1207. Characterization of Isolates Obtained from Pediatric Patients in Canadian Hospitals:  Results from the CANWARD Study 2007-2010
Session: Poster Abstract Session: Other Bacterial Infections in Children
Saturday, October 22, 2011
Room: Poster Hall B1
Background: Antimicrobial resistance in the hospital setting is an international concern and data from Canadian pediatric patients is lacking.  CANWARD assessed types of pathogens causing infections in Canadian hospitals and their rates of antimicrobial resistance in pediatric Canadian patients from 2007-2010, inclusive.

Methods: From January 2007 to November  2010, 10-15 sentinel Canadian hospitals submitted pathogens from patients attending hospital clinics (C), emergency rooms (ER), medical and surgical wards (MW, SW), and intensive care units (ICU).  Annually, each centre was asked to submit consecutive pathogens from blood, respiratory, urine, and wound infections.  Susceptibility testing was performed using CLSI broth microdilution methods.

Results: Pediatric isolates (≤ 17 years) accounted for 2,996 of 23,243 total isolates (12.9%).  The mean age of patients was 5.0 years, and 55% were males.  The majority of isolates originated from Ontario (55.2%) and western Canada (36.7%).  Cultures were obtained from cases in ER (28.0%), ICU (25.1%), MW (24.4%), C (17.9%), and SW (4.6%).  The most common pathogens overall were E. coli (17.1%), methicillin susceptible Staphylococcus aureus (MSSA) (15.9%), Streptococcus pneumoniae (8.6%), Pseudomonas aeruginosa (6.0%), and Klebsiella pneumoniae (4.7%).  E.coli was the most common pathogen from MW and ER, and from blood and urine cultures.  MSSA was the most common pathogen from patients in the C, ICU, and SW, and from wound and respiratory cultures.  Methicillin resistant Staphylococcus aureus (MRSA) accounted for 2.0% of all isolates and 11.4% of all S. aureus isolates.  Most MRSA were community-associated MRSA (74%) genotypes and susceptible to clindamycin (93.4%).  ESBL production was noted in 0.97% of E. coli and 2.8% of K. pneumoniae isolates.  One of 140 (0.7%) enterococcal isolates was vancomycin-resistant (VRE). 

Conclusion: E coli, MSSA, S. pneumoniae, P. aeruginosa and K. pneumoniae were common pathogens (52.3%) isolated from pediatric patients associated with Canadian hospitals from 2007-2010.  Rates of certain antibiotic-resistant pathogens, such as ESBL gram negative organisms, and VRE were low, as well MRSA was identified at rates lower than those reported from other North American studies.  


Subject Category: P. Pediatric and perinatal infections

Sergio Fanella, MD1, Melanie Baxter, MSc2, James Karlowsky, PhD3, Joanne Embree, MD2, Daryl J. Hoban, PhD3 and George G. Zhanel, PhD4, (1)Univ. of Manitoba, Winnipeg, MB, Canada, (2)University of Manitoba, Winnipeg, MB, Canada, (3)Health Sciences Centre, Winnipeg, MB, Canada, (4)Medical Microbiology, University of Manitoba, Winnipeg, MB, Canada

Disclosures:

S. Fanella, None

M. Baxter, None

J. Karlowsky, None

J. Embree, None

D. J. Hoban, Abbott Laboratories Ltd: Research Relationship, Research support
Astellas Pharma Canada Inc: Research Relationship, Research support
Bayer Schering Pharma AG: Research Relationship, Research support
Merck Frosst Canada Ltd: Research Relationship, Research support
Sepracor Phar,aceuticals Inc: Research relationship, Research support
The Medicines Company: Research Relationship, Research support

G. G. Zhanel, Abbott Laboratories Ltd.: , Research support
Astellas Pharma Canada Inc.: , Research support
Bayer Schering Pharma : , Research support
Merck Frosst Canada Ltd.: , Research support
Pfizer Canada Inc.: , Research support
Sepracor Pharmaceuticals Inc.: , Research support
The Medicines Company: , Research support

Findings in the abstracts are embargoed until 12:01 a.m. EST Thursday, Oct. 20 with the exception of research findings presented at IDSA press conferences.