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PubMed1994

Long-term care facility policies on life-sustaining treatments and advance directives in Canada.

OBJECTIVE: To describe the prevalence and content of long-term care facility policies regarding the use of life-sustaining treatments (cardiopulmonary resuscitation (CPR), artificial hydration and nutrition, dialysis, antibiotics for life-threatening infections, transfer to acute care hospital) and advance directives in Canada. DESIGN: Cross-sectional mailed survey. SETTING: Canadian long-term care facilities with 25 beds or more listed in the 1991-92 Directory of Long Term Care Centres in Canada. Institutions listed as, "general hospitals," "psychiatric hospitals," "children's treatment centres," "group homes," or as purely residential facilities were excluded. PARTICIPANTS: Chief Executive Officers or their designates. MAIN OUTCOME MEASURES: Respondents' self-reports regarding the existence of life-sustaining treatment or advance directive policies and content analysis of the policies themselves. RESULTS: Of 1472 long-term care facilities, 1021 (69%) responded. Of these, 344 (34%) institutions had 397 policies regarding the use of life-sustaining treatments or advance directives. Three hundred twenty facilities (31%) had 349 do-not-resuscitate (DNR) policies (40% on CPR alone and 60% on CPR plus other life-sustaining treatments). Seventeen institutions (2%) each had one policy addressing life-sustaining treatments other than CPR, and 31 institutions (3%) each had one policy addressing advance directives. Of the 397 policies, 171 (43%) required routine discussion with all patients, 156 (39%) mentioned futility, 331 (83%) indicated that the competent patient had the right to make a decision about life-sustaining treatment, 265 (67%) indicated that the family of the incompetent patient had this right, 27 policies (7%) mentioned conflict resolution, 378 (95%) had an explicit requirement for recording the decision, 10 (3%) required explicit communication of the decision to the competent patient, 10 (3%) required such communication to the family of the incompetent patient, 260 (66%) required updating of the decision, and 213 (54%) mentioned rescinding or changing the decision. CONCLUSIONS: Only one-third of Canadian long-term care facilities have do-not-resuscitate policies, and even fewer have policies on advance directives or life-sustaining treatments other than CPR. The policies themselves could be improved by encouraging routine advance discussions, scrutinizing the use of the futility standard, stipulating procedures for conflict resolution, and explicitly requiring communication of the decision to competent patients or substitute decision makers of incompetent patients.

Advance Directives↗
PubMed1999

Economic evaluation of donepezil for the treatment of Alzheimer's disease in Canada.

BACKGROUND: Donepezil is a new drug recently approved in the United States and Canada for the treatment of Alzheimer's disease (AD). We estimated the cost-effectiveness of donepezil 5 mg daily as an adjunct to usual care in the management of persons with mild-to-moderate AD defined as a Mini-Mental Health State Examination (MMSE) score in the range 10 to 26. METHODS: Treatment effect data as MMSE change-over-baseline scores were obtained from a 30-week placebo-controlled trial of donepezil. MMSE scores beyond observed trial data were estimated using a Markov model with 10 cycles of 24 weeks based on the placebo MMSE progression observed in the trial. Data from AD subjects in the Canadian Study of Health and Aging were used to estimate costs of nursing home care, community services, medications, and caregiver time as a function of MMSE score. A clinic-based cohort study from Alberta was used to estimate the distribution of AD patients by MMSE score presenting for treatment. The effectiveness measure for the economic model was expected time (over 5 years) spent with nonsevere AD (MMSE > or = 10). RESULTS: Over 5 years of treatment, donepezil is predicted to reduce health care costs by CA$929 per patient but increase caregiver time costs by CA$48 per patient for an overall cost saving to society of CA$882 per patient. Patients not receiving donepezil are predicted to spend 2.21 years of the 5 years in nonsevere AD compared with 2.41 years for treated patients (a gain of just over 2 months). Sensitivity analysis reveals that cost savings per patient increase if more AD patients are assumed to survive to 5 years; however, if donepezil treatment continues when patients' MMSE score falls below 10, the incremental cost is higher for treatment at CA$1554 per patient. CONCLUSION: Based on the limited available data, our model predicts that the use of donepezil for mild-to-moderate AD in Canada is associated with lower 5-year costs and less time spent with severe AD when compared with the alternative of usual care with no donepezil therapy. As more reliable long-term data become available, these predictions should be confirmed and/or updated.

Aged↗
PubMed1988

Unravelling the population turnaround in rural Canada.

