RESUMEN
Human infection with antimicrobial-resistant Campylobacter species is an important public health concern due to the potentially increased severity of illness and risk of death. Our objective was to synthesise the knowledge of factors associated with human infections with antimicrobial-resistant strains of Campylobacter. This scoping review followed systematic methods, including a protocol developed a priori. Comprehensive literature searches were developed in consultation with a research librarian and performed in five primary and three grey literature databases. Criteria for inclusion were analytical and English-language publications investigating human infections with an antimicrobial-resistant (macrolides, tetracyclines, fluoroquinolones, and/or quinolones) Campylobacter that reported factors potentially linked with the infection. The primary and secondary screening were completed by two independent reviewers using Distiller SR®. The search identified 8,527 unique articles and included 27 articles in the review. Factors were broadly categorised into animal contact, prior antimicrobial use, participant characteristics, food consumption and handling, travel, underlying health conditions, and water consumption/exposure. Important factors linked to an increased risk of infection with a fluoroquinolone-resistant strain included foreign travel and prior antimicrobial use. Identifying consistent risk factors was challenging due to the heterogeneity of results, inconsistent analysis, and the lack of data in low- and middle-income countries, highlighting the need for future research.
Asunto(s)
Antiinfecciosos , Infecciones por Campylobacter , Campylobacter , Animales , Humanos , Infecciones por Campylobacter/tratamiento farmacológico , Infecciones por Campylobacter/epidemiología , Antibacterianos/farmacología , Fluoroquinolonas/farmacología , Farmacorresistencia Bacteriana , Pruebas de Sensibilidad MicrobianaRESUMEN
Extended-spectrum ß-lactamases (ESBLs) confer resistance to extended-spectrum cephalosporins, a major class of clinical antimicrobial drugs. We used genomic analysis to investigate whether domestic food animals, retail meat, and pets were reservoirs of ESBL-producing Salmonella for human infection in Canada. Of 30,303 Salmonella isolates tested during 2012-2016, we detected 95 ESBL producers. ESBL serotypes and alleles were mostly different between humans (n = 54) and animals/meat (n = 41). Two exceptions were blaSHV-2 and blaCTX-M-1 IncI1 plasmids, which were found in both sources. A subclade of S. enterica serovar Heidelberg isolates carrying the same IncI1-blaSHV-2 plasmid differed by only 1-7 single nucleotide variants. The most common ESBL producer in humans was Salmonella Infantis carrying blaCTX-M-65, which has since emerged in poultry in other countries. There were few instances of similar isolates and plasmids, suggesting that domestic animals and retail meat might have been minor reservoirs of ESBL-producing Salmonella for human infection.
Asunto(s)
Salud Única , Salmonella enterica , Animales , Antibacterianos/farmacología , Pollos , Genómica , Plásmidos/genética , Salmonella , beta-Lactamasas/genéticaRESUMEN
We investigated whether gentamicin resistance (Genr) in Escherichia coli isolates from human infections was related to Genr E. coli in chicken and whether resistance may be due to coselection from use of lincomycin-spectinomycin in chickens on farms. Whole-genome sequencing was performed on 483 Genr E. coli isolates isolated between 2014 and 2017. These included 205 human-source isolates collected by the Canadian Ward (CANWARD) program and 278 chicken-source isolates: 167 from live/recently slaughtered chickens (animals) and 111 from retail chicken meat collected by the Canadian Integrated Program for Antimicrobial Resistance Surveillance (CIPARS). The predominant Genr gene was different in human and chicken sources; however, both sources carried aac(3)-IId, aac(3)-VIa, and aac(3)-IVa. Forty-one percent of human clinical isolates of Genr E. coli contained a blaCTX-M extended-spectrum beta-lactamase (ESBL) gene (84/205), and 53% of these were sequence type 131 (ST131). Phylogenomic analysis revealed a high diversity of Genr isolates; however, there were three small clusters of closely related isolates from human and chicken sources. Genr and spectinomycin resistance (Specr) genes were colocated in 148/167 (89%) chicken animal isolates, 94/111 (85%) chicken retail meat isolates, and 137/205 (67%) human-source isolates. Long-read sequencing of 23 isolates showed linkage of the Genr and Specr genes on the same plasmid in 14/15 (93%) isolates from chicken(s) and 6/8 (75%) isolates from humans. The use of lincomycin-spectinomycin on farms may be coselecting for gentamicin-resistant plasmids in E. coli in broiler chickens; however, Genr isolates and plasmids were mostly different in chickens and humans.
