National laboratory surveillance of invasive streptococcal disease in Canada - Annual summary 2019

Executive summary

Figure A. Invasive S. pneumoniae serotypes in all ages, 2015-2019

Figure A

* Component of PCV7; ** Component of PCV13; ^ Component of PPV23; ‡ Number of isolates for 2015, 2016, 2017, 2018 and 2019 respectively

Figure A - Text description

Bar graph displaying the percentage of Streptococcus pneumonia serotypes from 2015 to 2019 based on the total number of isolates tested annually.

  2015 (n=2724) 2016 (n=2855) 2017 (n=3270) 2018 (n=3327) 2019 (n=3673)
4* (103,182,234,205,262)‡ 3.8% 6.4% 7.2% 6.2% 7.1%
6B* (10,20,9,8,8) 0.4% 0.7% 0.3% 0.2% 0.2%
9V* (8,5,15,35,48) 0.3% 0.2% 0.5% 1.1% 1.3%
14* (12,16,29,13,11) 0.4% 0.6% 0.9% 0.4% 0.3%
18C* (6,9,8,4,15) 0.2% 0.3% 0.2% 0.1% 0.4%
19F* (47,46,91,75,75) 1.7% 1.6% 2.8% 2.3% 2.0%
23F* (8,4,2,2,2) 0.3% 0.1% 0.1% 0.1% 0.1%
1** (4,4,0,0,0) 0.1% 0.1% 0.0% 0.0% 0.0%
3** (239,272,312,398,424) 8.8% 9.5% 9.5% 12.0% 11.5%
5** (3,0,0,0,0) 0.1% 0.0% 0.0% 0.0% 0.0%
6A** (9,19,7,14,8) 0.3% 0.7% 0.2% 0.4% 0.2%
7F** (147,109,116,106,118) 5.4% 3.8% 3.5% 3.2% 3.2%
19A** (215,179,165,181,154) 7.9% 6.3% 5.0% 5.4% 4.2%
2^ (0,0,1,4,0) 0.0% 0.0% 0.0% 0.1% 0.0%
8^ (140,148,158,187,220) 5.1% 5.2% 4.8% 5.6% 6.0%
9N^ (117,141,214,189,254) 4.3% 4.9% 6.5% 5.7% 6.9%
10A^ (49,51,66,65,68) 1.8% 1.8% 2.0% 2.0% 1.9%
11A^ (97,93,95,117,99) 3.6% 3.3% 2.9% 3.5% 2.7%
12F^ (128,102,127,160,147) 4.7% 3.6% 3.9% 4.8% 4.0%
15B/C^(92,132,131,105,101) 3.4% 4.6% 4.0% 3.2% 2.7%
17F^ (22,29,38,37,35) 0.8% 1.0% 1.2% 1.1% 1.0%
20^ (90,81,118,127,133) 3.3% 2.8% 3.6% 3.8% 3.6%
22F^ (258,260,283,292,360) 9.5% 9.1% 8.7% 8.8% 9.8%
33F^ (92,100,107,96,147) 3.4% 3.5% 3.3% 2.9% 4.0%
6C (78,73,66,58,69) 2.9% 2.6% 2.0% 1.7% 1.9%
6D (3,0,0,0,9) 0.1% 0.0% 0.0% 0.0% 0.2%
7A (1,0,0,0,0) 0.0% 0.0% 0.0% 0.0% 0.0%
7B (2,0,2,0,4) 0.1% 0.0% 0.1% 0.0% 0.1%
7C (30,45,28,57,44) 1.1% 1.6% 0.9% 1.7% 1.2%
9A (1,0,0,1,0) 0.0% 0.0% 0.0% 0.0% 0.0%
9L (0,1,2,2,2) 0.0% 0.0% 0.1% 0.1% 0.1%
10B (2,2,2,3,2) 0.1% 0.1% 0.1% 0.1% 0.1%
10F (0,2,3,2,2) 0.0% 0.1% 0.1% 0.1% 0.1%
11B (6,3,0,0,1) 0.2% 0.1% 0.0% 0.0% 0.0%
11C (0,0,0,1,1) 0.0% 0.0% 0.0% 0.0% 0.0%
11D (0,0,1,0,1) 0.0% 0.0% 0.0% 0.0% 0.0%
12A (0,0,0,4,2) 0.0% 0.0% 0.0% 0.1% 0.1%
12B (0,0,1,0,0) 0.0% 0.0% 0.0% 0.0% 0.0%
13 (8,9,6,10,9) 0.3% 0.3% 0.2% 0.3% 0.2%
15A (121,123,155,130,160) 4.4% 4.3% 4.7% 3.9% 4.4%
16F (73,72,77,71,109) 2.7% 2.5% 2.4% 2.1% 3.0%
17A (1,0,0,0,2) 0.0% 0.0% 0.0% 0.0% 0.1%
18A (0,1,0,0,2) 0.0% 0.0% 0.0% 0.0% 0.1%
18F (0,1,0,2,0) 0.0% 0.0% 0.0% 0.1% 0.0%
21 (15,14,21,15,12) 0.6% 0.5% 0.6% 0.5% 0.3%
22A (1,0,1,0,3) 0.0% 0.0% 0.0% 0.0% 0.1%
23A (111,108,155,115,135) 4.1% 3.8% 4.7% 3.5% 3.7%
23B (85,90,104,117,119) 3.1% 3.2% 3.2% 3.5% 3.2%
24 (0,1,0,1,0) 0.0% 0.0% 0.0% 0.0% 0.0%
24A (0,1,0,1,0) 0.0% 0.0% 0.0% 0.0% 0.0%
24B (4,1,1,2,1) 0.1% 0.0% 0.0% 0.1% 0.0%
24F (20,24,27,24,19) 0.7% 0.8% 0.8% 0.7% 0.5%
25A (0,0,0,1,0) 0.0% 0.0% 0.0% 0.0% 0.0%
27 (0,0,0,2,0) 0.0% 0.0% 0.0% 0.1% 0.0%
28A (3,5,10,10,9) 0.1% 0.2% 0.3% 0.3% 0.2%
29 (15,10,4,7,6) 0.6% 0.4% 0.1% 0.2% 0.2%
31 (36,50,51,54,46) 1.3% 1.8% 1.6% 1.6% 1.3%
32A (0,0,2,0,0) 0.0% 0.0% 0.1% 0.0% 0.0%
33A (10,4,2,0,1) 0.4% 0.1% 0.1% 0.0% 0.0%
33B (0,1,0,0,0) 0.0% 0.0% 0.0% 0.0% 0.0%
33C (0,0,1,0,0) 0.0% 0.0% 0.0% 0.0% 0.0%
34 (28,30,29,33,35) 1.0% 1.1% 0.9% 1.0% 1.0%
35A (1,4,2,0,1) 0.0% 0.1% 0.1% 0.0% 0.0%
35B (62,64,80,76,82) 2.3% 2.2% 2.4% 2.3% 2.2%
35C (1,0,0,0,1) 0.0% 0.0% 0.0% 0.0% 0.0%
35F (64,58,51,46,54) 2.3% 2.0% 1.6% 1.4% 1.5%
37 (2,2,2,1,1) 0.1% 0.1% 0.1% 0.0% 0.0%
38 (38,48,53,51,27) 1.4% 1.7% 1.6% 1.5% 0.7%
42 (0,0,1,0,0) 0.0% 0.0% 0.0% 0.0% 0.0%
NT (6,6,4,10,13) 0.2% 0.2% 0.1% 0.3% 0.4%

