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Walkty A, Karlowsky J, Golden A, Lagace-Wiens P, Baxter M, Denisuik A, McCracken M, Mulvey M, Adam H, Zhanel G. 668. Presence of the Narrow-Spectrum OXA-1 Beta-Lactamase Enzyme is not Associated with Elevated Ceftolozane-Tazobactam MIC Values among ESBL-Producing Escherichia coli Clinical Isolates (CANWARD, 2011-2018). Open Forum Infect Dis 2022. [PMCID: PMC9752124 DOI: 10.1093/ofid/ofac492.720] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
Background Beta-lactam-beta-lactamase inhibitor combinations have been proposed as an alternative to carbapenems for the treatment of infections caused by extended-spectrum beta-lactamase (ESBL)-producing Escherichia coli as an antimicrobial stewardship initiative. However, in a recent randomized trial evaluating patients with bacteremia, presence of the narrow spectrum OXA-1 beta-lactamase enzyme among ESBL-producing Enterobacterales was associated with higher piperacillin-tazobactam MICs, and in turn excess mortality among patients treated with piperacillin-tazobactam relative to meropenem. The purpose of this study was to determine whether the in vitro activity of ceftolozane-tazobactam versus ESBL-producing E. coli is similarly compromised by the presence of OXA-1. Methods E. coli clinical isolates were obtained from patients evaluated at hospitals across Canada (January 2011 to December 2018) as part of an ongoing national surveillance study (CANWARD). ESBL production was confirmed using the Clinical and Laboratory Standards Institute phenotypic method. Susceptibility testing was carried out using custom broth microdilution panels, and all isolates underwent whole genome sequencing for beta-lactamase gene detection. Results In total, 485 ESBL-producing E. coli identified as part of the CANWARD study were included. The majority of isolates (91.3%; 443/485) harbored a CTX-M ESBL enzyme. OXA-1 was present in 39.6% (192/485) of isolates. OXA-1 was detected in 62.5% (187/299) of isolates with a CTX-M-15 ESBL enzyme versus only 2.7% (5/186) of isolates with other ESBL enzyme types. Ceftolozane-tazobactam MIC50 and MIC90 values were identical (0.25 µg/mL and 1 µg/mL, respectively) for the isolate subsets with and without OXA-1. Overall, 97.4% and 96.9% of isolates with and without OXA-1 remained susceptible (CLSI breakpoint) to ceftolozane-tazobactam. Conclusion The presence of OXA-1 among ESBL-producing E. coli clinical isolates was not associated with an elevation in MIC values for ceftolozane-tazobactam. These data support further evaluation of ceftolozane-tazobactam as an alternative to carbapenems for the treatment of infections caused by ESBL-producing E. coli, as is being done with the MERINO-3 trial. Disclosures George Zhanel, PhD, Merck: Grant/Research Support.
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Affiliation(s)
| | | | | | | | | | | | | | - Michael Mulvey
- National Microbiology Laboratory, Winnipeg, Manitoba, Canada
| | - Heather Adam
- University of Manitoba, Winnipeg, Manitoba, Canada
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Walkty A, Karlowsky JA, Lagace-Wiens P, Baxter MR, Adam HJ, Zhanel GG. Antimicrobial resistance patterns of bacterial pathogens recovered from the urine of patients at Canadian hospitals from 2009 to 2020. JAC Antimicrob Resist 2022; 4:dlac122. [PMID: 36466136 PMCID: PMC9710733 DOI: 10.1093/jacamr/dlac122] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2022] [Accepted: 11/13/2022] [Indexed: 12/05/2022] Open
Abstract
Objectives To investigate in vitro susceptibility patterns of bacterial pathogens recovered from the urine of outpatients (isolates from outpatient clinics or emergency departments) and hospital inpatients across Canada from 2009 to 2020 as part of the CANWARD study. Methods Canadian hospital microbiology laboratories submitted bacterial pathogens cultured from urine to the CANWARD study coordinating laboratory on an annual basis (January 2009 to December 2020). Antimicrobial susceptibility testing was performed by CLSI broth microdilution, with MICs interpreted by current CLSI breakpoints. Results In total, 4644 urinary pathogens were included in this study. Escherichia coli was recovered most frequently (53.3% of all isolates), followed by Enterococcus faecalis, Klebsiella pneumoniae, Proteus mirabilis, Pseudomonas aeruginosa and Staphylococcus aureus. Together, these six species accounted for 84.2% of study isolates. Nitrofurantoin demonstrated excellent in vitro activity versus E. coli, with 97.6% of outpatient and 96.1% of inpatient isolates remaining susceptible. In contrast, E. coli susceptibility rates were lower for ciprofloxacin (outpatient 79.5%, inpatient 65.9%) and trimethoprim/sulfamethoxazole (outpatient 75.2%, inpatient 73.5%). The percentage of E. coli isolates that were phenotypically positive for ESBL production significantly increased from 4.2% (2009-11) to 11.3% (2018-20). A similar although less pronounced temporal trend was observed with ESBL-producing K. pneumoniae. Conclusions E. coli was the pathogen most frequently recovered from the urine of Canadian patients, and the proportion of isolates that were ESBL producers increased over time. Susceptibility data presented here suggest that ciprofloxacin and trimethoprim/sulfamethoxazole may be suboptimal for the empirical treatment of complicated urinary infections.
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Affiliation(s)
- Andrew Walkty
- Max Rady College of Medicine, University of Manitoba, 502 Basic Medical Sciences Building, 745 Bannatyne Avenue, Winnipeg R3E 0J9, Manitoba, Canada,Shared Health, Winnipeg, Manitoba, Canada
| | - James A Karlowsky
- Max Rady College of Medicine, University of Manitoba, 502 Basic Medical Sciences Building, 745 Bannatyne Avenue, Winnipeg R3E 0J9, Manitoba, Canada,Shared Health, Winnipeg, Manitoba, Canada
| | - Philippe Lagace-Wiens
- Max Rady College of Medicine, University of Manitoba, 502 Basic Medical Sciences Building, 745 Bannatyne Avenue, Winnipeg R3E 0J9, Manitoba, Canada,Shared Health, Winnipeg, Manitoba, Canada
| | - Melanie R Baxter
- Max Rady College of Medicine, University of Manitoba, 502 Basic Medical Sciences Building, 745 Bannatyne Avenue, Winnipeg R3E 0J9, Manitoba, Canada
| | - Heather J Adam
- Max Rady College of Medicine, University of Manitoba, 502 Basic Medical Sciences Building, 745 Bannatyne Avenue, Winnipeg R3E 0J9, Manitoba, Canada,Shared Health, Winnipeg, Manitoba, Canada
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Walkty A, Karlowsky J, Lagace-Wiens P, Golden A, Baxter M, Denisuik A, McCracken M, Mulvey M, Adam H, Zhanel G. 1216. Presence of the Narrow-Spectrum OXA-1 Beta-lactamase Enzyme Is Associated with Elevated Piperacillin-Tazobactam MIC Values Among ESBL-producing Escherichia coli Clinical Isolates (CANWARD, 2007-2018). Open Forum Infect Dis 2021. [PMCID: PMC8644077 DOI: 10.1093/ofid/ofab466.1408] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open
Abstract
