Volume 24, Number 9—September 2018
Research
Emergence of Carbapenemase-Producing Enterobacteriaceae, South-Central Ontario, Canada1
Table 1
Characteristic | No. (%) |
||||
---|---|---|---|---|---|
All patients, n = 258 | Escherichia coli, n = 86 | Klebsiella pneumoniae, n = 122 | Enterobacter spp., n = 30 | Other,† n = 20 | |
Isolate source‡ | |||||
Only screening | 115 (45) | 58 (67) | 47 (39) | 6 (20) | 4 (20) |
>1 clinical |
149 (58) |
30 (35) |
79 (65) |
24 (80) |
16 (80) |
Positive specimen types at first identification§ | |||||
Rectal or colostomy | 138 (54) | 61 (71) | 64 (53) | 9 (30) | 4 (20) |
Urine | 89 (35) | 19 (22) | 52 (43) | 11 (37) | 7 (35) |
Blood | 21 (8) | 4 (5) | 9 (7) | 3 (10) | 5 (25) |
Wound | 15 (6) | 2 (2) | 10 (8) | 1 (3.3) | 2 (10) |
Sputum or broncoalveolar lavage | 12 (5) | 1 (1) | 6 (5) | 3 (10) | 2 (10) |
Other |
17 (7) |
4 (5) |
5 (4) |
6 (20) |
2 (10) |
Infection‡ | |||||
Any | 92 (36) | 21¶ (24) | 46 (38) | 13 (43) | 12 (60) |
Urinary tract | 75 (29) | 19 (22) | 46 (38) | 6 (20) | 4 (20) |
Pneumonia | 13 (5) | 4 (5) | 3 (3) | 4 (13) | 2 (10) |
Other# | 13 (5) | 3 (4) | 5 (4) | 3 (10) | 2 (15) |
Primary bacteremia** | 13 (5) | 2 (2) | 4 (3) | 2 (7) | 1 (5) |
*Among first patient isolates; sums of specimen types exceed the number of patients because >1 specimen type may have yielded carbapenemase-producing Enterobacteriaceae.
†Citrobacter spp. (n = 7), Morganella morganii (n = 4), Serratia marcescens (n = 4), Klebsiella oxytoca (n = 3), Providencia rettgeri (n = 1), Proteus mirabilis (n = 1).
‡Including all follow-up isolates available and all infections during the patients' hospitalization.
§Including isolates from all specimens obtained within 2 days of the first positive specimen.
¶One patient originally colonized with a carbapenemase-producing E. coli subsequently experienced an infection with a carbapenemase-producing Enterobacter cloacae.
#Includes 7 skin or soft tissue infections, 5 bone or joint infections, and 1 abdominal infection.
**Patients with secondary bacteremia were classified according to their primary source of infection (urinary tract [n = 12] and pneumonia [n = 6]). Two bacteremic patients had both urinary tract infection and pneumonia diagnosed.
1Preliminary results from this study were presented at IDWeek, October 26–30, 2016, New Orleans, Louisiana, USA.
2Current affiliation: Cantonal Hospital, St. Gallen, Switzerland.
3Additional members are listed at the end of this article.