Figure B. Annual trend of multi-drug resistance of S. pneumoniae

Figure B.

*Antimicrobial classes include: β-lactams (amoxicillin/clavulanic acid, penicillin using meningitis breakpoints, ceftriaxone using meningitis breakpoints, cefuroxime using parenteral breakpoint, ertapenem, imipenem and meropenem); macrolides (clarithromycin); fluoroquinolones (levofloxacin and moxifloxacin); tetracyclines (doxycycline); folate pathway inhibitors (trimethoprim-sulfamethoxazole); phenicols (chloramphenicol); lincosamides (clindamycin); oxazolidinones (linezolid).

Figure B - Text description

A combination line and stacked bar graph displaying multidrug resistance trends from 2015 to 2019 for Streptococcus pneumoniae

Resistant to 7 classes* Resistant to 6 classes Resistant to 5 classes Resistant to 4 classes Resistant to 3 classes Resistant to 2 classes Resistant to 1 class Resistant to ≥3 classes
2015 (n=1133) 0.0% 0.0% 1.1% 1.3% 2.9% 4.9% 18.8% 5.4%
2016 (n=1120) 0.0% 0.1% 0.3% 0.9% 2.9% 7.1% 17.2% 4.2%
2017 (n=1130) 0.0% 0.4% 0.8% 1.8% 4.6% 7.6% 18.1% 7.5%
2018 (n=1785) 0.0% 0.6% 1.3% 2.3% 2.2% 6.2% 20.8% 6.4%
2019 (n=1815) 0.0% 0.0% 0.6% 2.0% 5.0% 7.1% 16.7% 7.6%

Figure C. Invasive S. pyogenes emm types

Figure C.

