Table 5. Carbapenemase-producing Enterobacterales data, Canada, 2017–2021a.
| CPE data | Year | |||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 2017 | 2018 | 2019 | 2020 | 2021 | ||||||||||
| Number of infections and incidence rates | ||||||||||||||
| Number of CPE infections | 20 | 36 | 50 | 41 | 55 | |||||||||
| Infection rate per 1,000 patient admissions | 0.02 | 0.04 | 0.06 | 0.05 | 0.06 | |||||||||
| Infection rate per 1,000 patient days | 0.3 | 0.6 | 0.8 | 0.6 | 0.8 | |||||||||
| Infection rate per 10,000 patient days | 0.03 | 0.06 | 0.08 | 0.06 | 0.08 | |||||||||
| Number of reporting hospitals | 52 | 51 | 59 | 75 | 77 | |||||||||
| Drugs tested for antimicrobial resistance | ||||||||||||||
| Antibioticsb,c | n | % | n | % | n | % | n | % | n | % | ||||
| Piperacillin-Tazobactam | 159 | 85.0 | 210 | 92.1 | 237 | 90.8 | 230 | 93.9 | 262 | 92.3 | ||||
| Ceftriaxone | 173 | 92.5 | 212 | 93.0 | 250 | 95.8 | 218 | 88.9 | 244 | 85.9 | ||||
| Ceftazidime | 160 | 85.6 | 192 | 84.2 | 233 | 89.3 | 203 | 82.9 | 225 | 79.2 | ||||
| Meropenem | 159 | 85.0 | 198 | 86.8 | 190 | 72.8 | 149 | 60.8 | 183 | 64.4 | ||||
| Ciprofloxacin | 138 | 73.8 | 158 | 69.3 | 183 | 70.1 | 173 | 70.6 | 195 | 68.7 | ||||
| Amikacin | 32 | 17.1 | 44 | 19.3 | 23 | 8.8 | 24 | 9.8 | 22 | 7.7 | ||||
| Gentamicin | 64 | 34.2 | 80 | 35.1 | 86 | 33.0 | 76 | 31 | 78 | 27.5 | ||||
| Tobramycin | 71 | 38.0 | 101 | 44.3 | 121 | 46.4 | 91 | 37.1 | 106 | 37.2 | ||||
| Trimethoprim-sulfamethoxazole | 113 | 60.4 | 143 | 62.7 | 193 | 73.9 | 184 | 75.1 | 204 | 71.8 | ||||
| Tigecycline | 18 | 9.6 | 30 | 13.2 | 36 | 13.8 | 0 | 0 | 1 | 0.4 | ||||
| Total number of isolates testedd | 187 | N/A | 228 | N/A | 261 | N/A | 245 | N/A | 284 | N/A | ||||
| Carbapenemases identified | ||||||||||||||
| KPC | 86 | 46.0 | 122 | 53.0 | 127 | 48.5 | 98 | 40 | 133 | 46.8 | ||||
| NDM | 53 | 28.3 | 59 | 25.7 | 74 | 28.2 | 80 | 32.7 | 74 | 26.1 | ||||
| OXA-48 | 33 | 17.6 | 30 | 13.0 | 40 | 15.3 | 48 | 19.6 | 45 | 15.8 | ||||
| SMEe | 2 | 1.1 | 4 | 1.7 | 1 | 0.4 | 2 | 0.8 | 1 | 0.4 | ||||
| NDM/OXA-48 | 5 | 2.7 | 6 | 2.6 | 10 | 3.8 | 9 | 3.7 | 11 | 3.9 | ||||
| GES | 1 | 0.5 | 1 | 0.4 | 2 | 0.8 | 0 | 0 | 1 | 0.4 | ||||
| IMP | 0 | 0.0 | 3 | 1.3 | 1 | 0.4 | 1 | 0.4 | 1 | 0.4 | ||||
| NMC | 4 | 2.1 | 2 | 0.9 | 4 | 1.5 | 7 | 2.9 | 15 | 5.3 | ||||
| VIM | 3 | 1.6 | 3 | 1.3 | 3 | 1.1 | 0 | 0 | 1 | 0.4 | ||||
| Other | 0 | 0.0 | 0 | 0.0 | 0 | 0.0 | 0 | 0 | 2 | 0.7 | ||||
| Total number of isolates testedf | 187 | N/A | 230 | N/A | 262 | N/A | 245 | N/A | 284 | N/A | ||||
Abbreviations: CPE, carbapenemase-producing Enterobacterales; GES, Guiana extended-spectrum ß-lactamase; IMP, active-on-imipenem; KPC, Klebsiella pneumoniae carbapenemase; NDM, New Delhi metallo-ß-lactamase; NMC, not metalloenzyme carbapenemase; N/A, not applicable; OXA-48, Oxacillinase-48; SME, Serratia marcescens enzymes; VIM, Verona integron-encoded metallo-ß-lactamase
a Includes data for all CPE isolates submitted
b All isolates were resistant to ampicillin, and all but one to cefazolin. All carbapenemase-producing organism isolates were screened for the mcr-type gene which is an acquired gene associated with colistin resistance
c The denominator for some drugs were adjusted as minimum inhibitory concentration values were not given in all cases due to VITEK® algorithms
d Total number reflects the number of isolates tested for each of the antibiotics listed above
e Only found in Serratia marcescens
f Some isolates contain multiple carbapenemases therefore the total number of isolates tested and the number of carbapenemases indicated may not match
Note: Aggregate mortality data reported in-text due to fluctuations in the small numbers of CPE deaths reported each year