ABSTRACT
Rates of vancomycin-resistant enterococci bloodstream infections have remained relatively low in Canada. We recently observed an increase of 113% in these infections rates, which coincided with emergence of Enterococcus faecium pstS-null sequence type 1478. The proportion of this sequence type increased from 2.7% to 38.7% for all tested isolates from 2013-2018.
Subject(s)
Enterococcus faecium , Gram-Positive Bacterial Infections , Vancomycin-Resistant Enterococci , Anti-Bacterial Agents/pharmacology , Canada/epidemiology , Clone Cells , Enterococcus faecium/genetics , Gram-Positive Bacterial Infections/epidemiology , Humans , Microbial Sensitivity Tests , Vancomycin/pharmacology , Vancomycin-Resistant Enterococci/geneticsABSTRACT
BACKGROUND: Diabetic foot clinics have been reported as a source of acquisition of methicillin-resistant Staphylococcus aureus (MRSA). We undertook a 10-year review of patients infected or colonized with MRSA from a tertiary care hospital diabetic foot clinic and describe the epidemiology and genotypes of newly acquired MRSA in comparison with the community at large. METHODS: All new MRSA cases from the diabetic foot clinic, the hospital, and the province were reviewed to identify and compare the 10-year trend in MRSA incidence. Pulsed-field gel electrophoresis using SmaI of all clinic isolates was performed, and standard genotypes were assigned to assess the genetic heterogeneity of MRSA in the clinic. RESULTS: Analysis of trends revealed a low-potential, clinic-attributable incidence and a total clinic incidence that was comparable with regional and hospital MRSA rates. Strains recovered from clinic patients were genetically heterogeneous. CONCLUSION: Our 10-year analysis of trends in MRSA acquisition and MRSA genotypes data does not support significant transmission of MRSA in this clinic setting.
Subject(s)
Community-Acquired Infections/epidemiology , Cross Infection/epidemiology , Methicillin-Resistant Staphylococcus aureus/genetics , Outpatient Clinics, Hospital/statistics & numerical data , Staphylococcal Infections/epidemiology , Community-Acquired Infections/etiology , Community-Acquired Infections/microbiology , Cross Infection/etiology , Cross Infection/microbiology , DNA, Bacterial/genetics , Diabetic Foot , Electrophoresis, Gel, Pulsed-Field , Genotype , Humans , Prevalence , Risk Factors , Sentinel Surveillance , Staphylococcal Infections/etiology , Staphylococcal Infections/microbiologyABSTRACT
Surveillance for vancomycin-resistant enterococci (VRE) in sentinel Canadian hospitals has been conducted since 1999. From 1999 to 2005, the rate of VRE detection increased from 0.37 to 1.32 cases per 1,000 patients admitted, and the rate of VRE infection increased from 0.02 to 0.05 cases per 1,000 patients admitted. Thirty-three percent of all patients with VRE detected that were reported during 1999-2005 were identified in 2005, with increases seen in all regions of Canada. Although the incidence rate of VRE carriage in Canada is increasing, it remains very low.
