Prevalence of Antimicrobial-Resistant Pathogens in Canadian Hospitals: Results of the Canadian Ward Surveillance Study (CANWARD 2007)
BACKGROUND: Canadian hospitals as well as hospitals worldwide are increasingly faced with antibiotic-resistant pathogens, including multidrug-resistant (MDR) strains. OBJECTIVES: To assess the prevalence of pathogens, including the resistance genotypes of methicillin-resistant Staphylococcus aureus...
Saved in:
| Main Authors: | , , , , , , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Wiley
2009-01-01
|
| Series: | Canadian Journal of Infectious Diseases and Medical Microbiology |
| Online Access: | http://dx.doi.org/10.1155/2009/398264 |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1832553968702586880 |
|---|---|
| author | George G Zhanel James A Karlowsky Mel DeCorby Kim A Nichol Aleksandra Wierzbowski Patricia J Baudry Philippe Lagacé-Wiens Andrew Walkty Frank Schweizer Heather Adam Melissa McCracken Michael R Mulvey The Canadian Antimicrobial Resistance Alliance (CARA) Daryl J Hoban |
| author_facet | George G Zhanel James A Karlowsky Mel DeCorby Kim A Nichol Aleksandra Wierzbowski Patricia J Baudry Philippe Lagacé-Wiens Andrew Walkty Frank Schweizer Heather Adam Melissa McCracken Michael R Mulvey The Canadian Antimicrobial Resistance Alliance (CARA) Daryl J Hoban |
| author_sort | George G Zhanel |
| collection | DOAJ |
| description | BACKGROUND: Canadian hospitals as well as hospitals worldwide
are increasingly faced with antibiotic-resistant pathogens, including
multidrug-resistant (MDR) strains.
OBJECTIVES: To assess the prevalence of pathogens, including the
resistance genotypes of methicillin-resistant Staphylococcus aureus
(MRSA), vancomycin-resistant enterococci (VRE) and extendedspectrum
beta-lactamase (ESBL)-producing Escherichia coli in Canadian
hospitals, as well as their antimicrobial resistance patterns.
MEtHODS: Bacterial isolates were obtained between January 1,
2007, and December 31, 2007, inclusive, from patients in 12 hospitals
across Canada as part of the Canadian Ward Surveillance Study
(CANWARD 2007). Isolates were obtained from bacteremic, urinary,
respiratory and wound specimens and underwent antimicrobial susceptibility
testing. Susceptibility testing was assessed using the Clinical
and Laboratory Standards Institute broth microdilution method.
RESULTS: In total, 7881 isolates were recovered from clinical specimens
of patients attending Canadian hospitals. The 7881 isolates were
collected from respiratory (n=2306; 29.3%), blood (n=3631; 46.1%),
wounds/tissue (n=617; 7.8%) and urinary (n=1327; 16.8%) specimens.
The 10 most common organisms isolated from 76.5% of all
clinical specimens were E coli (21.6%), methicillin-susceptible S aureus
(13.9%), Streptococcus pneumoniae (8.9%), Pseudomonas aeruginosa
(8.0%), Klebsiella pneumoniae (5.8%), MRSA (4.9%), Haemophilus
influenzae (4.3%), coagulase-negative staphylococci/taphylococcus
epidermidisS (4.0%), Enterococcus species (3.0%) and Enterobacter cloacae
(2.1%). MRSA made up 26.0% (385 of 1480) of all S aureus (genotypically,
79.2% of MRSA were health care-associated MRSA and
19.5% were community-associated MRSA), and VRE made up 1.8%
of all enterococci (62.5% of VRE had the vanA genotype). ESBLproducing
E coli occurred in 3.4% of E coli isolates. The CTX-M type
was the predominant ESBL, with CTX-M-15 as the predominant
genotype. With MRSA, no resistance was observed to daptomycin,
linezolid, tigecycline and vancomycin, while resistance rates to other
agents were: clarithromycin 91.4%, clindamycin 61.8%, fluoroquinolones
88.6% to 89.6%, and trimethoprim-sulfamethoxazole 12.2%.
