Robyn Mitchell, Laura Mataseje, Joëlle Cayen, Erin McGill, Kristine Cannon, Ian Davis, Tamara Duncombe, Chelsey Ellis, Jennifer Ellison, Jennifer Happe, Susy S Hota, Kevin C Katz, Pamela Kibsey, Santina Lee, Jerome A Leis, Xena Li, Allison McGeer, Jessica Minion, Sonja Musto, Connie Patterson, Ewa Rajda, Stephanie W Smith, Jocelyn A Srigley, Kathryn N Suh, Nisha Thampi, Jen Tomlinson, Joseph Vayalumkal, Kristen Versluys, Titus Wong, Yves Longtin
{"title":"2010-2023年加拿大急性护理设施中产碳青霉烯酶肠杆菌的流行病学演变","authors":"Robyn Mitchell, Laura Mataseje, Joëlle Cayen, Erin McGill, Kristine Cannon, Ian Davis, Tamara Duncombe, Chelsey Ellis, Jennifer Ellison, Jennifer Happe, Susy S Hota, Kevin C Katz, Pamela Kibsey, Santina Lee, Jerome A Leis, Xena Li, Allison McGeer, Jessica Minion, Sonja Musto, Connie Patterson, Ewa Rajda, Stephanie W Smith, Jocelyn A Srigley, Kathryn N Suh, Nisha Thampi, Jen Tomlinson, Joseph Vayalumkal, Kristen Versluys, Titus Wong, Yves Longtin","doi":"10.1186/s13756-025-01602-w","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Carbapenemase-producing Enterobacterales (CPE) are associated with substantial morbidity and mortality with limited treatment options and have an ability to spread rapidly in healthcare settings. We analyzed surveillance data from the Canadian Nosocomial Infection Surveillance Program to describe trends and the epidemiology of CPE from 2010 to 2023.</p><p><strong>Methods: </strong>Participating acute-care hospitals submitted eligible isolates to the National Microbiology Laboratory for detection of carbapenemase genes. Trained infection control professionals applied standardized definitions to collect epidemiological data by chart review from 30-97 hospitals from 2010 to 2023.</p><p><strong>Results: </strong>The national incidence of CPE infection (0.03 to 0.14 per 10,000 patient days; R<sup>2</sup> = 0.76) and colonization (0.02 to 0.78 per 10,000 patient days; R<sup>2</sup> = 0.83) increased exponentially from 2010 to 2023. We identified rapidly rising rates of healthcare-associated (HA) CPE infections from 2019 to 2023 (0.05 to 0.09 per 10,000 patient-days, p = 0.04), attributed to select hospitals (7/97) which accounted for half (53%) of all HA-CPE infections in 2023. Similarly, we identified that 2023 HA-CPE colonization rates were highest in medium (201-499 beds) and large (≥500 beds) hospitals in the Central region. Most patients did not report international travel (66%) nor receipt of medical care abroad (74%). Travel and receipt of medical care were less commonly reported among bla<sub>KPC</sub> associated cases (7.1% and 5.3% respectively) compared to bla<sub>NDM</sub> (55% and 45% respectively) and bla<sub>OXA-48</sub> (57% and 39%) associated cases. Furthermore, bla<sub>KPC</sub> was the predominant carbapenemase among all HA-CPE isolates (62%, 950/1,534).</p><p><strong>Conclusions: </strong>Surveillance data from a national network of Canadian acute care hospitals indicates that while the incidence of CPE in Canada remains low, it is accelerating at an exponential rate. Our findings suggest that nosocomial transmission is driving the recent increase in CPE incidence in Canada. Improved infection control measures and antimicrobial stewardship as well as access to newer antimicrobials are all urgently needed.</p>","PeriodicalId":7950,"journal":{"name":"Antimicrobial Resistance and Infection Control","volume":"14 1","pages":"88"},"PeriodicalIF":4.8000,"publicationDate":"2025-07-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12256002/pdf/","citationCount":"0","resultStr":"{\"title\":\"The evolving epidemiology of Carbapenemase-producing Enterobacterales in Canadian acute care facilities, 2010-2023.\",\"authors\":\"Robyn Mitchell, Laura Mataseje, Joëlle Cayen, Erin McGill, Kristine Cannon, Ian Davis, Tamara Duncombe, Chelsey Ellis, Jennifer Ellison, Jennifer Happe, Susy S Hota, Kevin C Katz, Pamela Kibsey, Santina Lee, Jerome A Leis, Xena Li, Allison McGeer, Jessica Minion, Sonja Musto, Connie Patterson, Ewa Rajda, Stephanie W Smith, Jocelyn A Srigley, Kathryn N Suh, Nisha Thampi, Jen Tomlinson, Joseph Vayalumkal, Kristen Versluys, Titus Wong, Yves Longtin\",\"doi\":\"10.1186/s13756-025-01602-w\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>Carbapenemase-producing Enterobacterales (CPE) are associated with substantial morbidity and mortality with limited treatment options and have an ability to spread rapidly in healthcare settings. We analyzed surveillance data from the Canadian Nosocomial Infection Surveillance Program to describe trends and the epidemiology of CPE from 2010 to 2023.</p><p><strong>Methods: </strong>Participating acute-care hospitals submitted eligible isolates to the National Microbiology Laboratory for detection of carbapenemase genes. Trained infection control professionals applied standardized definitions to collect epidemiological data by chart review from 30-97 hospitals from 2010 to 2023.