Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2024 Jul 19;9(2):104-107.
doi: 10.3138/jammi-2023-0037. eCollection 2024 Jun.

Epidemiology of Carbapenemase-Producing Enterobacterales Carriage in a Paediatric Tertiary Health Care Centre of Ontario, Canada

Ana C Blanchard  1 , Stephanie Zahradnik  2 , Sandra Isabel  2 , Kayur Mehta  2 , Mohsin Ali  2 , Adriana Airo  3 , Laurie Streitenberger  2   4 , Renee Freeman  2   4 , Yvonne Cw Yau  3 , Aaron Campigotto  3 , Manal Tadros  3 , Michelle Science  2   4
Affiliations

Epidemiology of Carbapenemase-Producing Enterobacterales Carriage in a Paediatric Tertiary Health Care Centre of Ontario, Canada

Ana C Blanchard et al. J Assoc Med Microbiol Infect Dis Can. .

Abstract
in English, French

Introduction: 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.

Methods: 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.

Results: 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.

Discussion: 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.

Historique: On connait mal l’épidémiologie des entérobactéries productrices de carbépénémase (EPC) chez les enfants hospitalisés en milieu à faible endémicité. Les chercheurs l'ont décrite dans un grand centre de soins tertiaires pédiatriques du Canada.

Méthodologie: Les chercheurs ont repris une étude de prévalence ponctuelle incluant tous les patients de The Hospital for Sick Children de Toronto pour procéder à une surveillance sérielle sur une période de trois jours en avril 2017, en avril 2019 et en avril 2022. Les patients à l'urgence et aux unités de jour étaient exclus. Les chercheurs ont analysé des écouvillons de selle ou rectaux pour déceler les EPC et demandé des tests de confirmation au laboratoire de référence provincial.

Résultats: Les chercheurs ont décelé une colonisation par des EPC chez 0,4 % (n = 1 sur 242), 0,7 % (n = 2 sur 278) et 0,9 % (n = 2 sur 220) des patients hospitalisés en 2017, 2019 et 2022, respectivement. Les EPC identifiés incluaient des bêta-lactamases pseudo-OXA-48 et des bêta-lactamases NDM dans l’E. coli et le K. pneumoniae. Tous les patients colonisés par les EPC avaient voyagé ou été hospitalisés à l'extérieur du Canada, y compris au Moyen-Orient et en Asie.

Conclusions: Les chercheurs ont décelé une colonisation par des EPC chez des enfants hospitalisés dans des hôpitaux canadiens. Un voyage prolongé ou une hospitalisation hors du Canada sont des facteurs de risque qui devraient être envisagés dans le cadre de programmes de dépistage ciblés.

Keywords: carbapenemase-producing Enterobacterales; epidemiology; infection prevention and control; paediatrics.

PubMed Disclaimer

Conflict of interest statement

The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this article.

References

    1. WHO publishes list of bacteria for which new antibiotics are urgently needed. Geneva: World Health Organization, 2017; https://www.who.int/news/item/27-02-2017-who-publishes-list-of-bacteria-... (Accessed January 10, 2023)
    1. Ara-Montojo MF, Escosa-García L, Alguacil-Guillén M, et al. Predictors of mortality and clinical characteristics among carbapenem-resistant or carbapenemase-producing Enterobacteriaceae bloodstream infections in Spanish children. J Antimicrob Chemother. 2021;76(1):220–5. - PubMed
    1. Guidance: Infection prevention and control measures for healthcare workers in all healthcare settings: carbapenem-resistant gram-negative bacilli. Public Health Agency of Canada, 2010; https://www.canada.ca/en/public-health/services/infectious-diseases/noso... (Accessed January 10, 2023)
    1. Centers for Disease Control and Prevention. Guidance for control of infections with carbapenem-resistant or carbapenemase-producing Enterobacteriaceae in acute care facilities. MMWR Morb Mortal Wkly Rep. 2009;58(10):256–60. - PubMed
    1. Yan L, Sun J, Xu X, et al. Epidemiology and risk factors of rectal colonization of carbapenemase-producing Enterobacteriaceae among high-risk patients from ICU and HSCT wards in a university hospital. Antimicrob Resist Infect Control. 2020;9(1):155. - PMC - PubMed

LinkOut - more resources