"This paper attempts to unravel the rural population turnaround in Canada through a disaggregation and analysis of rural growth rates by (1) two decades, 1961-71 and 1971-81, (2) the farm and non-farm components of rural population, (3) provincially based regions, and (4) area types based on proximity to urban centres. Following a discussion of the various definitional and boundary-matching issues arising from the use of the Census of Canada, results are presented in tabular and map form. Although rural growth rates did in all likelihood exceed urban rates in the 1970s, the extent of this turnaround is undoubtedly exaggerated in the census data, primarily because of definitional and reclassification effects. Moreover, setting aside data-related anomalies, there is strong evidence that much of this rural population growth was in fact 'spillover' from urban centres." (SUMMARY IN FRE)

Americas↗
PubMed1992

Metropolitan and nonmetropolitan population trends in Canada, 1966-1982.

"The purpose of this paper is to discuss the recent dynamics of spatial population distribution in Canada. More specifically, we examine the effect of interregional migration flows on growth and decline in Canadian regions. Our analysis is based on an annual series of aggregate migration at the metropolitan level, which supplements the information available in existing census-year studies and further clarifies the impact of international migrants on recent spatial population trends in Canada." (SUMMARY IN FRE)

Americas↗
PubMed2001

An epidemiological survey of constipation in canada: definitions, rates, demographics, and predictors of health care seeking.

OBJECTIVES: The prevalence of functional constipation is highly variable among epidemiological surveys and may relate to the definitions applied. We estimated the population prevalence of self-reported, Rome I-defined, and Rome II-defined constipation in Canada and determined the variables that best predicted health care seeking. METHODS: A research firm was employed to conduct a random digit dial national survey, inviting household members at least 18 yr of age to participate in a study assessing personal health issues. The sample was stratified to ensure that each region of Canada was represented. Data collection involved three stages: 1) recruitment of participants by phone, 2) mailing of the questionnaire, and 3) data retrieval through a follow-up phone call. The Rome II questionnaire was used to derive the prevalence of functional constipation using both Rome I and Rome II criteria. RESULTS: Of the 1149 participants, 27.2% self-reported constipation within the past 3 months, and 16.7% and 14.9% had functional constipation according to Rome I and II, criteria, respectively. For all three definitions, the rate for women was close to twice that for men. Approximately 34% of those with self-reported constipation had visited a physician for it, versus 26.3% of Rome II subjects. In a regression model, subjects self-reporting in the past 3 months were more likely to have seen a doctor for their constipation (odds ratio 2.47, p < 0.01) and significantly more women than men (35.6% vs 19.5%, p < 0.05). CONCLUSIONS: Functional constipation and related health care seeking are common in the Canadian population and are strongly determined by the definition used. The Rome II criteria for this disorder seem to be satisfactory, but modifications may be considered to allow for constipated subjects taking laxatives and to increase the number of qualifying symptoms.

Adolescent↗
PubMed2006

Hospitalization, surgery, and readmission rates of IBD in Canada: a population-based study.

BACKGROUND: We aimed to define the rates of hospitalization and readmission for inflammatory bowel disease in Canada. METHODS: The data source was Statistics Canada Person Oriented Information Database (1994-2001). The number of stays for a diagnosis of Crohn's disease (CD) or ulcerative colitis (UC) by ICD-9-CM code 555 or 556 was extracted (and assessed when CD or UC was the first diagnosis or was 1 of 16 diagnoses on the patient discharge abstract). Age-, gender-, and disease-specific rates of hospitalization, length of stay, readmission, and surgery were assessed. RESULTS: The age-adjusted hospitalization rate for CD declined over 1994-2001 from 29.2 to 26.9/100,000 but was stable for UC at 12.6-13.3 per 100,000. In the 7 yr, 39.4% of CD patients (21.3-24.0%/yr) and 33.7% of UC patients (18.5-20.3%/yr) got readmitted at least once. The average length of stay declined from 10.3 (1994-1995) to 9.1 days (2000-2001) (p = 0.029) in CD and in UC declined from 12.2 to 10.1 days (p = 0.054). Of all hospitalizations, major surgery occurred in 48% of CD (44.8-49.8% per yr) and 55% of UC (51.5-59.0% per yr). CONCLUSIONS: Rates of hospitalization declined slightly for CD over the 7 yr but still remained twice as great as the rates for UC. Approximately 20% of CD and UC subjects got readmitted per year and over 7 yr approximately 35% got readmitted. Major surgery was a more common reason for hospitalization in UC than in CD.

