Though the rate of MDR S. pneumoniae has remained relatively stable since 2007, XDR strains have emerged in Canada. These strains are virulent, possess resistance determinants and are related to international clones.

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to mothers younger than 19 years old. 1 More than 80% of adolescent pregnancies, however, are unplanned and many end in termination. 2 The Canadian Pediatric Society recommends quick-start methods of contraception and year-long prescriptions to decrease unplanned pregnancies and increase continuation rates. 3 2 Adolescents face multiple barriers when accessing contraception Many adolescents have concerns with their ability to pay for contraceptives and express difficulty accessing confidential contraceptive care. 2 Clin icians should emphasize the benefits of physician-patient confidentiality while explaining the exceptions, including the need to disclose selfharm and activities occurring in a position of vulnerability.This article has been peer reviewed.