Background The clinical outcome of patients with bacteremia due to an extended-spectrum beta-lactamase (ESBL)-producing member of the family Enterobacteriaceae who are treated with piperacillin-tazobactam appears to depend, at least in part, on the piperacillin-tazobactam MIC. The purpose of this study was to determine whether there is any association between the MIC of piperacillin-tazobactam and presence of the narrow spectrum OXA-1 beta-lactamase enzyme among ESBL-producing Escherichia coli. Methods E. coli clinical isolates were obtained from patients evaluated at hospitals across Canada (January 2007 to December 2018) as part of an ongoing national surveillance study (CANWARD). ESBL production was confirmed using the Clinical and Laboratory Standards Institute phenotypic method. Susceptibility testing was carried out using custom broth microdilution panels, and all isolates underwent whole genome sequencing for beta-lactamase gene detection. Results In total, 671 ESBL-producing E. coli were identified as part of the CANWARD study. The majority of isolates (92.0%; 617/671) harbored a CTX-M ESBL enzyme. CTX-M-15 (62.3%; 418/671), CTX-M-27 (13.9%; 93/671), and CTX-M-14 (13.4%; 90/671) were the most common variants identified. The narrow spectrum OXA-1 beta-lactamase enzyme was present in 42.6% (286/671) of isolates. OXA-1 was detected in 66.3% (277/418) of isolates with a CTX-M-15 ESBL enzyme versus only 3.6% (9/253) of isolates with other ESBL enzyme types. The piperacillin-tazobactam MIC50 and MIC90 values were 8 µg/mL and 32 µg/mL for isolates that possessed the OXA-1 enzyme versus 2 μg/mL and 8 µg/mL for those that did not. The percentage of ESBL-producing E. coli isolates that were inhibited by a piperacillin-tazobactam MIC of ≤8 μg/mL was 68.5% for isolates that were OXA-1 positive and 93.8% for isolates that were OXA-1 negative. Conclusion The MIC50 and MIC90 values of piperacillin-tazobactam among ESBL-producing E. coli were higher for the subset of isolates that harbored a narrow spectrum OXA-1 beta-lactamase enzyme relative to the subset that did not. This association was primarily observed among ESBL-producers with the CTX-M-15 enzyme variant. OXA-1 was infrequently detected among isolates with other ESBL enzyme types. Disclosures George Zhanel, PhD, AVIR (Grant/Research Support)Iterum (Grant/Research Support)Merck (Grant/Research Support)Pfizer (Grant/Research Support)Sandoz (Grant/Research Support)Sunovion (Grant/Research Support)Venatorx (Grant/Research Support)Verity (Grant/Research Support)
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Affiliation(s)
| | | | | | | | | | | | | | - Michael Mulvey
- National Microbiology Laboratory, Public Health Agency of Canada, Winnipeg, MB, Canada
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Walkty A, Karlowsky JA, Baxter MR, Adam HJ, Golden A, Lagace-Wiens P, Zhanel GG. In vitro activity of imipenem-relebactam against various resistance phenotypes/genotypes of Enterobacterales and Pseudomonas aeruginosa isolated from patients across Canada as part of the CANWARD study, 2016-2019. Diagn Microbiol Infect Dis 2021; 101:115418. [PMID: 34102373 DOI: 10.1016/j.diagmicrobio.2021.115418] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2020] [Revised: 03/15/2021] [Accepted: 04/26/2021] [Indexed: 10/21/2022]
Abstract
Broth microdilution was used to determine the in vitro activities of imipenem-relebactam and comparators versus 4260 Enterobacterales and 1324 Pseudomonas aeruginosa clinical isolates. Excluding Serratia marcescens, 96.7% to 100% of Enterobacterales species were susceptible to imipenem-relebactam. Susceptibility of P. aeruginosa isolates to imipenem-relebactam and imipenem was 91.3% and 59.1%, respectively.
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Affiliation(s)
- Andrew Walkty
- Department of Medical Microbiology and Infectious Diseases, Max Rady College of Medicine, University of Manitoba, Winnipeg, Canada; Clinical Microbiology, Shared Health, Winnipeg, Canada.
| | - James A Karlowsky
- Department of Medical Microbiology and Infectious Diseases, Max Rady College of Medicine, University of Manitoba, Winnipeg, Canada; Clinical Microbiology, Shared Health, Winnipeg, Canada
| | - Melanie R Baxter
- Department of Medical Microbiology and Infectious Diseases, Max Rady College of Medicine, University of Manitoba, Winnipeg, Canada
| | - Heather J Adam
- Department of Medical Microbiology and Infectious Diseases, Max Rady College of Medicine, University of Manitoba, Winnipeg, Canada; Clinical Microbiology, Shared Health, Winnipeg, Canada
| | - Alyssa Golden
- Department of Medical Microbiology and Infectious Diseases, Max Rady College of Medicine, University of Manitoba, Winnipeg, Canada
| | - Philippe Lagace-Wiens
- Department of Medical Microbiology and Infectious Diseases, Max Rady College of Medicine, University of Manitoba, Winnipeg, Canada; Clinical Microbiology, Shared Health, Winnipeg, Canada
| | - George G Zhanel
- Department of Medical Microbiology and Infectious Diseases, Max Rady College of Medicine, University of Manitoba, Winnipeg, Canada
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Walkty A, Adam H, Baxter M, Henni A, Lagace-Wiens P, Karlowsky J, Zhanel G. 128. Adequacy of Commonly Prescribed Antimicrobials for Empiric Coverage of Gram-Negative Bacterial Pathogens Recovered from the Bloodstream of Patients Attending Emergency Rooms in Canada: Analysis of Data from the CANWARD Study, 2007 to 2018. Open Forum Infect Dis 2019. [PMCID: PMC6809260 DOI: 10.1093/ofid/ofz360.203] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Background Inadequate empiric antimicrobial therapy for Gram-negative bacteremia is associated with adverse clinical outcomes. The purpose of this study was to evaluate the proportion of Gram-negative bacterial isolates recovered from the bloodstream of patients attending Canadian emergency rooms (ERs) that remain susceptible to commonly prescribed antimicrobials. Methods Annually from 2007 to 2018, sentinel hospitals across Canada collected bloodstream isolates from patients attending ERs as part of the CANWARD study. Susceptibility testing was performed using broth microdilution as described by CLSI (data analysis limited to Gram-negative bacteria in the top 10 pathogens), with current CLSI breakpoints applied. Extended-spectrum β-lactamase (ESBL)-producing isolates were confirmed using the CLSI disk diffusion method. Results Gram-negative bacteria among the top 10 bloodstream pathogens for patients seen at ERs across Canada were: Escherichia coli (n = 2,414), Klebsiella pneumoniae (n = 573), Pseudomonas aeruginosa (n = 211), Proteus mirabilis (n = 119), and Enterobacter cloacae (n = 114). Aggregate susceptibility of these isolates to common antimicrobials was as follows (% susceptible [S]): meropenem 99.4% S, piperacillin–tazobactam 98.5% S, gentamicin 93.3% S, ceftriaxone 88.1% S, ciprofloxacin 81.4% S, TMP-SMX 73.5% S. The most active antimicrobials evaluated vs. E. coli were meropenem (100% S), piperacillin–tazobactam (98.8% S), and ceftriaxone (93.3% S). Ceftriaxone susceptibility among E. coli isolates declined from 95.4% in 2007 to 89.8% in 2018. The average proportion of E. coli isolates that harbored an ESBL enzyme increased from 3.4% in the first three study years to 8.4% in the last three study years. The most active antimicrobials evaluated vs. K. pneumoniae isolates were meropenem (99.7% S), piperacillin–tazobactam (98.8% S), gentamicin (97.7% S), and ceftriaxone (96.9% S). Conclusion The most consistently active antimicrobials for empiric treatment of patients at Canadian ERs with Gram-negative bacteremia are meropenem and piperacillin–tazobactam. Ceftriaxone susceptibility among E. coli has declined over the last 12 years, mostly related to an increase in ESBL-producing isolates. Disclosures All authors: No reported disclosures.