Adolescent↗
PubMed1988

Suicide trends in Canada, 1956-1981.

Using official suicide statistics, this study examined suicide rates in Canada over a 25-year span (1956 to 1981) as a function of age, gender, and geographical region. The analysis revealed that, for both sexes, the risk of suicide among the 15-24 year-olds increased at a faster rate than in any other age group. Male and female age-standardized suicide rates demonstrated an overall increase between 1956 and 1981. The trend for males was one of continuous increase, whereas female rates reached a maximum in 1976 and then decreased. Regional differences in suicide rates were also apparent. Although not strictly observed, a trend toward increasing risk of suicide in males as one proceeds westward across Canada was found. For females, a pattern of increasing suicide with more westerly location was also found, except that Ontario and the Prairie Provinces were in reverse order. Several possible explanations for these findings are presented.

Adolescent↗
PubMed2006

Mortality after kidney transplantation: a comparison between the United States and Canada.

There is a paucity of comparative studies on country-specific outcomes in kidney transplantation. We compared post-transplant mortality among primary, adult, solitary kidney transplant recipients (KTR) from the United States (n = 70 708) and Canada (n = 5773), between January 1, 1991 and December 31, 1998, using data from the Scientific Registry of Transplant Recipients and the Canadian Organ Replacement Register. Multivariable Cox regression revealed higher adjusted post-transplant mortality among U.S. (vs. Canadian) KTR (HR = 1.35 [95% CI 1.24, 1.47; p < 0.005]). Mortality risk in the first post-transplant year was similar in both countries but higher in the United States beyond the first year (HR = 1.49-1.53; p < 0.005). There was no difference in mortality among patients transplanted within 1 year of starting dialysis, but mortality was increased in U.S. (vs. Canadian) patients after 1-2 and 4+ years on dialysis (HR = 1.36-1.66; p < 0.005). Greater mortality was also seen in U.S. patients with diabetes mellitus and/or graft failure. In conclusion, there are considerable differences in the survival of KTR in the United States and Canada. A detailed examination of factors contributing to this variation may yield important insights into improving outcomes for all KTR.

Adolescent↗
PubMed1995

Issues in health policy for indigenous peoples in Canada.

This paper provides a preliminary report on the work of the Canadian Royal Commission on Aboriginal Peoples. This commission has spent the past four years undertaking a comprehensive review of all matters pertaining to indigenous people in Canada, and will publish a final report in late 1995 or early 1996. The paper provides an overview of health policy issues examined by the commission. The author was employed by the commission in various capacities to contribute to this analysis of indigenous people's health policy concerns. A disproportionate burden of illness has been suffered by indigenous peoples in Canada. Past policy has systematically undermined the capacity of indigenous communities to develop their own health care systems. Current concerns about health problems and services, as expressed by indigenous people at the commission's community hearings, describe a need for a community-controlled and culturally appropriate approach to healing in indigenous communities. The commission's framework for developing an indigenous people's health strategy is intended to ensure that indigenous people have the capacity, the resources and the appropriate political environment in which to implement community healing. Its relevance to the Australian context may best be seen through a careful review of the commission's final report.

Canada↗
PubMed1982

Toxic chemical regulation in Canada: preliminary estimates of costs and benefits.

This paper makes an assessment of the impact of toxic chemical regulation in Canada. Ranges of costs and benefits, supplemented by survey information, analogous American data, interviews and case studies have been used to demonstrate the general usefulness of a cost-benefit framework for public sector decision-making even where information availability is constrained and complete analysis is not feasible. It is concluded that, with few exceptions, the impact of environmental regulation on chemical producers in Canada is neither excessive nor unduly onerous.

Air Pollution↗
PubMed2003

Postgraduate training programs in veterinary clinical pathology in the United States and Canada (1998 to 2002).

