Molecular epidemiology of extended-spectrum β-lactamase-, AmpC β-lactamase-, and carbapenemase-producing Escherichia coli and Klebsiella pneumoniae isolated in Canadian hospitals from 2007 to 2012

Abstract

This thesis assessed the prevalence, patterns of antibiotic resistance, and molecular characteristics of ESBL-, AmpC-, and carbapenemase-producing Escherichia coli (EC) and Klebsiella pneumoniae (KPN) isolated from Canadian hospitals. Bacterial isolates were collected as part of the CANWARD national surveillance study. The prevalence of ESBL-EC [2007: 3.4%, 2012: 7.6%], AmpC-EC [2007: 0.7%, 2012: 2.2%], and ESBL-KPN [2007: 1.5%, 2012: 3.6%] increased between 2007 and 2012. Antimicrobials demonstrating the greatest activity against isolates in this study were colistin, amikacin, ertapenem, and meropenem, while 78.8%, 34.9%, and 66.7% of ESBL-EC, AmpC-EC, and ESBL-KPN, respectively, were multidrug resistant. Isolates were generally unrelated by PFGE; however, ST-131 was identified among 56.9% and 31.7% of ESBL-EC and AmpC-EC, respectively. CTX-M-15 was the dominant genotype in ESBL-EC (66.5%) and ESBL-KPN (48.1%), while the dominant genotype in AmpC-EC was CMY-2 (53.2%). Carbapenemase production was identified in 0.03% of EC and 0.05% of KPN, all of which produced KPC-3.