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Affiliation(s)
| | | | | | - Amina Henni
- Max Rady Colleg of Medicine, University of Manitoba, Winnipeg, MB, Canada
| | | | | | - George Zhanel
- Max Rady Colleg of Medicine, University of Manitoba, Winnipeg, MB, Canada
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Walkty A, Adam H, Baxter M, Lagace-Wiens P, Karlowsky J, Zhanel G. 708. In Vitro Activity of Plazomicin vs. Clinical Isolates of Gram-Negative Bacilli, Including Aminoglycoside Nonsusceptible and Multidrug-Resistant Subsets, Recovered from Patients Across Canada as Part of the CANWARD study, 2011–2018. Open Forum Infect Dis 2019. [PMCID: PMC6810879 DOI: 10.1093/ofid/ofz360.776] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/05/2022] Open
Abstract
Background Plazomicin (PLZ) is a next-generation aminoglycoside currently approved by the US FDA for the treatment of complicated urinary tract infections, including pyelonephritis. The purpose of this study was to evaluate the in vitro activity of PLZ against a large collection of Gram-negative bacilli obtained from patients attending Canadian hospitals. Methods Annually from 2011 to 2018, sentinel hospitals across Canada submitted blood, respiratory, urine, and wound isolates from patients attending ERs, medical and surgical wards, hospital clinics, and ICUs (CANWARD). Susceptibility testing was performed using broth microdilution (and breakpoints) as described by CLSI (FDA breakpoints used for PLZ). Results See table. S, susceptible; NS, nonsusceptible; ESBL, extended-spectrum β-lactamase; MDR, multidrug-resistant (NS to antimicrobials from three or more classes); n.d., not defined. Conclusion PLZ demonstrated excellent in vitro activity vs. E. coli and K. pneumoniae clinical isolates, including aminoglycoside NS, ESBL-positive, and MDR subsets. ![]()
Disclosures All authors: No reported disclosures.
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Affiliation(s)
| | | | | | | | | | - George Zhanel
- Max Rady Colleg of Medicine, University of Manitoba, Winnipeg, MB, Canada
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7
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Righolt CH, Lagace-Wiens P, Mahmud SM. Prevalence, predictors, and consequences of inappropriate empiric antimicrobial therapy for complicated urinary tract and intra-abdominal infections in Winnipeg hospitals. Diagn Microbiol Infect Dis 2019; 96:114891. [PMID: 31668828 DOI: 10.1016/j.diagmicrobio.2019.114891] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2019] [Revised: 08/23/2019] [Accepted: 08/24/2019] [Indexed: 12/20/2022]
Abstract
Information on inappropriate empiric antimicrobial therapy (ET) in Canadian hospitals is scarce. All Manitobans 18 years of age and over who were admitted to a hospital in Winnipeg with a complicated urinary tract infection (cUTI) or complicated intra-abdominal infection (cIAI) from January 2006 to December 2014 were eligible for inclusion in this cohort study. The prevalence of inappropriate ET was 11% for cUTI patients and 9% for cIAI patients. The risk of receiving inappropriate ET was higher for older patients (cUTI patients 65 or older had 2-fold increased risk compared to younger patients; odds ratio 2.1, 95% confidence interval 1.3-3.6; this was 1.6 [0.7-3.5] for cIAI patients) and those hospitalized in the previous year: 1.5 (1.0-2.4) in cUTIs and 1.5 (0.6-3.4) in cIAIs. The risk for a hospital stay over 3 weeks was increased for inappropriate ET in cUTI patients, 2.3 (1.4-3.7), but not in cIAI patients, 0.9 (0.4-2.1).
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Affiliation(s)
- Christiaan H Righolt
- Vaccine and Drug Evaluation Centre, Department of Community Health Sciences, University of Manitoba, 337-750 McDermot Avenue, Winnipeg, MB, R3E 0T5, Canada
| | - Philippe Lagace-Wiens
- Diagnostic Services, Shared Health, Clinical Microbiology, Saint-Boniface Hospital, L4025-409 Taché Avenue, Winnipeg, MB, R2H 2A6
| | - Salaheddin M Mahmud
- Vaccine and Drug Evaluation Centre, Department of Community Health Sciences, University of Manitoba, 337-750 McDermot Avenue, Winnipeg, MB, R3E 0T5, Canada.
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Walkty A, Adam HJ, Baxter M, Lagace-Wiens P, Karlowsky J, Hoban D, Zhanel G. 2383. In Vitro Activity of Ceftolozane–Tazobactam in Comparison With Ceftazidime–Avibactam vs. Antimicrobial Non-Susceptible Pseudomonas aeruginosa Clinical Isolates, Including Multidrug-Resistant and Extensively Drug-Resistant Subsets: CANWARD, 2007–2017. Open Forum Infect Dis 2018. [PMCID: PMC6255566 DOI: 10.1093/ofid/ofy210.2036] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Background Methods Results Conclusion Disclosures
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Affiliation(s)
- Andrew Walkty
- Shared Health, Winnipeg, MB, Canada
- Medical Microbiology and Infectious Diseases, University of Manitoba, Winnipeg, MB, Canada
| | - Heather J Adam
- Shared Health, Winnipeg, MB, Canada
- Medical Microbiology and Infectious Diseases, University of Manitoba, Winnipeg, MB, Canada
| | - Melanie Baxter
- Medical Microbiology and Infectious Diseases, University of Manitoba, Winnipeg, MB, Canada
| | - Philippe Lagace-Wiens
- Shared Health, Winnipeg, MB, Canada
- Medical Microbiology and Infectious Diseases, University of Manitoba, Winnipeg, MB, Canada
| | - James Karlowsky
- Shared Health, Winnipeg, MB, Canada
- Medical Microbiology and Infectious Diseases, University of Manitoba, Winnipeg, MB, Canada
| | - Daryl Hoban
- Shared Health, Winnipeg, MB, Canada
- Medical Microbiology and Infectious Diseases, University of Manitoba, Winnipeg, MB, Canada
| | - George Zhanel
- Medical Microbiology and Infectious Diseases, University of Manitoba, Winnipeg, MB, Canada
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Walkty A, Baxter M, Adam HJ, Lagace-Wiens P, Karlowsky J, Zhanel G. In Vitro Activity of Newer Antimicrobials and Relevant Comparators Vs. 349 Stenotrophomonas maltophilia Clinical Isolates Obtained from Patients in Canadian Hospitals (CANWARD, 2011–2016). Open Forum Infect Dis 2017. [PMCID: PMC5631693 DOI: 10.1093/ofid/ofx163.899] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Background Stenotrophomonas maltophilia is a non-fermentative gram-negative bacillus that has emerged as an important opportunistic pathogen among hospitalized, debilitated patients. Treatment options for infections caused by this organism are limited because it is intrinsically resistant to antimicrobials from multiple different classes. The purpose of this study was to evaluate the in vitro activity of several newer antimicrobial agents (ceftazidime-avibactam [CZA], ceftolozane-tazobactam [C/T], moxifloxacin [MXF], tigecycline [TGC]) and relevant comparators [e.g., trimethoprim-sulfamethoxazole [TMP-SMX]) against a large collection of S. maltophilia clinical isolates obtained as part of an ongoing national surveillance study (CANWARD, 2011–2016). Methods From January 2011 to December 2016, inclusive, 12 to 15 sentinel hospitals across Canada submitted clinical isolates from patients attending ERs, medical and surgical wards, hospital clinics, and ICUs (CANWARD). Each center was asked to annually submit clinical isolates (consecutive, one per patient/infection site) from blood (100), respiratory (100), urine (25), and wound (25) infections. Susceptibility testing was performed using broth microdilution as described by CLSI. MICs were interpreted using CLSI breakpoints, where available. Results 349 S. maltophilia clinical isolates were obtained as a part of CANWARD (86% from a respiratory source). The susceptibility profile of these isolates is presented below. Conclusion TMP-SMX continues to demonstrate excellent in-vitro activity against S. maltophilia clinical isolates. MXF and TGC may also prove useful in the treatment of infections caused by this pathogen. Disclosures G. Zhanel, Achaogen: Research relationship, Research support Astellas: Research relationship, Research support Merck Canada: Research relationship, Research support Merck USA: Research relationship, Research support Paratek Pharma: Research relationship, Research support Pharmascience: Research relationship, Research support Sunovion: Research relationship, Research support Tetraphase: Research relationship, Research support The Medicines Co.: Research relationship, Research support Zoetis: Research relationship, Research support
