301. Characterization of Isolates Obtained from Pediatric Patients in Canadian Hospitals:  Results from the CANWARD Study 2007-2012
Session: Poster Abstract Session: HAIs in Children
Thursday, October 3, 2013
Room: The Moscone Center: Poster Hall C
Posters
  • 301_IDWPoster_Pelly.pdf (238.5 kB)
  • 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 2007-2012, inclusive.

    Methods:

    From January 2007 to October 2012, 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 3916 of 29 932 total isolates (13.1%).  The median age of patients was 2 years (interquartile range: 1 to 9 years).  The majority of isolates originated from Ontario (55.8%).  Cultures were obtained from cases in ER (27.6%), ICU (26.5%), MW (23.2%), C (17.8%), and SW (4.8%).  The most common pathogens overall were methicillin susceptible Staphylococcus aureus (MSSA) (16.5%), E. coli (16.0%), Streptococcus pneumoniae (8.1%), Pseudomonas aeruginosa (6.4%), and Haemophilus influenzae (5.5%).  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 S. aureus (MRSA) accounted for 2.3% of all isolates and 12.2% of all S. aureus isolates, including a rate of 14.5% over each of the last 2 years.  Most MRSA were community-associated MRSA genotypes (72.2%) and susceptible to clindamycin (91.0%).  ESBL production was noted in 1.1% of E. coli and 3.5 % of K. pneumoniae isolates.  One of 162 (0.6%) enterococcal isolates was vancomycin-resistant (VRE). 

    Conclusion:

    MSSA, E.coli, S. pneumoniae, P. aeruginosa and H. influenzae were common pathogens (52.5%) isolated from pediatric patients associated with Canadian hospitals from 2007-2012.  Rates of certain antibiotic-resistant pathogens, such as ESBL gram negative organisms, remain consistently low over the past 6 years.  MRSA in our pediatric population was identified at rates lower than those reported from other North American studies.

    Lorine Pelly, MD1, Sergio Fanella, MD1, Heather J. Adam, PhD2,3, Melanie Baxter, MSc3, James Karlowsky, PhD2,3, Joanne Embree, MD1, Daryl Hoban, PhD2,3 and George Zhanel, PhD3, (1)Pediatric and Child Health, University of Manitoba, Winnipeg, MB, Canada, (2)Department of Clinical Microbiology, Health Sciences Centre, Winnipeg, MB, Canada, (3)Medical Microbiology, University of Manitoba, Winnipeg, MB, Canada

    Disclosures:

    L. Pelly, None

    S. Fanella, None

    H. J. Adam, None

    M. Baxter, None

    J. Karlowsky, None

    J. Embree, None

    D. Hoban, Abbott Laboratories: Research Contractor, Research support
    Achaogen, Inc: Research Contractor, Research support
    Affinium Pharmaceuticals: Research Contractor, Research support
    Astellas Pharma Canada: Research Contractor, Research support
    AstraZeneca Pharmaceuticals: Research Contractor, Research support
    Cerexa/Forest: Research Contractor, Research support
    Cubist Pharmaceuticals: Research Contractor, Research support
    Merck Frosst Canada: Research Contractor, Research support
    Pfizer Canada Inc: Research Contractor, Research support
    The Medicines Company: Research Contractor, Research support

    G. Zhanel, Abbott Laboratories: Research Contractor, Research support
    Achaogen, Inc: Research Contractor, Research support
    Affinium Pharmaceuticals: Research Contractor, Research support
    Astellas Pharma Canada: Research Contractor, Research support
    AstraZeneca Pharmaceuticals: Research Contractor, Research support
    Cerexa/Forest Inc: Research Contractor, Research support
    Cubist Pharmaceuticals: Research Contractor, Research support
    Merck Frosst Canada: Research Contractor, Research support
    Pfizer Canada Inc: Research Contractor, Research support
    Sunovion Pharmaceuticals: Research Contractor, Research support

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