Canadian surveillance shows rise in multidrug-resistant pathogens
The proportion of multidrug-resistant Escherichia coli and Klebsiella pneumoniae found in Canadian hospital patients increased substantially from 2007 through 2018, according to a surveillance study published today in the Journal of Antimicrobial Chemotherapy.
The findings are from an analysis of bacterial isolates collected through CANWARD, an ongoing national surveillance study that analyzes isolates from hospitals in 8 of Canada’s 10 provinces for antibiotic resistance. Researchers conducted antimicrobial susceptibility tests to confirm phenotypic resistance and performed whole-genome sequencing to detect production of extended-spectrum beta-lactamase (ESBL) enzymes, which confer resistance to multiple antibiotic classes.
Of the 9,588 E coli isolates collected from 2007 through 2018, 7.0% (671) were ESBL producers, and the proportion of ESBL-producing E coli climbed from 3.3% in 2007 to 11.2% in 2018. Of the 3,056 K pneumoniae isolates collected, 4.6% (141) were ESBL producers; the proportion of ESBL-producing K pneumoniae rose from 1.3% to 9.3%. Overall, 97.2% of ESBL-producing E coli and K pneumoniae were multidrug-resistant (MDR). The most common ESBL enzyme in E coli (62.3% of isolates) and K pneumoniae (48.9%) was blaCTX-M-15.
The most frequent sequence types (STs) were ST131 for E coli (62.4%) and ST11 (7.8%) and ST147 (7.8%) for K pneumoniae.
“Increases in the proportion of infections caused by ESBL-producing Enterobacteriaceae, especially specific STs, are detrimental to patient care and public health because they result in increased use of carbapenems, which may in turn drive the emergence and increased isolation of carbapenem-resistant Enterobacteriaceae,” the authors write. “Prospective surveillance of these evolving MDR pathogens is imperative.”
Aug 11 J Antimicrob Chemother abstract
UN, India team up to boost understanding of AMR in the environment
The United Nations Environmental Programme (UNEP) has launched a collaboration with Indian researchers to address the environmental dimension of antimicrobial resistance (AMR).
The collaboration between UNEP and the Indian Council of Medical Research aims to strengthen the environmental aspects of national- and state-level AMR action strategies and plans, according to a UNEP press release. It will conduct secondary research and stakeholder consultations to better understand the role the environment plays in harboring and transmitting resistant pathogens.
Among the areas the project will likely explore is the effects of discharging antibiotics and other antimicrobial compounds into natural environments, which has the potential to drive the evolution of resistant bacteria. India is a major manufacturer of antibiotics, and studies have found high concentrations of antibiotics and high levels of AMR genes in waterways in and around Hyderabad, the country’s pharmaceutical manufacturing hub.
“AMR in the environment is an issue inadequately recognized by the stakeholders,” said Lav Aggarwal, a member of India’s Ministry of Health and Family Welfare. “It is critical to understand that we have to engage with the environment as a critical part of our AMR response.”
Aug 9 UNEP press release