Asunto(s)
Infecciones por Escherichia coli , Salud Única , Humanos , Animales , Escherichia coli/genética , Pollos , beta-Lactamasas/genética , Espectinomicina/farmacología , Gentamicinas/farmacología , Antibacterianos/farmacología , Canadá/epidemiología , Infecciones por Escherichia coli/tratamiento farmacológico , Infecciones por Escherichia coli/veterinaria , Plásmidos/genética , Lincomicina , GenómicaRESUMEN
Antimicrobial resistance (AMR) is a complex problem that is a threat to global public health. Consumption of turkey meat may be an important source of foodborne exposure to resistant bacteria; recent outbreaks of multi-drug-resistant Salmonella Reading in Canada and the USA have implicated raw turkey products. To better understand the epidemiology of AMR in farmed turkey production, a scoping review was conducted. The objectives were to identify (1) modifiable factors potentially associated with antimicrobial-resistant Campylobacter, Enterococcus, Escherichia coli and Salmonella enterica along the farm-to-fork pathway in turkeys, and (2) data gaps with respect to factors potentially associated with AMR and Canadian commercial turkey production. A comprehensive search of the peer-reviewed literature was conducted in 2019 and updated in 2021. Thirteen references were included, reporting 36 factors. Antimicrobial use factors and their potential associations with AMR were most frequently reported (n = 15 factors; 42%), followed by biosecurity (n = 11; 31%) and management practices (n = 10; 28%). This review revealed important data gaps; no factors pertaining to S. enterica or to stages other than the farm (e.g. abattoir, retail) were identified, and only one Canadian reference was identified. These findings will inform priorities for future research and surveillance regarding turkeys and AMR.
Asunto(s)
Salmonella enterica , Pavos , Animales , Antibacterianos/farmacología , Canadá/epidemiología , Farmacorresistencia Bacteriana , Escherichia coli , Pavos/microbiologíaRESUMEN
In this study, we isolated and molecularly characterized 10 (1.6%) C. difficile isolates from 644 commercially available raw meat samples. Molecular typing by PFGE and ribotyping revealed NAP and ribotypes commonly associated with human clinical cases, suggesting retail meat could be a possible source of transmission warranting further investigation.
Asunto(s)
Clostridioides difficile , Infecciones por Clostridium , Canadá/epidemiología , Clostridioides , Clostridioides difficile/genética , Infecciones por Clostridium/epidemiología , Humanos , Carne , RibotipificaciónRESUMEN
We investigated whether the increased prevalence of gentamicin resistance in Salmonella from human infections was related to a similar increased prevalence in isolates from broiler chickens and whether this increase may have been due to coselection from use of lincomycin-spectinomycin in chickens on farms. Whole-genome sequencing was performed on gentamicin-resistant (Genr) Salmonella isolates from human and chicken sources collected from 2014 to 2017 by the Canadian Integrated Program for Antimicrobial Resistance Surveillance (CIPARS). We determined the genomic relatedness of strains and characterized resistance genes and plasmids. From 2014 to 2017, 247 isolates of Genr Salmonella were identified by CIPARS: 188 were from humans, and 59 were from chicken sources (26 from live animals on farm and 33 from retail meat). The five most common Genr serovars were Salmonella enterica serovars Heidelberg (n = 93; 31.5%), 4,[5],12:i:- (n = 42; 14.2%), Kentucky (n = 37; 12.5%), Infantis (n = 33; 11.2%), and Typhimurium (n = 23; 7.8%). Phylogenomic analysis revealed that for S. Heidelberg and S. Infantis, there were closely related isolates from human and chicken sources. In both sources, resistance to gentamicin and spectinomycin was most frequently conferred by aac(3)-VIa and ant(3'')-Ia, respectively. Plasmid closure confirmed linkages of gentamicin and spectinomycin resistance genes and revealed instances of similar plasmids from both sources. Gentamicin and spectinomycin resistance genes were linked on the same plasmids, and some plasmids and isolates from humans and chickens were genetically similar, suggesting that the use of lincomycin-spectinomycin in chickens may be selecting for gentamicin-resistant Salmonella in broiler chickens and that these resistant strains may be acquired by humans.
Asunto(s)
Salud Única , Salmonella enterica , Animales , Antibacterianos/farmacología , Canadá , Pollos , Farmacorresistencia Bacteriana Múltiple/genética , Genómica , Gentamicinas/farmacología , Humanos , Salmonella/genética , Salmonella enterica/genéticaRESUMEN
Antimicrobial resistance surveillance targeting agricultural animals is practiced in many countries but does not often include media selective for cephalosporin resistance. Here, we compared the frequency of recovery of resistant Escherichia coli using selective and non-selective media from the cecal contents of 116 chickens collected by the Canadian Integrated Program for Antimicrobial Resistance Surveillance (CIPARS). Third generation cephalosporin resistance was detected in 24 samples including 12, 10, and 2 on selective, non-selective, and both media, respectively. Isolates producing the CTX-M-1 ESBL were grown from 11 samples, 10 on selective medium only. Our results suggest that current surveillance approaches underestimate the true prevalence of resistance to critically important antimicrobials.
