell Kevin Katz Michael Mulvey Laura Mataseje |
| author_facet | Jessica J. Bartoszko Robyn Mitchell Kevin Katz Michael Mulvey Laura Mataseje |
| author_sort | Jessica J. Bartoszko |
| collection | DOAJ |
| description | ABSTRACT Data regarding the epidemiology of extensively drug-resistant (XDR) carbapenemase-producing Enterobacterales (CPE) in Canada are scarce. Among CPE patients identified by the Canadian Nosocomial Infection Surveillance Program, the following were each significantly associated with XDR status: international travel history; CPE acquisition from a health care exposure abroad; presence of the New Delhi metallo-β-lactamase (NDM) carbapenemase gene; E. coli sequence type (ST) 167, ST405, and ST648; E. cloaceae ST177; C. freundii ST22; and resistance to all antimicrobials except colistin, tigecycline, and ceftazidime-avibactam. IMPORTANCE Extensively drug-resistant (XDR) carbapenemase-producing Enterobacterales (CPE) are a global public health concern. XDR CPE are among the most drug-resistant and difficult-to-treat bacteria, and infected patients are likely to experience adverse outcomes. Because XDR status further reduces effective therapeutic options, it is critical for clinicians to consider resistance and therapeutic options not only in the context of a patient with CPE but also in the context of potential XDR status. Our study reports on patient characteristics associated with the acquisition of an XDR CPE. Our study also reports on the species and carbapenemases associated with XDR status among Enterobacterales identified in Canada. Among a panel of 22 antibiotics, including novel combination drugs, we showed which retained the highest activity against XDR CPE, which may help guide the selection of antibiotic treatments. |
| first_indexed | 2024-04-13T18:00:47Z |
| format | Article |
| id | doaj.art-896a4b4a8cd84e1284bf5ee5709eb398 |
| institution | Directory Open Access Journal |
| issn | 2165-0497 |
| language | English |
| last_indexed | 2024-04-13T18:00:47Z |
| publishDate | 2022-08-01 |
| publisher | American Society for Microbiology |
| record_format | Article |
| series | Microbiology Spectrum |
| spelling | doaj.art-896a4b4a8cd84e1284bf5ee5709eb3982022-12-22T02:36:16ZengAmerican Society for MicrobiologyMicrobiology Spectrum2165-04972022-08-0110410.1128/spectrum.00975-22Characterization of Extensively Drug-Resistant (XDR) Carbapenemase-Producing Enterobacterales (CPE) in Canada from 2019 to 2020Jessica J. Bartoszko0Robyn Mitchell1Kevin Katz2Michael Mulvey3Laura Mataseje4Centre for Communicable Diseases and Infection Control, Public Health Agency of Canada, Ottawa, Ontario, CanadaCentre for Communicable Diseases and Infection Control, Public Health Agency of Canada, Ottawa, Ontario, CanadaDepartment of Infection Prevention and Control, North York General Hospital, Toronto, Ontario, CanadaNational Microbiology Laboratory, Public Health Agency of Canada, Winnipeg, Manitoba, CanadaNational Microbiology Laboratory, Public Health Agency of Canada, Winnipeg, Manitoba, CanadaABSTRACT Data regarding the epidemiology of extensively drug-resistant (XDR) carbapenemase-producing Enterobacterales (CPE) in Canada are scarce. Among CPE patients identified by the Canadian Nosocomial Infection Surveillance Program, the following were each significantly associated with XDR status: international travel history; CPE acquisition from a health care exposure abroad; presence of the New Delhi metallo-β-lactamase (NDM) carbapenemase gene; E. coli sequence type (ST) 167, ST405, and ST648; E. cloaceae ST177; C. freundii ST22; and resistance to all antimicrobials except colistin, tigecycline, and ceftazidime-avibactam. IMPORTANCE Extensively drug-resistant (XDR) carbapenemase-producing Enterobacterales (CPE) are a global public health concern. XDR CPE are among the most drug-resistant and difficult-to-treat bacteria, and infected patients are likely to experience adverse outcomes. Because XDR status further reduces effective therapeutic options, it is critical for clinicians to consider resistance and therapeutic options not only in the context of a patient with CPE but also in the context of potential XDR status. Our study reports on patient characteristics associated with the acquisition of an XDR CPE. Our study also reports on the species and carbapenemases associated with XDR status among Enterobacterales identified in Canada. Among a panel of 22 antibiotics, including novel combination drugs, we showed which retained the highest activity against XDR CPE, which may help guide the selection of antibiotic treatments.https://journals.asm.org/doi/10.1128/spectrum.00975-22AMRAROCPEantimicrobial resistancecarbapenease-producing Enterobacteralesdrug-resistant |
| spellingShingle | Jessica J. Bartoszko Robyn Mitchell Kevin Katz Michael Mulvey Laura Mataseje Characterization of Extensively Drug-Resistant (XDR) Carbapenemase-Producing Enterobacterales (CPE) in Canada from 2019 to 2020 Microbiology Spectrum AMR ARO CPE antimicrobial resistance carbapenease-producing Enterobacterales drug-resistant |
| title | Characterization of Extensively Drug-Resistant (XDR) Carbapenemase-Producing Enterobacterales (CPE) in Canada from 2019 to 2020 |
| title_full | Characterization of Extensively Drug-Resistant (XDR) Carbapenemase-Producing Enterobacterales (CPE) in Canada from 2019 to 2020 |
| title_fullStr | Characterization of Extensively Drug-Resistant (XDR) Carbapenemase-Producing Enterobacterales (CPE) in Canada from 2019 to 2020 |
| title_full_unstemmed | Characterization of Extensively Drug-Resistant (XDR) Carbapenemase-Producing Enterobacterales (CPE) in Canada from 2019 to 2020 |
| title_short | Characterization of Extensively Drug-Resistant (XDR) Carbapenemase-Producing Enterobacterales (CPE) in Canada from 2019 to 2020 |
| title_sort | characterization of extensively drug resistant xdr carbapenemase producing enterobacterales cpe in canada from 2019 to 2020 |
| topic | AMR ARO CPE antimicrobial resistance carbapenease-producing Enterobacterales drug-resistant |
| url | https://journals.asm.org/doi/10.1128/spectrum.00975-22 |
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