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Affiliation(s)
- Andrew Walkty
- Diagnostic Services Manitoba, Winnipeg, MB, Canada
- Medical Microbiology, University of Manitoba, Winnipeg, MB, Canada
| | - Melanie Baxter
- Medical Microbiology, University of Manitoba, Winnipeg, MB, Canada
| | - Heather J Adam
- Diagnostic Services Manitoba, Winnipeg, MB, Canada
- Medical Microbiology, University of Manitoba, Winnipeg, MB, Canada
| | - Philippe Lagace-Wiens
- Diagnostic Services Manitoba, Winnipeg, MB, Canada
- Medical Microbiology, University of Manitoba, Winnipeg, MB, Canada
| | - James Karlowsky
- Diagnostic Services Manitoba, Winnipeg, MB, Canada
- Medical Microbiology, University of Manitoba, Winnipeg, MB, Canada
| | - George Zhanel
- Medical Microbiology, University of Manitoba, Winnipeg, MB, Canada
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Walkty A, Adam HJ, Baxter M, Lagace-Wiens P, Karlowsky J, Hoban D, Zhanel G. In Vitro Activity of Ceftolozane-Tazobactam vs. Antimicrobial Non-Susceptible Pseudomonas aeruginosa Clinical Isolates Obtained from Across Canada as Part of the CANWARD Study, 2008–2016. Open Forum Infect Dis 2017. [PMCID: PMC5630865 DOI: 10.1093/ofid/ofx163.913] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
Background Ceftolozane-tazobactam (C/T) is a novel β-lactam β-lactamase inhibitor combination with a broad spectrum of activity that includes Pseudomonas aeruginosa. The purpose of this study was to evaluate the in vitro activity of C/T and relevant comparators vs. a large collection of antimicrobial non-susceptible (NS) P. aeruginosa clinical isolates obtained from patients across Canada (CANWARD, 2008–2016). Methods From January 2008 to December 2016, inclusive, 12 to 15 sentinel hospitals across Canada submitted clinical isolates from patients attending ERs, medical and surgical wards, hospital clinics, and ICUs (CANWARD). Each center was asked to annually submit clinical isolates (consecutive, one per patient/infection site) from blood, respiratory, urine, and wound infections. Susceptibility testing was performed using broth microdilution as described by CLSI. Multidrug-resistant (MDR) P. aeruginosa were defined as isolates that tested NS to at least one antimicrobial from ≥3 classes. Extensively drug-resistant (XDR) P. aeruginosa were defined as isolates that tested NS to at least one antimicrobial from ≥5 classes. Results 3229 P. aeruginosa isolates were obtained as a part of CANWARD. The in vitro activity of C/T and relevant comparators is presented below. Conclusion C/T demonstrated excellent in vitro activity vs. antimicrobial NS P. aeruginosa clinical isolates, including MDR, XDR, and meropenem NS subsets. It may prove useful in the treatment of infections caused by these organisms. Disclosures D. Hoban, Abbott: Research relationship, Research support Achaogen: Research relationship, Research support Astellas: Research relationship, Research support Merck Canada: Research relationship, Research support Merck USA: Research relationship, Research support Paratek Pharma: Research relationship, Research support Pharmascience: Research relationship, Research support Sunovion: Research relationship, Research support Tetraphase: Research relationship, Research support The Medicines Co.: Research relationship, Research support Zoetis: Research relationship, Research support; G. Zhanel, Achaogen: Research relationship, Research support Astellas: Research relationship, Research support Merck Canada: Research relationship, Research support Merck USA: Research relationship, Research support Paratek Pharma: Research relationship, Research support Pharmascience: Research relationship, Research support Sunovion: Research relationship, Research support Tetraphase: Research relationship, Research support The Medicines Co.: Research relationship, Research support Zoetis: Research relationship, Research support
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Affiliation(s)
- Andrew Walkty
- Diagnostic Services Manitoba, Winnipeg, MB, Canada
- Medical Microbiology, University of Manitoba, Winnipeg, MB, Canada
| | - Heather J Adam
- Diagnostic Services Manitoba, Winnipeg, MB, Canada
- Medical Microbiology, University of Manitoba, Winnipeg, MB, Canada
| | - Melanie Baxter
- Medical Microbiology, University of Manitoba, Winnipeg, MB, Canada
| | - Philippe Lagace-Wiens
- Diagnostic Services Manitoba, Winnipeg, MB, Canada
- Medical Microbiology, University of Manitoba, Winnipeg, MB, Canada
| | - James Karlowsky
- Diagnostic Services Manitoba, Winnipeg, MB, Canada
- Medical Microbiology, University of Manitoba, Winnipeg, MB, Canada
| | - Daryl Hoban
- Diagnostic Services Manitoba, Winnipeg, MB, Canada
- Medical Microbiology, University of Manitoba, Winnipeg, MB, Canada
| | - George Zhanel
- Medical Microbiology, University of Manitoba, Winnipeg, MB, Canada
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Shaffelburg Z, Nichols M, Ye L, Andrew MK, Ambrose A, Boivin G, Bowie WR, Chit A, Santos GD, Elsherif M, Green K, Haguinet F, Halperin SA, Hatchette T, Ibarguchi B, Johnstone J, Katz K, Langley JM, Leblanc J, Lagace-Wiens P, Loeb M, Mackinnon-Cameron D, Mccarthy A, Mcelhaney J, Mcgeer A, Powis J, Richardson D, Semret M, Shinde V, Smith S, Smyth D, Taylor G, Trottier S, Valiquette L, Webster D, McNeil S. Impact of Antivirals in the Prevention of Serious Outcomes Associated with Influenza in Hospitalized Canadian Adults: A Pooled Analysis from the Serious Outcomes Surveillance (SOS) Network of the Canadian Immunization Research Network (CIRN). Open Forum Infect Dis 2017. [PMCID: PMC5631643 DOI: 10.1093/ofid/ofx162.046] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Background
Antiviral treatment of influenza in outpatient settings is associated with modest improvement in outcomes but benefit in inpatient settings remains unclear. We assessed the impact of antiviral treatment on the severe outcomes death and intensive care unit (ICU) admission and/or need for mechanical ventilation (MV) in hospitalized influenza patients.
Methods
Patients admitted to hospitals of the CIRN SOS Network with an acute respiratory illness from 2011/12–2013/14 who tested polymerase chain reaction (PCR) positive for influenza were included. Demographic and medical information were obtained from patient interview or the medical chart. Main outcomes of interest were ICU admission and/or need for MV, and death. Logistic regression with backwards stepwise selection was used to estimate odds ratios (ORs) and 95% confidence limits (CIs) for the association between antiviral use and severe outcomes overall, and stratified by time from symptom onset to antiviral start (<48hours, 48hours <5 days, 5–21 days).
