Format

Send to

Choose Destination
See comment in PubMed Commons below
J Clin Microbiol. 2016 Feb;54(2):317-27. doi: 10.1128/JCM.02289-15. Epub 2015 Nov 25.

Epidemiologic and Genotypic Review of Carbapenemase-Producing Organisms in British Columbia, Canada, between 2008 and 2014.

Author information

1
British Columbia Center for Disease Control Public Health Laboratory, Provincial Health Services Authority, Vancouver, British Columbia, Canada Department of Pathology and Laboratory Medicine, The University of British Columbia, Vancouver, British Columbia, Canada.
2
British Columbia Center for Disease Control Public Health Laboratory, Provincial Health Services Authority, Vancouver, British Columbia, Canada.
3
Public Health Agency of Canada, Winnipeg, Manitoba, Canada.
4
Department of Pathology and Laboratory Medicine, The University of British Columbia, Vancouver, British Columbia, Canada Surrey Memorial Hospital, Fraser Health Authority, Surrey, British Columbia, Canada.
5
Department of Pathology and Laboratory Medicine, The University of British Columbia, Vancouver, British Columbia, Canada Royal Jubilee Hospital, Vancouver Island Health Authority, Victoria, British Columbia, Canada.
6
Department of Pathology and Laboratory Medicine, The University of British Columbia, Vancouver, British Columbia, Canada Vancouver General Hospital, Vancouver Coastal Health, Vancouver, British Columbia, Canada.
7
Department of Pathology and Laboratory Medicine, The University of British Columbia, Vancouver, British Columbia, Canada St. Paul's Hospital, Providence Health Care, Vancouver, British Columbia, Canada.
8
British Columbia Center for Disease Control Public Health Laboratory, Provincial Health Services Authority, Vancouver, British Columbia, Canada Department of Pathology and Laboratory Medicine, The University of British Columbia, Vancouver, British Columbia, Canada linda.hoang@bccdc.ca.

Abstract

Carbapenemase-producing organisms (CPOs) are a serious emerging problem for health care facilities worldwide. Owing to their resistance to most antimicrobial therapies, CPOs are difficult to treat and pose a challenge for infection prevention and control. Since 2010, lab-based surveillance for CPOs and PCR-based testing were implemented in British Columbia (BC), Canada. A review of CPOs in BC from 2008 to March 2014 was done to characterize the resistance mechanisms and possible clonal strain transmission and to compare pulsed-field gel electrophoresis (PFGE), multilocus sequence typing (MLST), and plasmid restriction fragment length polymorphism (RFLP) as molecular typing tools. During this study period, a total of 177 CPO cases were identified. Patient demographics and travel history were reviewed, and a descriptive analysis was carried out. PFGE profiles, MLST, and plasmid RFLP analysis for a subset of Escherichia coli, Klebsiella pneumoniae, and Enterobacter species isolates were obtained and analyzed. Our findings demonstrate that CPOs have been increasing in number in BC over time, from 1 isolate/year retrospectively identified in 2008 and 2009 to 82 isolates in 2013 and 30 isolates in the first quarter of 2014. Overall, K. pneumoniae isolates lack clonality, although some seemingly related clusters have been found. Plasmid analysis showed evidence of the spread of plasmids carrying carbapenemase-encoding genes between the examined isolates. Analysis of Enterobacter cloacae isolates revealed a more clonal nature of these CPOs in BC. The presence of related clusters provides evidence of interpatient organism transmission both within and between institutions. Although in our study, NDM-harboring E. cloacae isolates appeared to spread clonally, the spread of carbapenem resistance in K. pneumoniae seems to be plasmid mediated.

PMID:
26607987
PMCID:
PMC4733174
DOI:
10.1128/JCM.02289-15
[Indexed for MEDLINE]
Free PMC Article
PubMed Commons home

PubMed Commons

0 comments
How to join PubMed Commons

    Supplemental Content

    Full text links

    Icon for HighWire Icon for PubMed Central
    Loading ...
    Support Center