{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,17]],"date-time":"2026-09-17T22:03:21Z","timestamp":1789682601891,"version":"4.0.1"},"reference-count":49,"publisher":"Oxford University Press (OUP)","issue":"Supplement_2","license":[{"start":{"date-parts":[[2025,8,28]],"date-time":"2025-08-28T00:00:00Z","timestamp":1756339200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"funder":[{"DOI":"10.13039\/100010318","name":"University of Manitoba","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100010318","id-type":"DOI","asserted-by":"publisher"}]},{"name":"Shared Health"},{"name":"the National Microbiology Laboratory"},{"name":"Avir Pharma Inc."},{"name":"Iterum Therapeutics"},{"DOI":"10.13039\/501100015631","name":"Merck Canada Inc.","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100015631","id-type":"DOI","asserted-by":"publisher"}]},{"name":"Paladin Labs"},{"DOI":"10.13039\/100004319","name":"Pfizer","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100004319","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100023517","name":"Sandoz Canada","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100023517","id-type":"DOI","asserted-by":"publisher"}]},{"name":"Shionogi Inc."},{"name":"Sunovion Pharmaceuticals Canada Inc."},{"name":"Venatorx Pharmaceuticals Inc."},{"name":"Verity Pharmaceuticals"},{"name":"Xediton Pharmaceuticals Inc"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2025,8,28]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>Antimicrobial resistance in Pseudomonas aeruginosa is of increasing concern in Canada, leading to limited treatment options and poor clinical outcomes. Herein we characterized carbapenem-resistant P. aeruginosa identified through the Canadian national surveillance program CANWARD.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Antimicrobial susceptibility for 1725 P. aeruginosa isolates was assessed using broth microdilution and 2024 CLSI breakpoints. WGS of carbapenem-resistant isolates was used to identify STs, resistance and virulence markers. Genetic relatedness was further assessed using cgMLST for select STs.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>From 2018 to 2023, CANWARD collected 1725 P. aeruginosa isolates, of which 371 (21.5%) were carbapenem-resistant. The majority of carbapenem-resistant P. aeruginosa were isolated from respiratory specimens of male patients aged 18\u201365\u2005years living in central Canada. Only 0.8% (n\u200a=\u200a3) of the carbapenem-resistant isolates harboured a carbapenemase gene. WGS identified mutations associated with OprD dysfunction, MexAB\u2013OprM efflux and AmpC overexpression in 73.6%, 1.1% and 4.9% of isolates, respectively. Most isolates (98.1%) harboured at least one of the following class D \u03b2-lactamase genes: OXA-2, OXA-5, OXA-10 or OXA-50-like subfamily. Wide genetic diversity was observed with 151 different STs identified. The most common STs were ST17 (4.6%), ST27 (4.6%) and high-risk clones ST235 (4.3%), ST244 (3.5%), ST253 (6.4%) and ST357 (2.7%). cgMLST clusters were identified amongst 34.9% of the high-risk clones, suggesting clonal dissemination.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Currently, &amp;gt;20% of clinical isolates of P. aeruginosa in Canada are carbapenem-resistant. Genetic evidence indicates that clonal dissemination of high-risk clones is occurring in Canada. High-risk clones are virulent and often MDR. Continued surveillance of P. aeruginosa is important.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/jac\/dkaf222","type":"journal-article","created":{"date-parts":[[2025,6,25]],"date-time":"2025-06-25T08:00:36Z","timestamp":1750838436000},"page":"ii62-ii71","source":"Crossref","is-referenced-by-count":5,"title":["Characterization of carbapenem-resistant\n                    <i>Pseudomonas aeruginosa<\/i>\n                    in Canadian hospitals: 6\u2005years of the CANWARD study (2018\u201323)"],"prefix":"10.1093","volume":"80","author":[{"given":"Melissa","family":"McCracken","sequence":"first","affiliation":[{"name":"National Microbiology Laboratory, Public Health Agency of Canada , 1015 Arlington Street, Winnipeg, Manitoba , R3E 3M4","place":["Canada"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrew","family":"Walkty","sequence":"additional","affiliation":[{"name":"Department of Medical Microbiology\/Infectious Diseases, Max Rady College of 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1R9","place":["Canada"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"James A","family":"Karlowsky","sequence":"additional","affiliation":[{"name":"Department of Medical Microbiology\/Infectious Diseases, Max Rady College of Medicine, University of Manitoba , Room 543-745 Bannatyne Avenue, Winnipeg, Manitoba , R3E 0J9","place":["Canada"]},{"name":"Clinical Microbiology, Diagnostic Services, Shared Health , MS673-820 Sherbrook Street, Winnipeg, Manitoba , R3A 1R9","place":["Canada"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"George R","family":"Golding","sequence":"additional","affiliation":[{"name":"National Microbiology Laboratory, Public Health Agency of Canada , 1015 Arlington Street, Winnipeg, Manitoba , R3E 3M4","place":["Canada"]},{"name":"Department of Medical Microbiology\/Infectious Diseases, Max Rady College of Medicine, University of Manitoba , Room 543-745 Bannatyne Avenue, Winnipeg, Manitoba , R3E 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