Results
Over 3 influenza seasons, 4,679 patients were enrolled; 59% were aged ≥65 years, 52% were female, and 89% had a comorbidity. Influenza vaccination status was available for 4,019 (86%) patients, of whom 1,796 (45%) had received current season vaccine. Of 4,679 patients, 16% of patients were admitted to ICU and/or required MV and 9% died. Overall, 54% of hospitalized influenza patients received an antiviral; mean time from the onset of symptoms to antiviral start was 4.28 days (range: 0–21 days). Treatment with antivirals was associated with a significant reduction in admission to ICU and/or need for MV (OR = 0.10; 95% CI: 0.08–0.13; P < 0.001), but was not significantly associated with a reduction in death (P = 0.454) irrespective of time between symptom onset and start of antivirals.
Conclusion
In this study, treatment with antivirals in hospitalized patients with influenza was associated with a significant reduction in ICU admission and MV, even when initiated a mean of 4.28 days from symptom onset. Reduction in death was not demonstrated. These findings support current recommendations for antiviral use in hospitalized adults and suggest increased compliance with these guidelines may reduce morbidity and cost.
Disclosures
M. K. Andrew, GSK: Grant Investigator, Research grant; Pfizer: Grant Investigator, Research grant; Sanofi-Pasteur: Grant Investigator, Research grant; A. Chit, Sanofi pasteur: Employee, Salary; G. Dos Santos, GSK: Employee, Salary; Business and Decision Life Sciences (Contractor for GSK Vaccines): Independent Contractor, Salary; M. Elsherif, Canadian Institutes of Health Research: Investigator, Research grant; Public Health Agency of Canada: Investigator, Research grant; GSK: Investigator, Research grant; F. Haguinet, GSK: Employee, Salary; S. A. Halperin, GSK: Scientific Advisor, Consulting fee; GSK: Grant Investigator, Research grant; T. Hatchette, GSK: Grant Investigator, Grant recipient; Pfizer: Grant Investigator, Grant recipient; Abbvie: Speaker for a talk on biologics and risk of TB reactivation, Speaker honorarium; B. Ibarguchi, GSK: Employee, Salary; J. M. Langley, GSK: Investigator, Research grant; Canadian Institutes of Health Research: Investigator, Research grant; J. Mcelhaney, GSK: Scientific Advisor, Honorarium to institution; Sanofi pasteur: Scientific Advisor, Honorarium to institution; A. Mcgeer, Hoffman La Roche: Investigator, Research grant; GSK: Investigator, Research grant; Sanofi pasteur: Investigator, Research grant; J. Powis, Merck: Grant Investigator, Research grant; GSK: Grant Investigator, Research grant; Roche: Grant Investigator, Research grant; Synthetic Biologicals: Investigator, Research grant; M. Semret, GSK: Investigator, Research grant; Pfizer: Investigator, Research grant; V. Shinde, Novavax: Employee, Salary; GSK: Shareholder, Stocks; GSK: Employee, Salary; S. Trottier, Canadian Institutes of Health Research: Investigator, Research grant; L. Valiquette, GSK: Investigator, Research grant; S. McNeil, GSK: Contract Clinical Trials and Grant Investigator, Research grant; Merck: Contract Clinical Trials and Speaker’s Bureau, Speaker honorarium; Novartis: Contract Clinical Trials, No personal renumeration; Sanofi pasteur: Contract Clinical Trials, No personal renumeration
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Affiliation(s)
- Zach Shaffelburg
- Canadian Center for Vaccinology, IWK Health Centre and Nova Scotia Health Authority, Dalhousie University, Halifax, NS, Canada
| | - Michaela Nichols
- Canadian Center for Vaccinology, IWK Health Centre and Nova Scotia Health Authority, Dalhousie University, Halifax, NS, Canada
| | - Lingyun Ye
- Canadian Center for Vaccinology, IWK Health Centre and Nova Scotia Health Authority, Dalhousie University, Halifax, NS, Canada
| | - Melissa K Andrew
- Canadian Center for Vaccinology, IWK Health Centre and Nova Scotia Health Authority, Dalhousie University, Halifax, NS, Canada
| | - Ardith Ambrose
- Canadian Center for Vaccinology, IWK Health Centre and Nova Scotia Health Authority, Dalhousie University, Halifax, NS, Canada
| | - Guy Boivin
- Centre Hospitalier Universitaire de Quebec, Quebec City, QC, Canada
| | - William R Bowie
- Division of Infectious Diseases, Department of Medicine, University of British Columbia, Vancouver, BC, Canada
| | - Ayman Chit
- Leslie Dan School of Pharmacy, University of Toronto, Toronto, ON, Canada
| | - Gael Dos Santos
- Business & Decision Life Sciences (on behalf of GSK), Wavre, Belgium
| | - May Elsherif
- Canadian Center for Vaccinology, IWK Health Centre and Nova Scotia Health Authority, Dalhousie University, Halifax, NS, Canada
| | | | | | - Scott A Halperin
- Canadian Center for Vaccinology, IWK Health Centre and Nova Scotia Health Authority, Dalhousie University, Halifax, NS, Canada
| | - Todd Hatchette
- Nova Scotia Health Authority, Dalhousie University, Halifax, NS, Canada
| | - Barbara Ibarguchi
- GSK Vaccines (Current affiliation Bayer Inc.), Mississauga, ON, Canada
| | | | - Kevin Katz
- Department of Infection Control, North York General Hospital, Toronto, ON, Canada
| | - Joanne M Langley
- Canadian Center for Vaccinology, IWK Health Centre and Nova Scotia Health Authority, Dalhousie University, Halifax, NS, Canada
| | - Jason Leblanc
- Canadian Center for Vaccinology, IWK Health Centre and Nova Scotia Health Authority, Dalhousie University, Halifax, NS, Canada
- Sanofi pasteur, Toronto, ON, Canada
| | | | - Mark Loeb
- McMaster University, Hamilton, ON, Canada
| | - Donna Mackinnon-Cameron
- Canadian Center for Vaccinology, IWK Health Centre and Nova Scotia Health Authority, Dalhousie University, Halifax, NS, Canada
| | | | - Janet Mcelhaney
- Health Sciences North Research Institute, Sudbury, ON, Canada
| | | | - Jeff Powis
- Michael Garron Hospital, Toronto, ON, Canada
| | | | | | | | - Stephanie Smith
- Division of Infectious Diseases, Department of Medicine, University of Alberta Hospital, Edmonton, AB, Canada
| | | | - Geoffrey Taylor
- Division of Infectious Diseases, University of Alberta Hospital, Edmonton, AB, Canada
| | - Sylvie Trottier
- Centre Hospitalier Universitaire de Quebec, Quebec City, QC, Canada
| | - Louis Valiquette
- Microbiology and Infectious Disease, Université de Sherbrooke, Sherbrooke, QC, Canada
| | - Duncan Webster
- Saint John Regional Hospital, Dalhousie University, Saint John, NB, Canada
| | - Shelly McNeil
- Canadian Center for Vaccinology, IWK Health Centre and Nova Scotia Health Authority, Dalhousie University, Halifax, NS, Canada
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McNeil SA, Hatchette T, Andrew MK, Ambrose A, Boivin G, Diaz-Mitoma F, Bowie W, Chit A, Santos GD, Elsherif M, Green K, Haguinet F, Halperin SA, Ibarguchi B, Johnstone J, Katz K, Langley JM, Leblanc J, Lagace-Wiens P, Light B, Loeb M, Mackinnon-Cameron D, McCarthy AE, McElhaney JE, McGeer A, Poirier A, Powis J, Richardson D, Semret M, Shinde V, Smith S, Smyth D, Stiver G, Taylor G, Trottier S, Valiquette L, Webster D, Ye L. Influenza Vaccine Effectiveness in the Prevention of Influenza-Related Hospitalization in Canadian Adults Over the 2011/12 Through 2013/14 Season: A Pooled Analysis From the Serious Outcomes Surveillance (SOS) Network of the Canadian Influenza Research Network (CIRN). Open Forum Infect Dis 2016. [DOI: 10.1093/ofid/ofw194.75] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- Shelly A. McNeil
- Canadian Center for Vaccinology, IWK Health Centre and Nova Scotia Health Authority, Dalhousie University, Halifax, Nova Scotia, Canada
- Canadian Center for Vaccinology, IWK Health Centre and Nova Scotia Health Authority, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Todd Hatchette
