Trends in antimicrobial resistance over 10 years among key bacterial pathogens from Canadian hospitals: results of the CANWARD study 2007–16

Abstract

Objectives We sought to analyse 10 years of longitudinal surveillance data (2007–16) from the CANWARD study and describe emerging trends in antimicrobial resistance for key bacterial pathogens across Canada. Methods Longitudinal data from CANWARD study sites that contributed isolates every year from 2007 to 2016 were analysed to identify trends in antimicrobial resistance over time using univariate tests of trend and multivariate regression models to account for the effects of patient demographics. Results Statistically significant increases occurred in the proportion of Escherichia coli isolates resistant to extended-spectrum cephalosporins, amoxicillin/clavulanate, trimethoprim/sulfamethoxazole and ciprofloxacin. Similarly, the proportion of Klebsiella pneumoniae isolates resistant to extended-spectrum cephalosporins, amoxicillin/clavulanate, trimethoprim/sulfamethoxazole, ciprofloxacin and carbapenems increased during the study. The proportion of Enterobacter cloacae isolates resistant to ceftazidime and trimethoprim/sulfamethoxazole increased. The proportion of both ESBL-positive E. coli and K. pneumoniae (including bloodstream isolates) increased significantly between 2007 and 2016. A reduction in the proportion of Pseudomonas aeruginosa that were ciprofloxacin, cefepime, colistin, amikacin and gentamicin resistant and an increase in the proportion of P. aeruginosa isolates non-susceptible to meropenem were observed. The proportion of isolates of Staphylococcus aureus non-susceptible to clarithromycin, clindamycin and trimethoprim/sulfamethoxazole decreased over time while an increase in the proportion of isolates of Streptococcus pneumoniae non-susceptible to clarithromycin, clindamycin and doxycycline was observed. Conclusions Increases in Enterobacteriaceae resistance to multiple classes of antimicrobials, increases in ESBL-positive E. coli and K. pneumoniae, and the small but significant increase in carbapenem-resistant K. pneumoniae were the most remarkable changes in antimicrobial resistance observed from 2007 to 2016 in Canada.

Global colistin use: a review of the emergence of resistant Enterobacterales and the impact on their genetic basis

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Antimicrobial Resistance Surveillance in Low- and Middle-Income Countries: Progress and Challenges in Eight South Asian and Southeast Asian Countries

“…The Canadian Antimicrobial Resistance Alliance (CARA) has been reporting AMR surveillance data from all specimens since 2009 (http://www.can-r.com/index.php). CARA collects AMR data from 10 to 15 hospital sites from eight provinces across Canada (139). In 2017, carbapenem (meropenem) resistance among A. baumannii was 6.3%, whereas carbapenem (imipenem) resistance among P. aeruginosa was 22.8% (http://www.can-r.com/index.php).…”

Pseudomonas Aeruginosa İzolatlarinin Anti̇bi̇yoti̇k Di̇renci̇ Ve Yillar İçi̇ndeki̇ Deği̇şi̇mi̇

“…Düzce'de 2011-2013 yılları arası direnç oranlarının değerlendirildiği bir çalışmada imipenem, piperasilin/tazobaktam, siprofloksasin ve sefoperazon/sulbaktam, Manisa'da 2013-2016 yılları arasında yapılan çalışmada seftazidime ve Bolu'da 2015-2017 yılları arasında yapılan bir çalışmada ise sefepim ve aztreonama karşı direnç artışı gözlenmiştir (1,9,23) . Kanada'da çok merkezli yapılan CANWARD çalışmasının 2007-2016 sonuçlarına göre siprofloksasin, sefepim, kolistin, amikasin ve gentamisin dirençli P.aeruginosa oranında bir azalma ve meropeneme duyarlı olmayan izolatlarının oranında bir artış gözlenmiştir (11) . Çalışmamızda 2017-2021 yılı direnç oranları değerlendirildiğinde beş yıllık süreçte tüm antibiyotiklerin dirençlerinin yıllar içinde farklılık gösterdiği görülmüştür.…”