No abstract

he increase in antimicrobial-resistant organisms has reached alarming proportions. The Public Health Agency of Canada has stated that antimicrobial resistance is an increasingly serious threat to global public health. 1 The World Health Organization identified 12 bacterial groups that are of great concern. 2 The Centers for Disease Control and Prevention identified 18 microorganisms that pose urgent, serious and concerning threats. 3 Enterobacteriaceae that produce extended-spectrum β-lactamase (ESBL) are included on their lists as a "Priority 1: Critical" organism 2 or a "serious threat." 3 Within the Enterobacteriaceae, ESBL-producing Escherichia coli is a frequent cause of infection, with bloodstream infections being associated with substantial mortality rates (14%-30%). 4-6 Extendedspectrum β-lactamases are enzymes that are capable of hydrolyzing most β-lactam antimicrobials, and the plasmids on which they are transported frequently contain other resistance genes. 7,8 This leaves few treatments available to physicians and increases the likelihood of E. coli's developing resistance to all available drugs. The prevalence of ESBL production among E. coli isolates has increased worldwide and varies between regions. Rates as high as 70% have been reported in regions in Southeast Asia. 9,10 There is a paucity of recent published Canadian data.