title: Analysis of 3789 in- and outpatient Escherichia coli isolates from across Canada--results of the CANWARD 2007-2009 study.
abstract: Escherichia coli was the most commonly isolated pathogen in the Canadian Ward Surveillance Study 2007-2009 (3789 isolates). Susceptibility to cefazolin (34.1%), trimethoprim-sulfamethoxazole (73.8%), ciprofloxacin (78.4%), and levofloxacin (78.8%) was lowest. Susceptibility was above 90% for meropenem (100%), tigecycline (99.9%), piperacillin-tazobactam (97.6%), nitrofurantoin (96.9%), ceftazidime (95.6%), amoxicillin-clavulanate (94.9%), ceftriaxone (94.1%), cefoxitin (92.3%), and gentamicin (90.8%). Over the study period, there was a significant reduction in susceptibility to amoxicillin-clavulanate and trimethoprim-sulfamethoxazole for urinary tract isolates. Inpatient status was associated with greater resistance to nearly all antimicrobials including greater multidrug resistance (MDR). Increasing age was associated with resistance to fluoroquinolones, ceftriaxone, piperacillin-tazobactam, and MDR. Female gender was associated with susceptibility to fluoroquinolones and nitrofurantoin. In conclusion, greater antimicrobial resistance and MDR in E. coli were observed in inpatients, males, and with increasing age. The deterioration of susceptibility to trimethoprim-sulfamethoxazole continues with the greatest reduction in urinary isolates. Significant regional differences in resistance rates were apparent.
authors.affiliation: Department of Microbiology, St. Boniface General Hospital/Diagnostic Services of Manitoba, Winnipeg, Manitoba, Canada R2H 2A6. plagacewiens@sbgh.mb.ca
authors.forename: Philippe R S
authors.initials: PR
authors.lastname: Lagacé-Wiens
authors.forename: Patricia J
authors.initials: PJ
authors.lastname: Simner
authors.forename: Kevin R
authors.initials: KR
authors.lastname: Forward
authors.forename: Franil
authors.initials: F
authors.lastname: Tailor
authors.forename: Heather J
authors.initials: HJ
authors.lastname: Adam
authors.forename: Melanie
authors.initials: M
authors.lastname: Decorby
authors.forename: James
authors.initials: J
authors.lastname: Karlowsky
authors.forename: Daryl J
authors.initials: DJ
authors.lastname: Hoban
authors.forename: George G
authors.initials: GG
authors.lastname: Zhanel
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D000900:Anti-Bacterial Agents / Q000494:pharmacology*; D002170:Canada; D002648:Child; D002675:Child, Preschool; D024901:Drug Resistance, Multiple, Bacterial / Q000235:genetics*; D004926:Escherichia coli / Q000187:drug effects* / Q000235:genetics / Q000302:isolation & purification*; D004927:Escherichia coli Infections / Q000188:drug therapy / Q000382:microbiology*; D005260:Female; D005843:Geography; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007297:Inpatients; D008297:Male; D008826:Microbial Sensitivity Tests; D008875:Middle Aged; D010045:Outpatients; D012307:Risk Factors; D012737:Sex Factors; D014552:Urinary Tract Infections / Q000188:drug therapy / Q000382:microbiology; D001618:beta-Lactamases / Q000378:metabolism
chemical_list: D000900:Anti-Bacterial Agents; D001618:beta-Lactamases