BACKGROUND: Residency and graduate programs in veterinary clinical pathology provide specialized training for board certification and are important pathways to careers in clinical pathology diagnostics, teaching, and research. Information about training opportunities is useful for assessing disciplinary needs, outcomes, and changes, garnering program support, and providing objective data for program evaluation by faculty, trainees, and prospective applicants. OBJECTIVES: The goals of this study were to 1) compile detailed information on the number and types of postgraduate training programs in veterinary clinical pathology in the United States and Canada, 2) describe the goals, activities, strengths, and weaknesses of the programs, 3) assess the desirability of program accreditation and program standards, 4) identify supplemental training opportunities, and 5) evaluate changes in programs, trainees, and faculty 4 years later. METHODS: In July 1998, the American Society for Veterinary Clinical Pathology Education Committee sent a survey to representatives at the 31 schools and colleges of veterinary medicine in the United States and Canada and 31 diagnostic laboratories, private hospitals, and pharmaceutical companies. Survey data were compared with updated information obtained from training program coordinators in November 2002. RESULTS: Survey response rate was 94% for universities, 39% for nonuniversity institutions, and 66% overall. In 1998, there were 20 clinical pathology training programs, including residencies (n=10) and graduate programs combined with residency training (n=10), with 36 total training positions. In 2002, there were 25 training programs (14 residencies, 11 combined), with 52 total positions. The median faculty:trainee ratio was 2.0 in both years. Of 67 faculty members involved in training in 1998, 57 (85.1%) were board-certified in clinical pathology and 53 (79.1%) had DVM/PhD degrees. Net faculty numbers increased by 17 (25.4%) but the median per institution remained at 3.0. Primary program goals were 1) eligibility for and successful achievement of board certification in clinical pathology by the American College of Veterinary Pathologists, 2) proficiency in laboratory diagnostics, and 3) contemporary basic or applied research training. Many programs cited research opportunities, caseloads, and training in hematology and cytology as strengths. Program weaknesses included insufficient funding, too few faculty, and limited training in clinical chemistry and laboratory operations/quality assurance. Trainees completing programs within the past 5 years (n=70) were employed in academia (28.6%), diagnostic laboratories (32.9%), and industry (18.6%). For trainees completing programs between 1999 and 2002 (n=38), these percentages were 52.6%, 21.1%, and 7.9%, respectively. Most (62.5%) respondents supported program standards and accreditation, and 76% supported board review sessions for trainees. CONCLUSIONS: Opportunities for postgraduate training in veterinary clinical pathology increased between 1998 and 2002, with 5 new programs and 16 new training positions. These additions and the increased emphasis on diagnostic proficiency, efforts to strengthen training in clinical chemistry and quality assurance, and continuation of combined PhD-residency programs will help address the perceived need for increased numbers of qualified clinical pathologists in academia, diagnostic laboratories, and industry.

Accreditation↗
PubMed1993

[Biological characters of the clinically isolated strains of Escherichia coli O157:H7 in Canada].

Biological characters of enterohemorrhagic Escherichia coli (EHEC) strains isolated from food poisoning cases in Canada, 1987-1988 were examined in comparison with that isolated in Saitama, 1990. The Saitama strain was found to belong to biotype I, and biotypes I and II were found in Canada. Most of the strains including the Saitama strain were found to have siderophilins suggesting their advantageous growth in vivo. An enteroinvasive strain with 140 megadalton (Md) plasmid and two colicinogenic strains with 4.8 Md plasmids were detected. All strains were found to have 60 Md plasmids. This plasmid might be specific for this serotype. A few strains were resistant to streptomycin (SM) and/or tetracycline (TC), and a strain transferred its SM-TC resistances by conjugation. Many strains including the Saitama strain were found to produce vero cytotoxin (VT) types 1 and 2 (VT1 and VT2). A few type 2 and untypable toxin producing strains were also detected. VT titers produced by untypable toxin producing strains were over 10 times lower than those by other strains. High annealing temperature for PCR amplification of VT1 gene and a variety of annealing temperatures of VT2 gene suggested that the nucleotide sequences for VT1 gene were well preserved, but that those for VT2 might have some mutations.

Animals↗
PubMed2000

Comparison of dosimetry calibration factors at the NRCC and the NIST. National Research Council of Canada. National Institute of Standards and Technology.

In early 1998, three transfer ionization chambers were used to compare the air-kerma and absorbed-dose-to-water calibration factors measured by the National Research Council of Canada (NRCC) and the National Institute of Standards and Technology (NIST). The ratios between the NRCC and NIST calibration factors are 0.9950 and 1.0061 in the case of the absorbed-dose-to-water and air-kerma standards, respectively. In the case of the standard of absorbed dose to water, the combined uncertainty of the ratio between the standards of the two laboratories is about 0.6% and consequently, the observed difference of 0.5% is not significant at the one sigma level. In the case of the standard of air kerma, the combined uncertainty of the ratio between the standards of the two laboratories is about 0.4%, and so the observed difference of 0.61% is significant at the one sigma level. However, this discrepancy is due to the known differences in the methods of assessing the wall correction factor at the two laboratories. Taking into account changes implemented in the standards that form the basis of the calibrations, the present results are consistent with those of the previous comparison done in 1990/91. As a direct result of these differences in the calibration factors, changing from an air-kerma based protocol following TG-21 to an absorbed-dose-to-water based protocol following TG-51, would alter the relationship between clinical dosimetry in Canada and the United States by about 1%. For clinical reference dosimetry, the change from TG-21 to TG-51 could result in an increase of up to 2% depending upon the ion chamber used, the details of the protocol followed and the source of traceability, either NRCC or NIST.

