Prevalence of Antimicrobial‐Resistant Pathogens in Canadian Hospitals: Results of the Canadian Ward Surveillance Study (CANWARD 2007)
Notice bibliographique
Résumé
BACKGROUND: Canadian hospitals as well as hospitals worldwide are increasingly faced with antibiotic‐resistant pathogens, including multidrug‐resistant (MDR) strains. OBJECTIVES: To assess the prevalence of pathogens, including the resistance genotypes of methicillin‐resistant Staphylococcus aureus (MRSA), vancomycin‐resistant enterococci (VRE) and extendedspectrum beta‐lactamase (ESBL)‐producing Escherichia coli in Canadian hospitals, as well as their antimicrobial resistance patterns. MEtHODS: Bacterial isolates were obtained between January 1, 2007, and December 31, 2007, inclusive, from patients in 12 hospitals across Canada as part of the Canadian Ward Surveillance Study (CANWARD 2007). Isolates were obtained from bacteremic, urinary, respiratory and wound specimens and underwent antimicrobial susceptibility testing. Susceptibility testing was assessed using the Clinical and Laboratory Standards Institute broth microdilution method. RESULTS: In total, 7881 isolates were recovered from clinical specimens of patients attending Canadian hospitals. The 7881 isolates were collected from respiratory (n=2306; 29.3%), blood (n=3631; 46.1%), wounds/tissue (n=617; 7.8%) and urinary (n=1327; 16.8%) specimens. The 10 most common organisms isolated from 76.5% of all clinical specimens were E coli (21.6%), methicillin‐susceptible S aureus (13.9%), Streptococcus pneumoniae (8.9%), Pseudomonas aeruginosa (8.0%), Klebsiella pneumoniae (5.8%), MRSA (4.9%), Haemophilus influenzae (4.3%), coagulase‐negative staphylococci/ taphylococcus epidermidis S (4.0%), Enterococcus species (3.0%) and Enterobacter cloacae (2.1%). MRSA made up 26.0% (385 of 1480) of all S aureus (genotypically, 79.2% of MRSA were health care‐associated MRSA and 19.5% were community‐associated MRSA), and VRE made up 1.8% of all enterococci (62.5% of VRE had the van A genotype). ESBLproducing E coli occurred in 3.4% of E coli isolates. The CTX‐M type was the predominant ESBL, with CTX‐M‐15 as the predominant genotype. With MRSA, no resistance was observed to daptomycin, linezolid, tigecycline and vancomycin, while resistance rates to other agents were: clarithromycin 91.4%, clindamycin 61.8%, fluoroquinolones 88.6% to 89.6%, and trimethoprim‐sulfamethoxazole 12.2%. With E coli , no resistance was observed to ertapenem, meropenem and tigecycline, while resistance rates to other agents were: amikacin 0.1%, cefazolin 14.2%, cefepime 2.0%, ceftriaxone 8.9%, gentamicin 10.6%, fluoroquinolones 23.6% to 24.5%, piperacillin‐tazobactam 1.3% and trimethoprim‐sulfamethoxazole 26.6%. Resistance rates with P aeruginosa were: amikacin 7.6%, cefepime 11.7%, gentamicin 20.8%, fluoroquinolones 23.4% to 25.1%, meropenem 8.1% and piperacillin‐ tazobactam 7.3%. A MDR phenotype (resistance to three or more of cefepime, piperacillin‐tazobactam, meropenem, amikacin or gentamicin, and ciprofloxacin) occurred frequently in P aeruginosa (10.6%) but uncommonly in E coli (1.2%), K pneumoniae (1.5%), E cloacae (0%) or H influenzae (0%). CONCLUSIONS: E coli , S aureus (methicillin‐susceptible and MRSA), S pneumoniae , P aeruginosa , K pneumoniae , H influenzae and Enterococcus species are the most common isolates recovered from clinical specimens in Canadian hospitals. The prevalence of MRSA was 26.0% (of which genotypically, 19.5% was community‐associated MRSA), while VRE and ESBL‐producing E coli occurred in 1.8% and 3.4% of isolates, respectively. A MDR phenotype is common with P aeruginosa in Canadian hospitals.
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction distillée sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Apprise à partir de 10 348 étiquettes directes de Codex et de 10 348 étiquettes directes de Gemma. Le mode candidate est l'union des têtes enseignantes seuillées; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont ni des étiquettes humaines ni des étiquettes directes de modèles de pointe.
Scores Codex et Gemma par catégorie
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,001 | 0,003 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,001 | 0,000 |
| Bibliométrie | 0,001 | 0,000 |
| Études des sciences et des technologies | 0,000 | 0,001 |
| Communication savante | 0,000 | 0,000 |
| Science ouverte | 0,000 | 0,000 |
| Intégrité de la recherche | 0,000 | 0,001 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,000 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule tête enseignante, pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».