Emergence of Carbapenemase-Producing Enterobacteriaceae, South-Central Ontario, Canada1 Academic Article uri icon

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  • We analyzed population-based surveillance data from the Toronto Invasive Bacterial Diseases Network to describe carbapenemase-producing Enterobacteriaceae (CPE) infections during 2007-2015 in south-central Ontario, Canada. We reviewed patients' medical records and travel histories, analyzed microbiologic and clinical characteristics of CPE infections, and calculated incidence. Among 291 cases identified, New Delhi metallo-β-lactamase was the predominant carbapenemase (51%). The proportion of CPE-positive patients with prior admission to a hospital in Canada who had not received healthcare abroad or traveled to high-risk areas was 13% for patients with oxacillinase-48, 24% for patients with New Delhi metallo-β-lactamase, 55% for patients with Klebsiella pneumoniae carbapenemase, and 67% for patients with Verona integron-encoded metallo-β-lactamase. Incidence of CPE infection increased, reaching 0.33 cases/100,000 population in 2015. For a substantial proportion of patients, no healthcare abroad or high-risk travel could be established, suggesting CPE acquisition in Canada. Policy and practice changes are needed to mitigate nosocomial CPE transmission in hospitals in Canada.


  • Kohler, Philipp P
  • Melano, Roberto G
  • Patel, Samir N
  • Shafinaz, Shumona
  • Faheem, Amna
  • Coleman, Brenda L
  • Green, Karen
  • Armstrong, Irene
  • Almohri, Huda
  • Borgia, Sergio
  • Borgundvaag, Emily
  • Johnstone, Jennie
  • Katz, Kevin
  • Lam, Freda
  • Muller, Matthew P
  • Powis, Jeff
  • Poutanen, Susan M
  • Richardson, David
  • Rebbapragada, Anu
  • Sarabia, Alicia
  • Simor, Andrew
  • McGeer, Allison

publication date

  • September 2018

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