Epidemiology of carbapenemase-producing Enterobacterales carriage in a paediatric tertiary health care centre of Ontario, Canada

Abstract

The epidemiology of carbapenemase-producing Enterobacterales (CPE) in hospitalized children in low endemicity settings is not well known. We aim to describe it in a large tertiary paediatric health care centre in Canada. A repeated point-prevalence study including all inpatients was conducted at the Hospital for Sick Children, Toronto, for surveillance purposes over 3 days serially in April 2017, April 2019, and April 2022. Patients in the emergency department and medical day units were excluded. Stools or rectal swabs were analyzed for CPE identification, with confirmatory testing at the provincial reference laboratory. We detected CPE colonization in 0.4% (1/242), 0.7% (2/278), and 0.9% (2/220) of inpatients in 2017, 2019, and 2022, respectively. Identified CPE included OXA-48-like and NDM beta-lactamases in Escherichia coli and Klebsiella pneumoniae. All patients with CPE colonization had a history of travel or hospitalization outside of Canada, including in the Middle East and Asia. CPE colonization in children hospitalized in this Canadian hospital was detected. A history of prolonged travel or hospitalization outside of Canada are risk factors that should be considered in targeted screening programs.