Emergence of Carbapenemase-Producing Enterobacteriaceae, South-Central Ontario, Canada1
Philipp P. Kohler2
, Roberto G. Melano, Samir N. Patel, Shumona Shafinaz, Amna Faheem, Brenda L. Coleman, Karen Green, Irene Armstrong, Huda Almohri, Sergio Borgia, Emily Borgundvaag, Jennie Johnstone, Kevin Katz, Freda Lam, Matthew P. Muller, Jeff Powis, Susan M. Poutanen, David Richardson, Anu Rebbapragada, Alicia Sarabia, Andrew Simor, Allison McGeer, and for the Toronto Invasive Bacterial Diseases Network (TIBDN)
Author affiliations: Sinai Health System, Toronto, Ontario, Canada (P.P. Kohler, S. Shafinaz, A. Faheem, B.L. Coleman, K. Green, E. Borgundvaag, S.M. Poutanen, A. McGeer); Public Health Ontario Laboratories, Toronto (R.G. Melano, S.N. Patel); University of Toronto, Toronto (R.G. Melano, S.N. Patel, B.L. Coleman, I. Armstrong, J. Johnstone, K. Katz, M.P. Muller, J. Powis, S.M. Poutanen, A. Sarabia, A. Simor, A. McGeer); Toronto Public Health, Toronto (I. Armstrong); LifeLabs, Toronto (H. Almohri); McMaster University, Hamilton, Ontario, Canada (S. Borgia); William Osler Health System, Brampton, Ontario, Canada (S. Borgia, D. Richardson); St. Joseph’s Health Centre, Toronto (J. Johnstone); Public Health Ontario, Toronto (J. Johnstone, K. Katz, F. Lam); North York General Hospital, Toronto (K. Katz); St. Michael’s Hospital, Toronto (M.P. Muller); Toronto East Health Network, Toronto (J. Powis); University Health Network, Toronto (S.M. Poutanen); Dynacare, Brampton (A. Rebbapragada); Trillium Health Partners, Toronto and Mississauga, Ontario, Canada (A. Sarabia); Sunnybrook Health Sciences Centre, Toronto (A. Simor)
Figure 2. Healthcare visits abroad and travel history in patients with carbapenemase-producing Enterobacteriaceae infection in the 1 year before detection, stratified by type of carbapenemase, Metropolitan Toronto and the Regional Municipality of Peel, south-central Ontario, Canada, 2007–2015. Patients who traveled to any location other than the Indian subcontinent were classified as low-risk travel and indicated as no high-risk travel in the graph. n values indicate number of patients. KPC, Klebsiella pneumoniae carbapenemase; NDM, New Delhi metallo-β-lactamase; OXA-48, oxacillinase 48; VIM, Verona integron-encoded metallo-β-lactamase.
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