Évaluation de milieux sélectifs dans des programmes de surveillance antimicrobienne isolant Escherichia coli produisant des ß-lactamases à large spectre provenant de poulets à l'abattage. La surveillance de la résistance aux antimicrobiens ciblant les animaux d'élevage est pratiquée dans de nombreux pays mais n'inclut pas souvent les milieux sélectifs pour la résistance aux céphalosporines. Ici, nous avons comparé la fréquence d'isolement d'Escherichia coli résistants à l'aide de milieux sélectifs et non sélectifs à partir du contenu caecal de 116 poulets collectés dans le cadre du Programme intégré canadien de surveillance de la résistance aux antimicrobiens (PICRA). Une résistance aux céphalosporines de troisième génération a été détectée dans 24 échantillons dont 12, 10 et 2 sur des milieux sélectifs, non sélectifs et les deux, respectivement. Les isolats produisant les BLSE CTX-M-1 ont été cultivés à partir de 11 échantillons, 10 sur un milieu sélectif uniquement. Nos résultats suggèrent que les approches de surveillance actuelles sous-estiment la prévalence réelle de la résistance aux antimicrobiens d'importance critique.(Traduit par Dr Serge Messier).
Asunto(s)
Farmacorresistencia Bacteriana , Infecciones por Escherichia coli , Enfermedades de las Aves de Corral , Animales , Antibacterianos/farmacología , Antiinfecciosos , Canadá , Pollos , Escherichia coli , Infecciones por Escherichia coli/tratamiento farmacológico , Infecciones por Escherichia coli/veterinaria , Enfermedades de las Aves de Corral/tratamiento farmacológico , Enfermedades de las Aves de Corral/microbiología , beta-LactamasasRESUMEN
The objective of this study was to evaluate preferences for various metrics and denominators among Canadian swine veterinarians, in order to improve reporting of antimicrobial use (AMU) information to these stakeholders and to facilitate enhanced stewardship decisions. An online survey was made available to swine veterinarians across Canada; 12 responses (estimated response rate 17.6%) were submitted and analyzed. Responses represented veterinarians from every major pig-producing province and from a range of year of graduation from veterinary college. Participants self-evaluated their understanding of dose-based metrics as higher than weight- and frequency-based metrics and interpreted most results of AMU analyses correctly. Participants preferred dose-based metrics over others, and had various objectives for AMU information, including improving AMU on their clients' farms and enabling comparisons with other farms. The results are useful to those making decisions about which AMU metrics to use in reports targeted to swine veterinarians.
Choix des paramètres à utiliser lors de la communication d'informations sur l'utilisation des antimicrobiens aux vétérinaires de l'industrie porcine canadienne. L'objectif de la présente étude était d'évaluer les préférences pour divers paramètres et dénominateurs chez les vétérinaires porcins canadiens, afin d'améliorer la déclaration de l'information sur l'utilisation d'antimicrobiens (UMA) à ces intervenants et de faciliter des décisions de gérance améliorées. Un sondage en ligne a été mis à la disposition des vétérinaires porcins partout au Canada; 12 réponses (taux de réponse estimé à 17,6 %) ont été soumises et analysées. Les réponses représentaient des vétérinaires de toutes les grandes provinces productrices de porcs et d'une gamme d'années d'obtention du diplôme d'un collège vétérinaire. Les participants ont auto-évalué leur compréhension des mesures basées sur la dose comme étant supérieure aux mesures basées sur le poids et la fréquence et ont interprété correctement la plupart des résultats des analyses UMA. Les participants préféraient les mesures basées sur la dose aux autres, et avaient divers objectifs pour l'information sur l'UMA, notamment l'amélioration de l'UMA dans les fermes de leurs clients et la possibilité de comparer avec d'autres fermes. Les résultats sont utiles à ceux qui prennent des décisions sur les paramètres d'UMA à utiliser dans les rapports destinés aux vétérinaires porcins.(Traduit par Dr Serge Messier).