- Canadian Center for Vaccinology, IWK Health Centre and Nova Scotia Health Authority, Dalhousie University, Halifax, Nova Scotia, Canada
- Canadian Center for Vaccinology, IWK Health Centre and Nova Scotia Health Authority, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Melissa K. Andrew
- Canadian Center for Vaccinology, IWK Health Centre and Nova Scotia Health Authority, Dalhousie University, Halifax, Nova Scotia, Canada
- Canadian Center for Vaccinology, IWK Health Centre and Nova Scotia Health Authority, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Ardith Ambrose
- Canadian Center for Vaccinology, IWK Health Centre and Nova Scotia Health Authority, Dalhousie University, Halifax, Nova Scotia, Canada
- Canadian Center for Vaccinology, IWK Health Centre and Nova Scotia Health Authority, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Guy Boivin
- Centre Hospitalier Universitaire de Quebec, Quebec, Quebec, Canada
- Canadian Center for Vaccinology, IWK Health Centre and Nova Scotia Health Authority, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Francisco Diaz-Mitoma
- Health Sciences North Research Institute of Canada, Sudbury, Ontario, Canada
- Canadian Center for Vaccinology, IWK Health Centre and Nova Scotia Health Authority, Dalhousie University, Halifax, Nova Scotia, Canada
| | - William Bowie
- University of British Columbia, Vancouver, British Colombia, Canada
- Canadian Center for Vaccinology, IWK Health Centre and Nova Scotia Health Authority, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Ayman Chit
- Leslie Dan Faculty of Pharmacy, Toronto, Ontario, Canada
- Canadian Center for Vaccinology, IWK Health Centre and Nova Scotia Health Authority, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Gael Dos Santos
- Business and Decision Life Sciences (on behalf of GSK Vaccines), Wavre, Belgium
- Canadian Center for Vaccinology, IWK Health Centre and Nova Scotia Health Authority, Dalhousie University, Halifax, Nova Scotia, Canada
| | - May Elsherif
- Canadian Center for Vaccinology, IWK Health Centre and Nova Scotia Health Authority, Dalhousie University, Halifax, Nova Scotia, Canada
- Canadian Center for Vaccinology, IWK Health Centre and Nova Scotia Health Authority, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Karen Green
- Mount Sinai Hospital, Toronto, Ontario, Canada
- Canadian Center for Vaccinology, IWK Health Centre and Nova Scotia Health Authority, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Francois Haguinet
- GSK Vaccines, Wavre, Belgium
- Canadian Center for Vaccinology, IWK Health Centre and Nova Scotia Health Authority, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Scott A. Halperin
- Canadian Center for Vaccinology, IWK Health Centre and Nova Scotia Health Authority, Dalhousie University, Halifax, Nova Scotia, Canada
- Canadian Center for Vaccinology, IWK Health Centre and Nova Scotia Health Authority, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Barbara Ibarguchi
- GSK Vaccines (Current affiliation Bayer Inc), Mississauga, Ontario, Canada
- Canadian Center for Vaccinology, IWK Health Centre and Nova Scotia Health Authority, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Jennie Johnstone
- McMaster University, Hamilton, Ontario, Canada
- Canadian Center for Vaccinology, IWK Health Centre and Nova Scotia Health Authority, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Kevin Katz
- North York General Hospital, Toronto, Ontario, Canada
- Canadian Center for Vaccinology, IWK Health Centre and Nova Scotia Health Authority, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Joanne M. Langley
- Canadian Center for Vaccinology, IWK Health Centre and Nova Scotia Health Authority, Dalhousie University, Halifax, Nova Scotia, Canada
- Canadian Center for Vaccinology, IWK Health Centre and Nova Scotia Health Authority, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Jason Leblanc
- Canadian Center for Vaccinology, IWK Health Centre and Nova Scotia Health Authority, Dalhousie University, Halifax, Nova Scotia, Canada
- Canadian Center for Vaccinology, IWK Health Centre and Nova Scotia Health Authority, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Philippe Lagace-Wiens
- St. Boniface Hospital, Winnipeg, Manitoba, Canada
- Canadian Center for Vaccinology, IWK Health Centre and Nova Scotia Health Authority, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Bruce Light
- St. Boniface Hospital, Winnipeg, Manitoba, Canada
- Canadian Center for Vaccinology, IWK Health Centre and Nova Scotia Health Authority, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Mark Loeb
- McMaster University, Hamilton, Ontario, Canada
- Canadian Center for Vaccinology, IWK Health Centre and Nova Scotia Health Authority, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Donna Mackinnon-Cameron
- Canadian Center for Vaccinology, IWK Health Centre and Nova Scotia Health Authority, Dalhousie University, Halifax, Nova Scotia, Canada
- Canadian Center for Vaccinology, IWK Health Centre and Nova Scotia Health Authority, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Anne E. McCarthy
- The Ottawa Hospital, Ottawa, Ontario, Canada
- Canadian Center for Vaccinology, IWK Health Centre and Nova Scotia Health Authority, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Janet E. McElhaney
- Health Sciences North Research Institute of Canada, Sudbury, Ontario, Canada
- Canadian Center for Vaccinology, IWK Health Centre and Nova Scotia Health Authority, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Allison McGeer
- Mount Sinai Hospital, Toronto, Ontario, Canada
- Canadian Center for Vaccinology, IWK Health Centre and Nova Scotia Health Authority, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Andre Poirier
- Centre Integre de Sante et de Services Sociaux de la Maurice Centre du Quebec, Trois-Rivieres, Quebec, Canada
- Canadian Center for Vaccinology, IWK Health Centre and Nova Scotia Health Authority, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Jeff Powis
- Toronto East General Hospital, Toronto, Ontario, Canada
- Canadian Center for Vaccinology, IWK Health Centre and Nova Scotia Health Authority, Dalhousie University, Halifax, Nova Scotia, Canada
| | - David Richardson
- William Osler Health Centre, Brampton, Ontario, Canada
- Canadian Center for Vaccinology, IWK Health Centre and Nova Scotia Health Authority, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Makeda Semret
- McGill University, Montreal, Quebec, Canada
- Canadian Center for Vaccinology, IWK Health Centre and Nova Scotia Health Authority, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Vivek Shinde
- GSK Vaccines (Current affiliation Novavax Vaccines, Washington, District of Columbia, King of Prussia, Pennsylvania
- Canadian Center for Vaccinology, IWK Health Centre and Nova Scotia Health Authority, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Stephanie Smith
- University of Alberta Hospital, Edmonton, Alberta, Canada
- Canadian Center for Vaccinology, IWK Health Centre and Nova Scotia Health Authority, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Daniel Smyth
- Moncton Hospital, Moncton, New Brunswick, Canada
- Canadian Center for Vaccinology, IWK Health Centre and Nova Scotia Health Authority, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Grant Stiver
- University of British Columbia, Vancouver, British Colombia, Canada
- Canadian Center for Vaccinology, IWK Health Centre and Nova Scotia Health Authority, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Geoff Taylor
- University of Alberta Hospital, Edmonton, Alberta, Canada
- Canadian Center for Vaccinology, IWK Health Centre and Nova Scotia Health Authority, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Sylvie Trottier