Air↗
PubMed2006

Molecular characterization of increasing fluoroquinolone resistance in Streptococcus pneumoniae isolates in Canada, 1997 to 2005.

Molecular characterization of fluoroquinolone-resistant Streptococcus pneumoniae in Canada was conducted from 1997 to 2005. Over the course of the study, 205 ciprofloxacin-resistant isolates were evaluated for ParC and GyrA quinolone resistance-determining region (QRDR) substitutions, substitutions in the full genes of ParC, ParE, and GyrA, reserpine sensitivity, and serotype and by pulsed-field gel electrophoresis. Rates of ciprofloxacin resistance of S. pneumoniae increased significantly, from less than 1% in 1997 to 4.2% in 2005. Ciprofloxacin resistance was greatest in people >64 years of age and least in those <16 years of age. Significant increases were also noted in rates of resistance to gatifloxacin, gemifloxacin, levofloxacin, and moxifloxacin, to the current rates of 1.6%, 1.0%, 1.1%, and 1.0%, respectively. The most common genotype observed consisted of QRDR substitutions in GyrA (Ser81Phe) and ParC (Ser79Phe). Substitutions outside the QRDR of GyrA, ParC, and ParE were not associated with fluoroquinolone resistance in this study. Overall, 21% of isolates were reserpine-sensitive and were thus assumed to be efflux positive. The ciprofloxacin-resistant isolates belonged to 35 different serotypes, but 10 (19F, 11A, 23F, 6B, 22F, 12F, 6A, 14, 9V, and 19A) accounted for 72% of all isolates. The majority of the isolates were found to be genetically unrelated by pulsed-field gel electrophoresis. Within the observed clusters, there was considerable genetic heterogeneity with regard to fluoroquinolone resistance mechanisms and serotypes. Continued surveillance and molecular analysis of fluoroquinolone-resistant S. pneumoniae in Canada are essential for appropriate empirical treatment of infections and early detection of novel resistance mechanisms.

Adolescent↗
PubMed1994

Antimicrobial susceptibility of pathogenic Yersinia enterocolitica isolated in Canada from 1972 to 1990.

Yersinia enterocolitica has emerged as an enteropathogen associated with several types of human infections that often require antimicrobial therapy, but little is known about the antimicrobial susceptibilities of pathogenic strains isolated from humans in Canada. To determine the present patterns of antimicrobial susceptibility, to identify changes in these patterns that occurred during the past two decades, and to investigate the relationships between O serotypes and patterns of susceptibility, we tested a total of 1,105 pathogenic Y. enterocolitica strains isolated during 1972 to 1976, 1980, 1985, and 1990 for their susceptibilities to 22 antimicrobial agents. Susceptibility testing was performed by using a single breakpoint concentration in agar procedure. The results showed that all strains were susceptible to ciprofloxacin and piperacillin, and 98% or more of the strains from each period were susceptible to trimethoprim, sulfamethoxazole, cotrimoxazole, tetracycline, chloramphenicol, cefamandole, cefotaxime, aztreonam, and four aminoglycosides. In contrast, all strains were nonsusceptible to erythromycin, furazolidone, and clindamycin and 90% or more of the strains from each period were nonsusceptible to ampicillin, carbenicillin, ticarcillin, and cephalothin. Strains belonging to serotypes O:3, O:5,27, and O:8 had different patterns of susceptibility to ampicillin, carbenicillin, ticarcillin, and amoxicillin-clavulanic acid. No major difference in susceptibility was observed between any of the groups of human or animal strains included in the study, but nonsusceptibility to tetracycline increased from 0.4% in 1985 to 2% in 1990 in human strains isolated in those years. Our results indicate that between 1972 and 1990 there was no marked decrease in susceptibility to agents commonly used for therapy among pathogenic Y. enterocolitica strains isolated in Canada.

Animals↗
PubMed2003

In vitro susceptibilities of gram-negative bacteria isolated from hospitalized patients in four European countries, Canada, and the United States in 2000-2001 to expanded-spectrum cephalosporins and comparator antimicrobials: implications for therapy.