Asunto(s)
Antiinfecciosos , Veterinarios , Animales , Antibacterianos/uso terapéutico , Antiinfecciosos/uso terapéutico , Benchmarking , Canadá , Humanos , PorcinosRESUMEN
To describe a historical baseline of antimicrobial resistance (AMR) profiles for human clinical Campylobacter species isolates obtained by laboratory surveillance in the province of Saskatchewan from 1999 to 2006; to determine if there were differences in resistance between Campylobacter jejuni and Campylobacter coli; and to determine if there were changes in the annual resistance levels in the two species. One thousand three hundred seventy-eight Campylobacter isolates were subjected to antimicrobial susceptibility testing using the E-test method. Annual resistance levels in C. jejuni and C. coli were compared using logistic regression models. One thousand two hundred (87.1%) isolates were C. jejuni and 129 (9.4%) were C. coli. Resistance in C. jejuni isolates included ciprofloxacin (CIP: 9.4%), erythromycin (ERY: 0.5%), and tetracycline (33.3%). CIP resistance in C. jejuni was higher in 1999 (15.5%, odds ratio [OR] = 3.96, p = 0.01), 2000 (12.7%, OR = 3.10, p = 0.01), 2005 (10.2%, OR = 2.47, p = 0.05), and 2006 (13.0%, OR = 3.22, p = 0.01) compared with 2004 (4.4%). C. coli had significantly higher CIP resistance (15.5%, OR = 1.78, p = 0.03), ERY resistance (13.2%, OR = 60.12, p < 0.01), multidrug resistance (2.3%, OR = 36.29, p < 0.01), and CIP-ERY resistance (3.1%, OR = 50.23, p < 0.01) compared with C. jejuni. This represents the first and most current report of AMR of the collective human Campylobacter isolates from a province in Canada and provides a baseline against which current and future resistance patterns can be compared. Fluoroquinolone resistance in C. jejuni isolates fluctuated from 1999 to 2006, including an increased prevalence in 2005-2006, while macrolide/lincosamide resistance remained very low. Human clinical C. jejuni isolates from Saskatchewan demonstrated resistance to multiple antimicrobials but had significantly less fluoroquinolone and macrolide resistance than C. coli isolates.
Asunto(s)
Antibacterianos/farmacología , Infecciones por Campylobacter/epidemiología , Campylobacter/efectos de los fármacos , Farmacorresistencia Bacteriana Múltiple , Campylobacter/aislamiento & purificación , Campylobacter coli/efectos de los fármacos , Campylobacter coli/aislamiento & purificación , Campylobacter jejuni/efectos de los fármacos , Campylobacter jejuni/aislamiento & purificación , Ciprofloxacina/farmacología , Eritromicina/farmacología , Fluoroquinolonas/farmacología , Humanos , Macrólidos/farmacología , Pruebas de Sensibilidad Microbiana , Saskatchewan/epidemiología , Tetraciclina/farmacologíaRESUMEN
Salmonella enterica subsp. enterica serovar Dublin is a zoonotic pathogen that often leads to invasive bloodstream infections in humans that are multidrug resistant. Described here are the results of Canadian national surveillance of S Dublin from 2003 to 2015 in humans and bovines, principally collected through the Canadian Integrated Program for Antibiotic Resistance Surveillance (CIPARS). An increase in human infections due to multidrug-resistant (MDR) S Dublin was observed in 2010, many of which were bloodstream infections. Phylogenomic analysis of human and bovine isolates revealed a closely related network that differed by only 0 to 17 single nucleotide variants (SNVs), suggesting some potential transmission between humans and bovines. Phylogenomic comparison of global publicly available sequences of S Dublin showed that Canadian isolates clustered closely with those from the United States. A high correlation between phenotypic and genotypic antimicrobial susceptibility was observed in Canadian isolates. IS26 replication was widespread among U.S. and Canadian isolates and caused the truncation and inactivation of the resistance genes strA and blaTEM-1B A hybrid virulence and MDR plasmid (pN13-01125) isolated from a Canadian S Dublin isolate was searched against NCBI SRA data of bacteria. The pN13-01125 coding sequences were found in 13 Salmonella serovars, but S Dublin appears to be a specific reservoir. In summary, we have observed the rise of invasive MDR S Dublin in humans in Canada and found that they are closely related to bovine isolates and to American isolates in their mobile and chromosomal contents.
