A trend of growing concern amongst Infection Prevention professionals is the rapid spread of Carbapenemase-producing Enterobacterales (CPE) within healthcare facilities. Known for their substantive effect on morbidity and mortality combined with a severely limited treatment scope, these microorganisms have been identified as a significant global health worry. Their easy transmission in healthcare settings has put a strain on control efforts. Years of surveillance data from the Canadian Nosocomial Infection Surveillance Program, encompassing the period from 2010 to 2023, paints an alarming picture of this problem.
Detailed analysis of the collected data indicates a significant surge in the national incidence of both CPE infection and colonization during this period, with a particular spike in healthcare-associated (HA) CPE infections in the period from 2019 to 2023. This trend has largely been attributed to a small subset of hospitals which accounted for more than half of all HA-CPE infections in 2023.
Interestingly, data showed that majority of patients had not travelled internationally nor received medical care overseas. Reports of international travel or overseas medical care were particularly rare among ‘blaKPC’ associated cases. Nonetheless, this type of carbapenemase was the most common among all HA-CPE isolates.
In light of these observations, the study underscores the need for more stringent infection control measures, advances in antimicrobial stewardship, and the accessibility of new antimicrobials. Despite the incidence of CPE in Canada remaining relatively low in comparison to global figures, a rapidly accelerating rate is cause for concern – primarily because this uptick in CPE incidence appears to be driven by nosocomial transmissions.
CPEs pose a significant threat to healthcare settings due to their potential routes of transmission, including patient-to-patient transmission, both direct and indirect, environmental contamination, as well as transmission through contaminated hands and medical devices. The issue of CPE control has been a rising challenge for healthcare facilities for some years now, and monitoring incidence and epidemiology of CPE is now key to informing efforts to curb transmission.
Efforts to better understand the current situation in Canada and to inform control measures have been furthered by the data collected under the Canadian Nosocomial Infection Surveillance Program (CNISP). This program involves the collaborative efforts of the Public Health Agency of Canada, National Microbiology Laboratory, Association of Medical Microbiology and Infectious Disease Canada, and various sentinel hospitals across the country.
The data presented in the study reveals an urgent need for re-evaluation and enhancement of the preventive measures being taken in healthcare facilities, especially in regions and hospitals that are exhibiting a steeper surge in CPE infections.
Source: https://aricjournal.biomedcentral.com/articles/10.1186/s13756-025-01602-w