With E coli, no resistance was observed to ertapenem, meropenem and
tigecycline, while resistance rates to other agents were: amikacin
0.1%, cefazolin 14.2%, cefepime 2.0%, ceftriaxone 8.9%, gentamicin
10.6%, fluoroquinolones 23.6% to 24.5%, piperacillin-tazobactam
1.3% and trimethoprim-sulfamethoxazole 26.6%. Resistance rates
with P aeruginosa were: amikacin 7.6%, cefepime 11.7%, gentamicin
20.8%, fluoroquinolones 23.4% to 25.1%, meropenem 8.1% and piperacillin-
tazobactam 7.3%. A MDR phenotype (resistance to three or
more of cefepime, piperacillin-tazobactam, meropenem, amikacin or
gentamicin, and ciprofloxacin) occurred frequently in P aeruginosa
(10.6%) but uncommonly in E coli (1.2%), K pneumoniae (1.5%),
E cloacae (0%) or H influenzae (0%).
CONCLUSIONS: E coli, S aureus (methicillin-susceptible and MRSA),
S pneumoniae, P aeruginosa, K pneumoniae, H influenzae and Enterococcus
species are the most common isolates recovered from clinical specimens in
Canadian hospitals. The prevalence of MRSA was 26.0% (of which genotypically,
19.5% was community-associated MRSA), while VRE and
ESBL-producing E coli occurred in 1.8% and 3.4% of isolates, respectively.
A MDR phenotype is common with P aeruginosa in Canadian hospitals. |
| format | Article |
| id | doaj-art-c163b24ed96b4c83bfcde8d9a8eef229 |
| institution | Kabale University |
| issn | 1712-9532 |
| language | English |
| publishDate | 2009-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Canadian Journal of Infectious Diseases and Medical Microbiology |
| spelling | doaj-art-c163b24ed96b4c83bfcde8d9a8eef2292025-02-03T05:52:48ZengWileyCanadian Journal of Infectious Diseases and Medical Microbiology1712-95322009-01-0120Suppl A9A19A10.1155/2009/398264Prevalence of Antimicrobial-Resistant Pathogens in Canadian Hospitals: Results of the Canadian Ward Surveillance Study (CANWARD 2007)George G Zhanel0James A Karlowsky1Mel DeCorby2Kim A Nichol3Aleksandra Wierzbowski4Patricia J Baudry5Philippe Lagacé-Wiens6Andrew Walkty7Frank Schweizer8Heather Adam9Melissa McCracken10Michael R Mulvey11The Canadian Antimicrobial Resistance Alliance (CARA)Daryl J Hoban12Department of Medical Microbiology, Faculty of Medicine, University of Manitoba, CanadaDepartment of Medical Microbiology, Faculty of Medicine, University of Manitoba, CanadaDepartment of Medical Microbiology, Faculty of Medicine, University of Manitoba, CanadaDepartment of Clinical Microbiology, Health Sciences Centre, University of Manitoba, CanadaDepartment of Medical Microbiology, Faculty of Medicine, University of Manitoba, CanadaDepartment of Medical Microbiology, Faculty of Medicine, University of Manitoba, CanadaDepartment of Medical Microbiology, Faculty of Medicine, University of Manitoba, CanadaDepartment of Medical Microbiology, Faculty of Medicine, University of Manitoba, CanadaDepartment of Chemistry, Faculty of Science, University of Manitoba, Winnipeg, Manitoba, CanadaUniversity of Toronto, Toronto, Ontario, CanadaNosocomial Infections Branch, National Microbiology Laboratory, Winnipeg, Manitoba, CanadaNosocomial Infections Branch, National Microbiology Laboratory, Winnipeg, Manitoba, CanadaDepartment of Medical Microbiology, Faculty of Medicine, University of Manitoba, CanadaBACKGROUND: Canadian hospitals as well as hospitals worldwide are increasingly faced with antibiotic-resistant pathogens, including