Asunto(s)
Farmacorresistencia Bacteriana Múltiple/genética , Genómica , Salmonelosis Animal/epidemiología , Infecciones por Salmonella/epidemiología , Salmonella enterica/genética , Adolescente , Adulto , Anciano , Animales , Canadá/epidemiología , Bovinos , Niño , Preescolar , Femenino , Humanos , Lactante , Recién Nacido , Masculino , Persona de Mediana Edad , Plásmidos/genética , Infecciones por Salmonella/microbiología , Salmonelosis Animal/microbiología , Salmonella enterica/efectos de los fármacos , Salmonella enterica/aislamiento & purificación , Adulto JovenRESUMEN
One of the core goals of the Canadian Integrated Program for Antimicrobial Resistance Surveillance (CIPARS) is to monitor major meat commodities for antimicrobial resistance. Targeted studies with methodologies based on core surveillance protocols are used to examine other foods, e.g., seafood, for antimicrobial resistance to detect resistances of concern to public health. Here we report the discovery of a novel Ambler class A carbapenemase that was identified in a nontoxigenic strain of Vibrio cholerae (N14-02106) isolated from shrimp that was sold for human consumption in Canada. V. cholerae N14-02106 was resistant to penicillins, carbapenems, and monobactam antibiotics; however, PCR did not detect common ß-lactamases. Bioinformatic analysis of the whole-genome sequence of V. cholerae N14-02106 revealed on the large chromosome a novel carbapenemase (referred to here as VCC-1, for Vibrio cholerae carbapenemase 1) with sequence similarity to class A enzymes. Two copies of blaVCC-1 separated and flanked by ISVch9 (i.e., 3 copies of ISVch9) were found in an acquired 8.5-kb region inserted into a VrgG family protein gene. Cloned blaVCC-1 conferred a ß-lactam resistance profile similar to that in V. cholerae N14-02106 when it was transformed into a susceptible laboratory strain of Escherichia coli. Purified VCC-1 was found to hydrolyze penicillins, 1st-generation cephalosporins, aztreonam, and carbapenems, whereas 2nd- and 3rd-generation cephalosporins were poor substrates. Using nitrocefin as a reporter substrate, VCC-1 was moderately inhibited by clavulanic acid and tazobactam but not EDTA. In this report, we present the discovery of a novel class A carbapenemase from the food supply.
Asunto(s)
Proteínas Bacterianas/genética , Farmacorresistencia Bacteriana Múltiple/genética , Penaeidae/microbiología , Alimentos Marinos/microbiología , Vibrio cholerae/efectos de los fármacos , Vibrio cholerae/genética , beta-Lactamasas/genética , Secuencia de Aminoácidos , Animales , Aztreonam/metabolismo , Proteínas Bacterianas/antagonistas & inhibidores , Secuencia de Bases , Canadá , Carbapenémicos/metabolismo , Cefalosporinas/metabolismo , Ácido Clavulánico/química , Genoma Bacteriano/genética , Humanos , Pruebas de Sensibilidad Microbiana , Ácido Penicilánico/análogos & derivados , Ácido Penicilánico/química , Penicilinas/metabolismo , Alineación de Secuencia , Análisis de Secuencia de ADN , Tazobactam , Vibrio cholerae/aislamiento & purificaciónRESUMEN
We investigated whether specific sequence types, and their shared virulence gene profiles, may be associated with both human and food animal reservoirs. A total of 600 Escherichia coli isolates were assembled from human (n=265) and food-animal (n=335) sources from overlapping geographic areas and time periods (2005-2010) in Canada. The entire collection was subjected to multilocus sequence typing and a subset of 286 E. coli isolates was subjected to an E. coli-specific virulence gene microarray. The most common sequence type (ST) was E. coli ST10, which was present in all human and food-animal sources, followed by ST69, ST73, ST95, ST117, and ST131. A core group of virulence genes was associated with all 10 common STs including artJ, ycfZ, csgA, csgE, fimA, fimH, gad, hlyE, ibeB, mviM, mviN, and ompA. STs 73, 92, and 95 exhibited the largest number of virulence genes, and all were exclusively identified from human infections. ST117 was found in both human and food-animal sources and shared virulence genes common in extraintestinal pathogenic E. coli lineages. Select groups of E. coli may be found in both human and food-animal reservoirs.