- Centre Hospitalier Universitaire de Quebec, Quebec, Quebec, Canada
- Canadian Center for Vaccinology, IWK Health Centre and Nova Scotia Health Authority, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Louis Valiquette
- Universite de Sherbrooke, Sherbrooke, Quebec, Canada
- Canadian Center for Vaccinology, IWK Health Centre and Nova Scotia Health Authority, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Duncan Webster
- Horizon Health, St. John, New Brunswick, Canada
- Canadian Center for Vaccinology, IWK Health Centre and Nova Scotia Health Authority, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Lingyun Ye
- Canadian Center for Vaccinology, IWK Health Centre and Nova Scotia Health Authority, Dalhousie University, Halifax, Nova Scotia, Canada
- Canadian Center for Vaccinology, IWK Health Centre and Nova Scotia Health Authority, Dalhousie University, Halifax, Nova Scotia, Canada
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Andrew MK, MacDonald S, Ye L, Ambrose A, Boivin G, Diaz-Mitoma F, Bowie W, Chit A, Santos GD, Elsherif M, Green K, Hatchette T, Haguinet F, Halperin SA, Ibarguchi B, Johnstone J, Katz K, Lagace-Wiens P, Langley JM, Leblanc J, Light B, Loeb M, Mackinnon-Cameron D, Mccarthy AE, Mcelhaney JE, Mcgeer A, Poirier A, Powis J, Richardson D, Semret M, Shinde V, Smith S, Smyth D, Stiver G, Taylor G, Trottier S, Valiquette L, Webster D, McNeil SA. Impact of Frailty on Influenza Vaccine Effectiveness and Clinical Outcomes: Experience From the Canadian Immunization Research Network (CIRN) Serious Outcomes Surveillance (SOS) Network 2011/12 Season. Open Forum Infect Dis 2016. [DOI: 10.1093/ofid/ofw172.573] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- Melissa K. Andrew
- Canadian Center for Vaccinology, IWK Health Centre and Nova Scotia Health Authority, Dalhousie University, Halifax, Nova Scotia, Canada
- Canadian Center for Vaccinology, IWK Health Centre and Nova Scotia Health Authority, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Sarah MacDonald
- Canadian Center for Vaccinology, IWK Health Centre and Nova Scotia Health Authority, Dalhousie University, Halifax, Nova Scotia, Canada
- Canadian Center for Vaccinology, IWK Health Centre and Nova Scotia Health Authority, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Lingyun Ye
- Canadian Center for Vaccinology, IWK Health Centre and Nova Scotia Health Authority, Dalhousie University, Halifax, Nova Scotia, Canada
- Canadian Center for Vaccinology, IWK Health Centre and Nova Scotia Health Authority, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Ardith Ambrose
- Canadian Center for Vaccinology, IWK Health Centre and Nova Scotia Health Authority, Dalhousie University, Halifax, Nova Scotia, Canada
- Canadian Center for Vaccinology, IWK Health Centre and Nova Scotia Health Authority, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Guy Boivin
- Centre Hospitalier Universitaire de Quebec, Quebec, Quebec, Canada
- Canadian Center for Vaccinology, IWK Health Centre and Nova Scotia Health Authority, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Francisco Diaz-Mitoma
- Health Sciences North Research Institute of Canada, Sudbury, Ontario, Canada
- Canadian Center for Vaccinology, IWK Health Centre and Nova Scotia Health Authority, Dalhousie University, Halifax, Nova Scotia, Canada
| | - William Bowie
- University of British Columbia, Vancouver, British Columbia, Canada
- Canadian Center for Vaccinology, IWK Health Centre and Nova Scotia Health Authority, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Ayman Chit
- Leslie Dan Faculty of Pharmacy, Toronto, Ontario, Canada
- Canadian Center for Vaccinology, IWK Health Centre and Nova Scotia Health Authority, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Gael Dos Santos
- Business and Decision Life Sciences (on behalf of GSK Vaccines), Wavre, Belgium
- Canadian Center for Vaccinology, IWK Health Centre and Nova Scotia Health Authority, Dalhousie University, Halifax, Nova Scotia, Canada
| | - May Elsherif
- Canadian Center for Vaccinology, IWK Health Centre and Nova Scotia Health Authority, Dalhousie University, Halifax, Nova Scotia, Canada
- Canadian Center for Vaccinology, IWK Health Centre and Nova Scotia Health Authority, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Karen Green
- Mount Sinai Hospital, Toronto, Ontario, Canada
- Canadian Center for Vaccinology, IWK Health Centre and Nova Scotia Health Authority, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Todd Hatchette
- Canadian Center for Vaccinology, IWK Health Centre and Nova Scotia Health Authority, Dalhousie University, Halifax, Nova Scotia, Canada
- Canadian Center for Vaccinology, IWK Health Centre and Nova Scotia Health Authority, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Francois Haguinet
- GSK Vaccines, Wavre, Belgium
- Canadian Center for Vaccinology, IWK Health Centre and Nova Scotia Health Authority, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Scott A. Halperin
- Canadian Center for Vaccinology, IWK Health Centre and Nova Scotia Health Authority, Dalhousie University, Halifax, Nova Scotia, Canada
- Canadian Center for Vaccinology, IWK Health Centre and Nova Scotia Health Authority, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Barbara Ibarguchi
- GSK Vaccines (Current affiliation Bayer Inc.), Mississauga, Ontario, Canada
- Canadian Center for Vaccinology, IWK Health Centre and Nova Scotia Health Authority, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Jennie Johnstone
- McMaster University, Hamilton, Ontario, Canada
- Canadian Center for Vaccinology, IWK Health Centre and Nova Scotia Health Authority, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Kevin Katz
- North York General Hospital, Toronto, Ontario, Canada
- Canadian Center for Vaccinology, IWK Health Centre and Nova Scotia Health Authority, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Philippe Lagace-Wiens
- St. Boniface Hospital, Winnipeg, Manitoba, Canada
- Canadian Center for Vaccinology, IWK Health Centre and Nova Scotia Health Authority, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Joanne M. Langley
- Canadian Center for Vaccinology, IWK Health Centre and Nova Scotia Health Authority, Dalhousie University, Halifax, Nova Scotia, Canada
- Canadian Center for Vaccinology, IWK Health Centre and Nova Scotia Health Authority, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Jason Leblanc
- Canadian Center for Vaccinology, IWK Health Centre and Nova Scotia Health Authority, Dalhousie University, Halifax, Nova Scotia, Canada
- Canadian Center for Vaccinology, IWK Health Centre and Nova Scotia Health Authority, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Bruce Light
- St. Boniface Hospital, Winnipeg, Manitoba, Canada
- Canadian Center for Vaccinology, IWK Health Centre and Nova Scotia Health Authority, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Mark Loeb
- McMaster University, Hamilton, Ontario, Canada
- Canadian Center for Vaccinology, IWK Health Centre and Nova Scotia Health Authority, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Donna Mackinnon-Cameron
- Canadian Center for Vaccinology, IWK Health Centre and Nova Scotia Health Authority, Dalhousie University, Halifax, Nova Scotia, Canada
- Canadian Center for Vaccinology, IWK Health Centre and Nova Scotia Health Authority, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Anne E. Mccarthy
- The Ottawa Hospital, Ottawa, Ontario, Canada
- Canadian Center for Vaccinology, IWK Health Centre and Nova Scotia Health Authority, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Janet E. Mcelhaney
- Health Sciences North Research Institute of Canada, Sudbury, Ontario, Canada