multidrug-resistant (MDR) strains. OBJECTIVES: To assess the prevalence of pathogens, including the resistance genotypes of methicillin-resistant Staphylococcus aureus (MRSA), vancomycin-resistant enterococci (VRE) and extendedspectrum beta-lactamase (ESBL)-producing Escherichia coli in Canadian hospitals, as well as their antimicrobial resistance patterns. MEtHODS: Bacterial isolates were obtained between January 1, 2007, and December 31, 2007, inclusive, from patients in 12 hospitals across Canada as part of the Canadian Ward Surveillance Study (CANWARD 2007). Isolates were obtained from bacteremic, urinary, respiratory and wound specimens and underwent antimicrobial susceptibility testing. Susceptibility testing was assessed using the Clinical and Laboratory Standards Institute broth microdilution method. RESULTS: In total, 7881 isolates were recovered from clinical specimens of patients attending Canadian hospitals. The 7881 isolates were collected from respiratory (n=2306; 29.3%), blood (n=3631; 46.1%), wounds/tissue (n=617; 7.8%) and urinary (n=1327; 16.8%) specimens. The 10 most common organisms isolated from 76.5% of all clinical specimens were E coli (21.6%), methicillin-susceptible S aureus (13.9%), Streptococcus pneumoniae (8.9%), Pseudomonas aeruginosa (8.0%), Klebsiella pneumoniae (5.8%), MRSA (4.9%), Haemophilus influenzae (4.3%), coagulase-negative staphylococci/taphylococcus epidermidisS (4.0%), Enterococcus species (3.0%) and Enterobacter cloacae (2.1%). MRSA made up 26.0% (385 of 1480) of all S aureus (genotypically, 79.2% of MRSA were health care-associated MRSA and 19.5% were community-associated MRSA), and VRE made up 1.8% of all enterococci (62.5% of VRE had the vanA genotype). ESBLproducing E coli occurred in 3.4% of E coli isolates. The CTX-M type was the predominant ESBL, with CTX-M-15 as the predominant genotype. With MRSA, no resistance was observed to daptomycin, linezolid, tigecycline and vancomycin, while resistance rates to other agents were: clarithromycin 91.4%, clindamycin 61.8%, fluoroquinolones 88.6% to 89.6%, and trimethoprim-sulfamethoxazole 12.2%. With E coli, no resistance was observed to ertapenem, meropenem and tigecycline, while resistance rates to other agents were: amikacin 0.1%, cefazolin 14.2%, cefepime 2.0%, ceftriaxone 8.9%, gentamicin 10.6%, fluoroquinolones 23.6% to 24.5%, piperacillin-tazobactam 1.3% and trimethoprim-sulfamethoxazole 26.6%. Resistance rates with P aeruginosa were: amikacin 7.6%, cefepime 11.7%, gentamicin 20.8%, fluoroquinolones 23.4% to 25.1%, meropenem 8.1% and piperacillin- tazobactam 7.3%. A MDR phenotype (resistance to three or more of cefepime, piperacillin-tazobactam, meropenem, amikacin or gentamicin, and ciprofloxacin) occurred frequently in P aeruginosa (10.6%) but uncommonly in E coli (1.2%), K pneumoniae (1.5%), E cloacae (0%) or H influenzae (0%). CONCLUSIONS: E coli, S aureus (methicillin-susceptible and MRSA), S pneumoniae, P aeruginosa, K pneumoniae, H influenzae and Enterococcus species are the most common isolates recovered from clinical specimens in Canadian hospitals. The prevalence of MRSA was 26.0% (of which genotypically, 19.5% was community-associated MRSA), while VRE and ESBL-producing E coli occurred in 1.8% and 3.4% of isolates, respectively. A MDR phenotype is common with P aeruginosa in Canadian hospitals.http://dx.doi.org/10.1155/2009/398264 |