Access to current antimicrobial agent surveillance data is an important prerequisite for the optimal management of patients with hospital-acquired infections. The present study used data collected in 2000 to 2001 from 670 laboratories in Europe (France, Germany, Italy, and Spain), Canada, and the United States to report on the in vitro activities of ceftriaxone, cefotaxime, and comparative agents against >125,000 isolates of gram-negative bacteria from hospitalized patients. All but two isolates of Enterobacteriaceae (one isolate of Proteus mirabilis from France and one isolate of Morganella morganii from Canada) were susceptible to imipenem. The susceptibility of Escherichia coli to ceftriaxone or cefotaxime was > or = 97% in each country, and for P. mirabilis, susceptibility was 99% in each country except Italy. In contrast, susceptibility of E. coli to ciprofloxacin varied from 80.5% (Spain) to 94.0% (France); levofloxacin susceptibility ranged from 75.2% (Spain) to 91.6% (United States). Among Klebsiella pneumoniae and Klebsiella oxytoca isolates, ceftriaxone and cefotaxime susceptibilities ranged from 86.6 to 98.7% and 83.5 to 99.7%, respectively, depending upon the country. Considerable geographic variation in the susceptibilities (generally 85 to 95% susceptible) of Serratia marcescens and M. morganii to ceftriaxone and cefotaxime were observed. For S. marcescens, susceptibility to piperacillin-tazobactam varied from 81.5% (France) to 94.1% (Italy) and susceptibility to ciprofloxacin ranged from 66.2% (Germany) to 90.7% (Spain). Enterobacter cloacae and Enterobacter aerogenes were less susceptible to ceftriaxone and cefotaxime than were the other species of Enterobacteriaceae studied. The present study demonstrated that established parenteral expanded-spectrum cephalosporin antimicrobial agents retain significant in vitro activity against many clinically important gram-negative pathogens.

Anti-Bacterial Agents↗
PubMed2004

Complete nucleotide sequence of a 92-kilobase plasmid harboring the CTX-M-15 extended-spectrum beta-lactamase involved in an outbreak in long-term-care facilities in Toronto, Canada.

A major outbreak involving an Escherichia coli strain that was resistant to expanded-spectrum cephalosporins occurred in Toronto and surrounding regions in 2000 to 2002. We report the complete sequence of a plasmid, pC15-1a, that was found associated with the outbreak strain. Plasmid pC15-1a is a circular molecule of 92,353 bp consisting of two distinct regions. The first is a 64-kb region that is essentially homologous to the non-R-determinant region of plasmid R100 except for several point mutations, a few small insertions and deletions, and the absence of Tn10. The second is a 28.4-kb multidrug resistance region (MDR) that has replaced the R-determinant region of the R100 progenitor and consists mostly of transposons or partial transposons and five copies of the insertion element IS26. All drug resistance genes found in pC15-1a, including the beta-lactamase genes bla(CTX-M-15), bla(OXA-1), and bla(TEM-1), the tetracycline resistance gene tetA, and aminoglycoside resistance genes aac(6')-Ib and aac(3)-II, are located in the MDR. The bla(CTX-M-15) gene was found downstream of ISEcp1as part of a transposition unit, as determined from the surrounding sequence. Examination of the plasmids from CTX-M-15-harboring strains isolated from hospitals across Canada showed that pC15-1a was found in several strains isolated from a site in western Canada. Comparison of pC15-1a and pCTX15, found in an E. coli strain isolated in India in 1999, revealed that the plasmids had several features in common, including an R100 backbone and several of the resistance genes, including bla(CTX-M-15), bla(TEM-1), bla(OXA-1), tetA, and aac(6')-Ib.

Base Sequence↗
PubMed1974

Survey on the incidence of Yersinia enterocolitica infection in Canada.

Data pertaining to 278 cultures of Yersinia enterocolitica isolated in Canada are summarized in this paper. Of this amount, 256 were isolated from humans, whereas 22 were of nonhuman sources. The typing of these cultures is presented together with their geographical location. Y. enterocolitica serotype O:3 biotype 4, phage type 9b, was practically the only serotype present in the Province of Quebec. This serotype O:3 was also predominant in Ontario, followed by serotypes O:5,27 and O:6,30; other serotypes were seldom isolated. In the central and western areas of Canada, Y. enterocolitica was occasionally isolated; the strains were indole-positive, serotypes O:5,27, O:8, and O:4,32.

Adult↗