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Resistance to key antimicrobials declining in Canada

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WASHINGTON, D.C. — Resistance to widely-used antimicrobials has decreased in several pathogens over the past 7 years in Canada, including Pseudomonas aeruginosa, Staphylococcus aureus and MRSA, according to a large-scale epidemiological surveillance study presented at ICAAC 2014.

However, resistance in Escherichia coli and Klebsiella pneumoniae has increased over the same period, researchers said.

The researchers examined data from the Canadian Ward Surveillance Study (CANWARD), a national surveillance study assessing antimicrobial resistance in Canadian hospitals. A total of 18 tertiary-care centers from across the country submitted over 33,000 pathogenic isolates taken from patients in hospital clinics, emergency departments, medical and surgical wards and ICUs from 2007 to 2013. The isolates were tested for resistance to 18 different antimicrobials.

Results indicated resistance to several key antimicrobials decreased for P. aeruginosa, S. aureus and MRSA. During the study period, ciprofloxacin resistance in P. aeruginosa decreased from 34% to 19.4%; clindamycin resistance in S. aureus decreased from 22.8% to 10.5%; and MRSA decreased from 26.1% to 20.1%.  

The researchers observed an increase in infections from extended-spectrum beta-lactamase (ESBL)–producing E. coli, from 3.5% in 2007 to 9.5% in 2013. Ciprofloxacin resistance also increased in E. coli, from 20.7% to 24.9%. ESBL-producing K. pneumoniae increased from 1.6% to 5.7%.

 

Philippe Lagacé-Wiens

Based on these findings, efforts to reduce antimicrobial resistance should now focus on E. coli and K. pneumoniae, according to the researchers. However, clinicians should remain vigilant for the emergence of other antibiotic-resistant pathogens, they said.

“Multidrug resistance is the rise in bacteria that commonly cause urinary tract infections,” presenter Philippe Lagacé-Wiens, MD, medical microbiologist at Saint-Boniface Hospital and assistant professor of medical microbiology and infectious disease at the University of Manitoba, Canada, told Infectious Disease News. “Oral treatment options are extremely limited for these infections and clinicians should culture urine on patients that respond poorly to treatment.” — John Schoen

Philippe Lagacé-Wiens, MD, can be reached at L4025-409 Taché Ave., Winnipeg, Manitoba, R2H 2A6, Canada; email: plagacewiens@dsmanitoba.ca.

For more information:

Lagacé-Wiens P. Abstract C-112. Presented at: Interscience Conference on Antimicrobial Agents and Chemotherapy; Sept. 5-9, 2014; Washington, D.C.

Disclosure: Lagacé-Wiens reports no relevant financial disclosures. Other study authors report research relationships with various pharmaceutical companies. See the ICAAC website for a full list of relevant financial disclosures.