Asunto(s)
Proteínas de Escherichia coli/genética , Escherichia coli/clasificación , Escherichia coli/aislamiento & purificación , Carne/microbiología , Tipificación de Secuencias Multilocus , Animales , Técnicas de Tipificación Bacteriana , Canadá , Infecciones por Escherichia coli/microbiología , Genes Bacterianos , Humanos , Factores de Virulencia/genéticaRESUMEN
A stochastic model was used to estimate the number of human cases of ceftiofur-resistant Salmonella enterica serovar Heidelberg in Québec and Ontario attributable to chicken consumption and excess cases attributable to human prior antimicrobial consumption. The annual mean incidence of S. Heidelberg (Québec/Ontario) decreased from 70/62 cases per 100 000 in 2004 to 29/30 cases per 100 000 in 2007 (Québec)/2008 (Ontario), increasing to 59/45 cases per 100 000 in 2011. The annual mean incidence of ceftiofur-resistant cases from chicken decreased from 8/7 cases per 100 000 in 2004 to 1/1 cases per 100 000 in 2007 (Québec)/2008 (Ontario), increasing to 7/5 cases per 100 000 in 2011. The annual mean total number of excess ceftiofur-resistant cases from chicken attributable to human prior antimicrobial consumption (Québec/Ontario) decreased from 71/123 in 2004 to 6/24 in 2007 (Québec)/2008 (Ontario), but increased to 62/91 in 2011. This model will support future work to determine the increased severity, mortality and healthcare costs for ceftiofur-resistant Salmonella Heidelberg infections. These results provide a basis for the evaluation of future public health interventions to address antimicrobial resistance.
Asunto(s)
Antibacterianos/farmacología , Cefalosporinas/farmacología , Farmacorresistencia Bacteriana , Modelos Estadísticos , Infecciones por Salmonella/epidemiología , Salmonella enterica/efectos de los fármacos , Animales , Antibacterianos/uso terapéutico , Pollos , Enfermedades Transmitidas por los Alimentos , Humanos , Carne , Ontario/epidemiología , Quebec/epidemiología , Infecciones por Salmonella/etiología , Procesos EstocásticosRESUMEN
BACKGROUND: In hospitals, Clostridium difficile infection (CDI) surveillance relies on unvalidated guidelines or threshold criteria to identify outbreaks. This can result in false-positive and -negative cluster alarms. The application of statistical methods to identify and understand CDI clusters may be a useful alternative or complement to standard surveillance techniques. The objectives of this study were to investigate the utility of the temporal scan statistic for detecting CDI clusters and determine if there are significant differences in the rate of CDI cases by month, season, and year in a community hospital. METHODS: Bacteriology reports of patients identified with a CDI from August 2006 to February 2011 were collected. For patients detected with CDI from March 2010 to February 2011, stool specimens were obtained. Clostridium difficile isolates were characterized by ribotyping and investigated for the presence of toxin genes by PCR. CDI clusters were investigated using a retrospective temporal scan test statistic. Statistically significant clusters were compared to known CDI outbreaks within the hospital. A negative binomial regression model was used to identify associations between year, season, month and the rate of CDI cases. RESULTS: Overall, 86 CDI cases were identified. Eighteen specimens were analyzed and nine ribotypes were classified with ribotype 027 (n = 6) the most prevalent. The temporal scan statistic identified significant CDI clusters at the hospital (n = 5), service (n = 6), and ward (n = 4) levels (P ≤ 0.05). Three clusters were concordant with the one C. difficile outbreak identified by hospital personnel. Two clusters were identified as potential outbreaks. The negative binomial model indicated years 2007-2010 (P ≤ 0.05) had decreased CDI rates compared to 2006 and spring had an increased CDI rate compared to the fall (P = 0.023). CONCLUSIONS: Application of the temporal scan statistic identified several clusters, including potential outbreaks not detected by hospital personnel. The identification of time periods with decreased or increased CDI rates may have been a result of specific hospital events. Understanding the clustering of CDIs can aid in the interpretation of surveillance data and lead to the development of better early detection systems.