</p><p><strong>Results: </strong>The national incidence of CPE infection (0.03 to 0.14 per 10,000 patient days; R<sup>2</sup> = 0.76) and colonization (0.02 to 0.78 per 10,000 patient days; R<sup>2</sup> = 0.83) increased exponentially from 2010 to 2023. We identified rapidly rising rates of healthcare-associated (HA) CPE infections from 2019 to 2023 (0.05 to 0.09 per 10,000 patient-days, p = 0.04), attributed to select hospitals (7/97) which accounted for half (53%) of all HA-CPE infections in 2023. Similarly, we identified that 2023 HA-CPE colonization rates were highest in medium (201-499 beds) and large (≥500 beds) hospitals in the Central region. Most patients did not report international travel (66%) nor receipt of medical care abroad (74%). Travel and receipt of medical care were less commonly reported among bla<sub>KPC</sub> associated cases (7.1% and 5.3% respectively) compared to bla<sub>NDM</sub> (55% and 45% respectively) and bla<sub>OXA-48</sub> (57% and 39%) associated cases. Furthermore, bla<sub>KPC</sub> was the predominant carbapenemase among all HA-CPE isolates (62%, 950/1,534).</p><p><strong>Conclusions: </strong>Surveillance data from a national network of Canadian acute care hospitals indicates that while the incidence of CPE in Canada remains low, it is accelerating at an exponential rate. Our findings suggest that nosocomial transmission is driving the recent increase in CPE incidence in Canada. Improved infection control measures and antimicrobial stewardship as well as access to newer antimicrobials are all urgently needed.</p>\",\"PeriodicalId\":7950,\"journal\":{\"name\":\"Antimicrobial Resistance and Infection Control\",\"volume\":\"14 1\",\"pages\":\"88\"},\"PeriodicalIF\":4.8000,\"publicationDate\":\"2025-07-12\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12256002/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Antimicrobial Resistance and Infection Control\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1186/s13756-025-01602-w\",\"RegionNum\":2,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q1\",\"JCRName\":\"INFECTIOUS DISEASES\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Antimicrobial Resistance and Infection Control","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1186/s13756-025-01602-w","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"INFECTIOUS DISEASES","Score":null,"Total":0}
The evolving epidemiology of Carbapenemase-producing Enterobacterales in Canadian acute care facilities, 2010-2023.
Background: Carbapenemase-producing Enterobacterales (CPE) are associated with substantial morbidity and mortality with limited treatment options and have an ability to spread rapidly in healthcare settings. We analyzed surveillance data from the Canadian Nosocomial Infection Surveillance Program to describe trends and the epidemiology of CPE from 2010 to 2023.
Methods: Participating acute-care hospitals submitted eligible isolates to the National Microbiology Laboratory for detection of carbapenemase genes. Trained infection control professionals applied standardized definitions to collect epidemiological data by chart review from 30-97 hospitals from 2010 to 2023.
Results: The national incidence of CPE infection (0.03 to 0.14 per 10,000 patient days; R2 = 0.76) and colonization (0.02 to 0.78 per 10,000 patient days; R2 = 0.83) increased exponentially from 2010 to 2023. We identified rapidly rising rates of healthcare-associated (HA) CPE infections from 2019 to 2023 (0.05 to 0.09 per 10,000 patient-days, p = 0.04), attributed to select hospitals (7/97) which accounted for half (53%) of all HA-CPE infections in 2023. Similarly, we identified that 2023 HA-CPE colonization rates were highest in medium (201-499 beds) and large (≥500 beds) hospitals in the Central region. Most patients did not report international travel (66%) nor receipt of medical care abroad (74%). Travel and receipt of medical care were less commonly reported among blaKPC associated cases (7.1% and 5.3% respectively) compared to blaNDM (55% and 45% respectively) and blaOXA-48 (57% and 39%) associated cases. Furthermore, blaKPC was the predominant carbapenemase among all HA-CPE isolates (62%, 950/1,534).
Conclusions: Surveillance data from a national network of Canadian acute care hospitals indicates that while the incidence of CPE in Canada remains low, it is accelerating at an exponential rate. Our findings suggest that nosocomial transmission is driving the recent increase in CPE incidence in Canada. Improved infection control measures and antimicrobial stewardship as well as access to newer antimicrobials are all urgently needed.
期刊介绍：
Antimicrobial Resistance and Infection Control is a global forum for all those working on the prevention, diagnostic and treatment of health-care associated infections and antimicrobial resistance development in all health-care settings. The journal covers a broad spectrum of preeminent practices and best available data to the top interventional and translational research, and innovative developments in the field of infection control.
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