- Canadian Center for Vaccinology, IWK Health Centre and Nova Scotia Health Authority, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Allison Mcgeer
- Mount Sinai Hospital, Toronto, Ontario, Canada
- Canadian Center for Vaccinology, IWK Health Centre and Nova Scotia Health Authority, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Andre Poirier
- Centre Integre de Sante et de Services Sociaux de la Maurice Centre du Quebec, Trois-Rivieres, Quebec, Canada
- Canadian Center for Vaccinology, IWK Health Centre and Nova Scotia Health Authority, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Jeff Powis
- Toronto East General Hospital, Toronto, Ontario, Canada
- Canadian Center for Vaccinology, IWK Health Centre and Nova Scotia Health Authority, Dalhousie University, Halifax, Nova Scotia, Canada
| | - David Richardson
- William Osler Health Centre, Brampton, Ontario, Canada
- Canadian Center for Vaccinology, IWK Health Centre and Nova Scotia Health Authority, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Makeda Semret
- McGill University, Montreal, Quebec, Canada
- Canadian Center for Vaccinology, IWK Health Centre and Nova Scotia Health Authority, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Vivek Shinde
- GSK Vaccines (Current affiliation Novavax Vaccines, Washington, District of Columbia), King of Prussia, Pennsylvania
- Canadian Center for Vaccinology, IWK Health Centre and Nova Scotia Health Authority, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Stephanie Smith
- University of Alberta, Edmonton, AB, Canada
- Canadian Center for Vaccinology, IWK Health Centre and Nova Scotia Health Authority, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Daniel Smyth
- The Moncton Hospital, Moncton, New Brunswick, Canada
- Canadian Center for Vaccinology, IWK Health Centre and Nova Scotia Health Authority, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Grant Stiver
- University of British Columbia, Vancouver, British Columbia, Canada
- Canadian Center for Vaccinology, IWK Health Centre and Nova Scotia Health Authority, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Geoffrey Taylor
- University of Alberta, Edmonton, AB, Canada
- Canadian Center for Vaccinology, IWK Health Centre and Nova Scotia Health Authority, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Sylvie Trottier
- Centre Hospitalier Universitaire de Quebec, Quebec, Quebec, Canada
- Canadian Center for Vaccinology, IWK Health Centre and Nova Scotia Health Authority, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Louis Valiquette
- Universite de Sherbrooke, Sherbrooke, Quebec, Canada
- Canadian Center for Vaccinology, IWK Health Centre and Nova Scotia Health Authority, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Duncan Webster
- Horizon Health, St. John, New Brunswick, Canada
- Canadian Center for Vaccinology, IWK Health Centre and Nova Scotia Health Authority, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Shelly A. McNeil
- Canadian Center for Vaccinology, IWK Health Centre and Nova Scotia Health Authority, Dalhousie University, Halifax, Nova Scotia, Canada
- Canadian Center for Vaccinology, IWK Health Centre and Nova Scotia Health Authority, Dalhousie University, Halifax, Nova Scotia, Canada
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Walkty A, Lagace-Wiens P, Adam H, Baxter M, Karlowsky J, Mulvey MR, McCracken M, Zhanel GG. Antimicrobial susceptibility of 2906 Pseudomonasaeruginosa clinical isolates obtained from patients in Canadian hospitals over a period of 8 years: Results of the Canadian Ward surveillance study (CANWARD), 2008-2015. Diagn Microbiol Infect Dis 2016; 87:60-63. [PMID: 28336136 DOI: 10.1016/j.diagmicrobio.2016.10.003] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2016] [Revised: 09/28/2016] [Accepted: 10/03/2016] [Indexed: 11/16/2022]
Abstract
Pseudomonas aeruginosa is an important nosocomial pathogen. The purpose of this study was to evaluate the antimicrobial susceptibility profile of P. aeruginosa clinical isolates obtained from inpatients and outpatients at hospitals across Canada from January 2008 to December 2015 (CANWARD Study). Susceptibility testing was performed using broth microdilution, as described by the Clinical and Laboratory Standards Institute. In total, 2906 P. aeruginosa isolates were evaluated. The percentage of isolates susceptible to common antipseudomonal antimicrobials was: colistin 94.9%, amikacin 93.2%, piperacillin-tazobactam 84.3%, ceftazidime 83.1%, gentamicin 82.7%, meropenem 80.5%, ciprofloxacin 76.5%. In general, susceptibility to the antipseudomonal antimicrobials tested remained fairly stable or slightly improved (ciprofloxacin, gentamicin, colistin) over the 8year study period. Multidrug-resistant (MDR = non-susceptible to at least one antimicrobial from ≥3 classes) and extensively drug-resistant (XDR = non-susceptible to at least one antimicrobial from 5 classes) P. aeruginosa accounted for 14.5% and 2.6% of the isolates, respectively. Colistin remained active against 92.9% of MDR and 88.3% of XDR P. aeruginosa.
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Affiliation(s)
- Andrew Walkty
- Department of Internal Medicine, Section of Infectious Diseases, University of Manitoba, Winnipeg, Manitoba, Canada; Department of Medical Microbiology, University of Manitoba, Winnipeg, Manitoba, Canada; Diagnostic Services Manitoba, Winnipeg, Manitoba, Canada.
| | - Philippe Lagace-Wiens
- Department of Medical Microbiology, University of Manitoba, Winnipeg, Manitoba, Canada; Diagnostic Services Manitoba, Winnipeg, Manitoba, Canada
| | - Heather Adam
- Department of Medical Microbiology, University of Manitoba, Winnipeg, Manitoba, Canada; Diagnostic Services Manitoba, Winnipeg, Manitoba, Canada
| | - Melanie Baxter
- Department of Medical Microbiology, University of Manitoba, Winnipeg, Manitoba, Canada
| | - James Karlowsky
- Department of Medical Microbiology, University of Manitoba, Winnipeg, Manitoba, Canada; Diagnostic Services Manitoba, Winnipeg, Manitoba, Canada
| | | | | | - George G Zhanel
- Department of Medical Microbiology, University of Manitoba, Winnipeg, Manitoba, Canada
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Walkty A, Adam HJ, Baxter M, Lagace-Wiens P, Karlowsky J, Hoban D, Zhanel G. In Vitro Activity of Colistin (Polymyxin E) Versus 2541 Pseudomonas aeruginosa Clinical Isolates Obtained From Patients in Canadian Hospitals: Results of the CANWARD Study, 2008–2014. Open Forum Infect Dis 2015. [DOI: 10.1093/ofid/ofv133.1376] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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16
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Lagace-Wiens P, Baudry P, Decorby M, Zhanel G, Hoban D. P66 Escherichia coli isolates from Canadian hospitals – preliminary results of the CANWARD 2008 Study. Int J Antimicrob Agents 2009. [DOI: 10.1016/s0924-8579(09)70285-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Baudry P, Lagace-Wiens P, Zhanel G, Hoban D. P57 Extended-spectrum p-lactamase-producing Escherichia coli (ESBL-EC) from patients in Canadian hospitals: preliminary results from CANWARD 2008. Int J Antimicrob Agents 2009. [DOI: 10.1016/s0924-8579(09)70276-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Decorby M, Weshnoweski B, Vashisht R, Tailor F, Turner-Brannen E, McCracken M, Mulvey M, Karlowsky J, Lagace-Wiens P, Walkty A, Hoban D, Zhanel G. P67 Antimicrobial resistance in pathogens isolated from Canadian hospital clinics (C), emergency rooms (ER), medical/surgical wards (W) and intensive care units (ICU): results of the CANWARD 2008 study. Int J Antimicrob Agents 2009. [DOI: 10.1016/s0924-8579(09)70286-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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