期刊
MICROBIOLOGY SPECTRUM
卷 10, 期 4, 页码 -出版社
AMER SOC MICROBIOLOGY
DOI: 10.1128/spectrum.00975-22
关键词
AMR; ARO; CPE; antimicrobial resistance; carbapenease-producing Enterobacterales; drug-resistant
类别
资金
- Public Health Agency of Canada
- Canadian Nosocomial Infection Surveillance Program
There is limited information on the epidemiology of extensively drug-resistant (XDR) carbapenemase-producing Enterobacterales (CPE) in Canada. This study found that international travel history, acquisition of CPE from healthcare exposure abroad, specific carbapenemase genes and bacterial strains were significantly associated with XDR status among CPE patients in Canada.
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-beta-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.
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