Asunto(s)
Clostridioides difficile/aislamiento & purificación , Infecciones por Clostridium/epidemiología , Brotes de Enfermedades , Adulto , Anciano , Anciano de 80 o más Años , Clostridioides difficile/genética , Infecciones por Clostridium/microbiología , Análisis por Conglomerados , Femenino , Hospitales Comunitarios , Humanos , Estudios Longitudinales , Masculino , Persona de Mediana Edad , Modelos Estadísticos , Ontario , Reacción en Cadena de la Polimerasa , Prevalencia , Análisis de Regresión , Estudios Retrospectivos , RibotipificaciónRESUMEN
BACKGROUND: In healthcare facilities, conventional surveillance techniques using rule-based guidelines may result in under- or over-reporting of methicillin-resistant Staphylococcus aureus (MRSA) outbreaks, as these guidelines are generally unvalidated. The objectives of this study were to investigate the utility of the temporal scan statistic for detecting MRSA clusters, validate clusters using molecular techniques and hospital records, and determine significant differences in the rate of MRSA cases using regression models. METHODS: Patients admitted to a community hospital between August 2006 and February 2011, and identified with MRSA>48 hours following hospital admission, were included in this study. Between March 2010 and February 2011, MRSA specimens were obtained for spa typing. MRSA clusters were investigated using a retrospective temporal scan statistic. Tests were conducted on a monthly scale and significant clusters were compared to MRSA outbreaks identified by hospital personnel. Associations between the rate of MRSA cases and the variables year, month, and season were investigated using a negative binomial regression model. RESULTS: During the study period, 735 MRSA cases were identified and 167 MRSA isolates were spa typed. Nine different spa types were identified with spa type 2/t002 (88.6%) the most prevalent. The temporal scan statistic identified significant MRSA clusters at the hospital (n=2), service (n=16), and ward (n=10) levels (P ≤ 0.05). Seven clusters were concordant with nine MRSA outbreaks identified by hospital staff. For the remaining clusters, seven events may have been equivalent to true outbreaks and six clusters demonstrated possible transmission events. The regression analysis indicated years 2009-2011, compared to 2006, and months March and April, compared to January, were associated with an increase in the rate of MRSA cases (P ≤ 0.05). CONCLUSIONS: The application of the temporal scan statistic identified several MRSA clusters that were not detected by hospital personnel. The identification of specific years and months with increased MRSA rates may be attributable to several hospital level factors including the presence of other pathogens. Within hospitals, the incorporation of the temporal scan statistic to standard surveillance techniques is a valuable tool for healthcare workers to evaluate surveillance strategies and aid in the identification of MRSA clusters.
Asunto(s)
Infección Hospitalaria/epidemiología , Brotes de Enfermedades/estadística & datos numéricos , Hospitales Comunitarios/estadística & datos numéricos , Staphylococcus aureus Resistente a Meticilina/aislamiento & purificación , Modelos Estadísticos , Infecciones Estafilocócicas/epidemiología , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Niño , Preescolar , Infección Hospitalaria/microbiología , Femenino , Humanos , Lactante , Masculino , Persona de Mediana Edad , Ontario/epidemiología , Estudios Retrospectivos , Infecciones Estafilocócicas/microbiología , Staphylococcus aureus/aislamiento & purificación , Adulto JovenRESUMEN
A study was conducted over a 2-year period in the Perth District and Wellington-Dufferin-Guelph health units in Ontario, with an objective of using comparative genomic fingerprinting (CGF) with a 40-gene assay (CGF40) to investigate the association between human cases of campylobacteriosis and spatially and temporally related Campylobacter isolates from retail chicken. CGF results were available for isolates from 115 human cases and 718 retail chicken samples. These data were combined with CGF results from a large reference database of Campylobacter isolates. Isolates were categorized into types based on >90% CGF40 fingerprint similarity (CGF-90%). CGF-90% types were categorized as chicken associated (CA90) when the proportion of animal isolates in the given type that originated from chicken was at least 80% and was statistically significant. Risk factor data were collected from cases by questionnaire. Urban cases were significantly more likely than rural cases to be CA90 and there were significantly fewer CA90 cases in the second year of the study. Due to the population distribution in Canada and most industrialized countries, the majority of campylobacteriosis cases are urban dwellers. Therefore, the association between urban cases and chicken-associated types of Campylobacter emphasizes the importance of educational and food safety efforts to reduce the impact of Campylobacter from retail chicken on public health. Sources other than chicken may be more important for rural dwellers.
Asunto(s)
Infecciones por Campylobacter/epidemiología , Campylobacter jejuni/genética , Campylobacter jejuni/aislamiento & purificación , Carne/microbiología , Animales , Campylobacter jejuni/clasificación , Pollos/microbiología , Contaminación de Alimentos/análisis , Microbiología de Alimentos , Humanos , Epidemiología Molecular , Ontario/epidemiología , Población Rural , Población UrbanaRESUMEN
Antimicrobial susceptibility data on Escherichia coli F4, Pasteurella multocida, and Streptococcus suis isolates from Ontario swine (January 1998 to October 2010) were acquired from a comprehensive diagnostic veterinary laboratory in Ontario, Canada. In relation to the possible development of a surveillance system for antimicrobial resistance, data were assessed for ease of management, completeness, consistency, and applicability for temporal and spatial statistical analyses. Limited farm location data precluded spatial analyses and missing demographic data limited their use as predictors within multivariable statistical models. Changes in the standard panel of antimicrobials used for susceptibility testing reduced the number of antimicrobials available for temporal analyses. Data consistency and quality could improve over time in this and similar diagnostic laboratory settings by encouraging complete reporting with sample submission and by modifying database systems to limit free-text data entry. These changes could make more statistical methods available for disease surveillance and cluster detection.