| spellingShingle | George G Zhanel James A Karlowsky Mel DeCorby Kim A Nichol Aleksandra Wierzbowski Patricia J Baudry Philippe Lagacé-Wiens Andrew Walkty Frank Schweizer Heather Adam Melissa McCracken Michael R Mulvey The Canadian Antimicrobial Resistance Alliance (CARA) Daryl J Hoban Prevalence of Antimicrobial-Resistant Pathogens in Canadian Hospitals: Results of the Canadian Ward Surveillance Study (CANWARD 2007) Canadian Journal of Infectious Diseases and Medical Microbiology |
| title | Prevalence of Antimicrobial-Resistant Pathogens in Canadian Hospitals: Results of the Canadian Ward Surveillance Study (CANWARD 2007) |
| title_full | Prevalence of Antimicrobial-Resistant Pathogens in Canadian Hospitals: Results of the Canadian Ward Surveillance Study (CANWARD 2007) |
| title_fullStr | Prevalence of Antimicrobial-Resistant Pathogens in Canadian Hospitals: Results of the Canadian Ward Surveillance Study (CANWARD 2007) |
| title_full_unstemmed | Prevalence of Antimicrobial-Resistant Pathogens in Canadian Hospitals: Results of the Canadian Ward Surveillance Study (CANWARD 2007) |
| title_short | Prevalence of Antimicrobial-Resistant Pathogens in Canadian Hospitals: Results of the Canadian Ward Surveillance Study (CANWARD 2007) |
| title_sort | prevalence of antimicrobial resistant pathogens in canadian hospitals results of the canadian ward surveillance study canward 2007 |
| url | http://dx.doi.org/10.1155/2009/398264 |
| work_keys_str_mv | AT georgegzhanel prevalenceofantimicrobialresistantpathogensincanadianhospitalsresultsofthecanadianwardsurveillancestudycanward2007 AT jamesakarlowsky prevalenceofantimicrobialresistantpathogensincanadianhospitalsresultsofthecanadianwardsurveillancestudycanward2007 AT meldecorby prevalenceofantimicrobialresistantpathogensincanadianhospitalsresultsofthecanadianwardsurveillancestudycanward2007 AT kimanichol prevalenceofantimicrobialresistantpathogensincanadianhospitalsresultsofthecanadianwardsurveillancestudycanward2007 AT aleksandrawierzbowski prevalenceofantimicrobialresistantpathogensincanadianhospitalsresultsofthecanadianwardsurveillancestudycanward2007 AT patriciajbaudry prevalenceofantimicrobialresistantpathogensincanadianhospitalsresultsofthecanadianwardsurveillancestudycanward2007 AT philippelagacewiens prevalenceofantimicrobialresistantpathogensincanadianhospitalsresultsofthecanadianwardsurveillancestudycanward2007 AT andrewwalkty prevalenceofantimicrobialresistantpathogensincanadianhospitalsresultsofthecanadianwardsurveillancestudycanward2007 AT frankschweizer prevalenceofantimicrobialresistantpathogensincanadianhospitalsresultsofthecanadianwardsurveillancestudycanward2007 AT heatheradam prevalenceofantimicrobialresistantpathogensincanadianhospitalsresultsofthecanadianwardsurveillancestudycanward2007 AT melissamccracken prevalenceofantimicrobialresistantpathogensincanadianhospitalsresultsofthecanadianwardsurveillancestudycanward2007 AT michaelrmulvey prevalenceofantimicrobialresistantpathogensincanadianhospitalsresultsofthecanadianwardsurveillancestudycanward2007 AT thecanadianantimicrobialresistancealliancecara prevalenceofantimicrobialresistantpathogensincanadianhospitalsresultsofthecanadianwardsurveillancestudycanward2007 AT daryljhoban prevalenceofantimicrobialresistantpathogensincanadianhospitalsresultsofthecanadianwardsurveillancestudycanward2007 |