Sensibilité antimicrobienne des isolats d'Escherichia coliF4, dePasteurella multocidaet deStreptococcus suistransmise par un laboratoire de diagnostic vétérinaire et recommandations pour un système de surveillance. Les données de sensibilité antimicrobienne sur les isolats d'Escherichia coli F4, de Pasteurella multocida et de Streptococcus suis provenant des porcs de l'Ontario (de janvier 1998 à octobre 2010) ont été acquises auprès d'un laboratoire de diagnostic vétérinaire complet situé en Ontario, au Canada. En relation avec la création éventuelle d'un système de surveillance pour l'antibiorésistance, des données ont été évaluées pour déterminer la facilité de gestion, l'intégralité, la cohérence et l'applicabilité des analyses temporelles et spatiales. Des données limitées sur l'emplacement de la ferme empêchaient des analyses spatiales et des données démographiques manquantes limitaient leur utilisation comme prédicteurs au sein de modèles statistiques multivariables. Les changements du groupe standard d'antimicrobiens utilisés pour les tests de sensibilité ont réduit le nombre d'antimicrobiens disponibles pour des analyses temporelles. La cohérence et la qualité des données pourraient être améliorées au fil du temps dans ce laboratoire de diagnostic et d'autres installations semblables en encourageant la production de rapports complets avec la soumission d'échantillons et en modifiant les systèmes des bases de données afin de limiter l'entrée de données en forme libre. Ces changements pourraient rendre d'autres méthodes statistiques disponibles pour la surveillance des maladies et la détection de grappes.(Traduit par Isabelle Vallières).
Asunto(s)
Antibacterianos/farmacología , Escherichia coli/efectos de los fármacos , Pasteurella multocida/efectos de los fármacos , Streptococcus suis/efectos de los fármacos , Enfermedades de los Porcinos/microbiología , Animales , Escherichia coli/clasificación , Infecciones por Escherichia coli/epidemiología , Infecciones por Escherichia coli/microbiología , Infecciones por Escherichia coli/veterinaria , Laboratorios , Ontario/epidemiología , Infecciones por Pasteurella/epidemiología , Infecciones por Pasteurella/microbiología , Infecciones por Pasteurella/veterinaria , Vigilancia de la Población , Infecciones Estreptocócicas/epidemiología , Infecciones Estreptocócicas/microbiología , Infecciones Estreptocócicas/veterinaria , Porcinos , Enfermedades de los Porcinos/epidemiología , Medicina VeterinariaRESUMEN
The study objective was to determine the occurrence and antimicrobial resistance (AMR) attributes of select foodborne bacteria recovered from egg-producing (layer) chickens between 2007 and 2021 using different sample matrices (Study 1: liquid whole eggs, Study 2: spent hen cecal samples, Study 3: environmental sponge swabs and fecal samples from layer chicken barns, and Study 4: fecal samples from layer chicken barns). Samples from each study were submitted for the culture of Escherichia coli and Salmonella. In addition, samples from layer chicken barns were submitted for the culture of Campylobacter. Isolates were tested by microbroth dilution and interpreted using both clinical breakpoints and epidemiological cut-offs (ECOFFs). The ECOFFs were applied to detect non-wild type (NWT) strains. The proportion of resistant, NWT, and distribution of minimum inhibitory concentrations (MIC) were assessed. Ceftriaxone resistance was detected at a low-level in E. coli (< 2 %, all studies) and Salmonella (4.3 %, Study 2). Very low-level ciprofloxacin resistance was detected in E. coli (<1 %, Study 1) but a slightly elevated ciprofloxacin NWT E. coli (1 % to 6 %) observed. Only the farm fecal samples in Studies 2 and 3 were tested for Campylobacter as part of its study design, and moderate level ciprofloxacin resistance (<15 %) was observed. The MIC distribution patterns were similar across the organisms tested/studies and no substantial shifts in the distributions were detected. This analysis demonstrated that resistance to very important antimicrobials in bacteria from layers in Canada remains low, however, the detection of ciprofloxacin-resistant Campylobacter and the implications of this observation to the safety of egg products, and the role of laying flocks (i.e., as reservoir for resistant organisms) needs to be investigated.
Asunto(s)
Antiinfecciosos , Campylobacter , Animales , Femenino , Antibacterianos/farmacología , Pollos/microbiología , Escherichia coli , Farmacorresistencia Bacteriana , Antiinfecciosos/farmacología , Canadá , Salmonella , Pruebas de Sensibilidad Microbiana , CiprofloxacinaRESUMEN
[This corrects the article DOI: 10.1371/journal.pone.0260234.].