† Number of isolates from 2015, 2016, 2016, 2018 and 2019, respectively.

Figure C - Text description

Bar graph displaying emm types of Streptococcus pyogenes from 2015 to 2019 by percentage based on the total number of isolates tested annually.

  2015 (n=1490) 2016 (n=1799) 2017 (n=2085) 2018 (n=3207) 2019 (n=3253)
1 (270,267,369,547,394)† 18.1% 14.8% 17.7% 17.1% 12.1%
2 (37,28,29,53,34) 2.5% 1.6% 1.4% 1.7% 1.0%
3 (121,116,59,88,115) 8.1% 6.4% 2.8% 2.7% 3.5%
4 (79,92,75,102,95) 5.3% 5.1% 3.6% 3.2% 2.9%
5 (8,11,7,11,15) 0.5% 0.6% 0.3% 0.3% 0.5%
6 (29,52,46,109,87) 1.9% 2.9% 2.2% 3.4% 2.7%
8 (0,1,0,2,2) 0.0% 0.1% 0.0% 0.1% 0.1%
9 (10,10,38,45,21) 0.7% 0.6% 1.8% 1.4% 0.6%
11 (75,50,46,73,78) 5.0% 2.8% 2.2% 2.3% 2.4%
12 (119,118,128,145,135) 8.0% 6.6% 6.1% 4.5% 4.2%
22 (20,16,22,30,34) 1.3% 0.9% 1.1% 0.9% 1.0%
25 (0,2,1,4,2) 0.0% 0.1% 0.0% 0.1% 0.1%
27 (1,0,0,0,2) 0.1% 0.0% 0.0% 0.0% 0.1%
28 (77,77,103,164,161) 5.2% 4.3% 4.9% 5.1% 4.9%
33 (0,0,0,3,2) 0.0% 0.0% 0.0% 0.1% 0.1%
41 (28,31,50,47,64) 1.9% 1.7% 2.4% 1.5% 2.0%
44 (3,4,4,9,6) 0.2% 0.2% 0.2% 0.3% 0.2%
48 (3,5,4,3,6) 0.2% 0.3% 0.2% 0.1% 0.2%
49 (2,12,70,99,282) 0.1% 0.7% 3.4% 3.1% 8.7%
53 (54,26,34,131,142) 3.6% 1.4% 1.6% 4.1% 4.4%
58 (9,20,14,10,6) 0.6% 1.1% 0.7% 0.3% 0.2%
59 (16,31,28,35,49) 1.1% 1.7% 1.3% 1.1% 1.5%
68 (30,39,23,24,7) 2.0% 2.2% 1.1% 0.7% 0.2%
73 (9,6,14,7,9) 0.6% 0.3% 0.7% 0.2% 0.3%
74 (9,111,195,373,250) 0.6% 6.2% 9.4% 11.6% 7.7%
75 (19,30,40,60,58) 1.3% 1.7% 1.9% 1.9% 1.8%
76 (8,8,52,205,396) 0.5% 0.4% 2.5% 6.4% 12.2%
77 (31,30,27,64,77) 2.1% 1.7% 1.3% 2.0% 2.4%
78 (0,0,0,3,3) 0.0% 0.0% 0.0% 0.1% 0.1%
80 (26,21,9,9,28) 1.7% 1.2% 0.4% 0.3% 0.9%
81 (110,157,205,199,191) 7.4% 8.7% 9.8% 6.2% 5.9%
82 (39,79,48,68,34) 2.6% 4.4% 2.3% 2.1% 1.0%
83 (16,19,24,58,49) 1.1% 1.1% 1.2% 1.8% 1.5%
87 (24,31,27,40,40) 1.6% 1.7% 1.3% 1.2% 1.2%
89 (99,101,122,144,170) 6.6% 5.6% 5.9% 4.5% 5.2%
90 (2,0,2,3,2) 0.1% 0.0% 0.1% 0.1% 0.1%
91 (19,33,33,27,39) 1.3% 1.8% 1.6% 0.8% 1.2%
92 (2,3,11,64,36) 0.1% 0.2% 0.5% 2.0% 1.1%
94 (3,7,5,11,22) 0.2% 0.4% 0.2% 0.3% 0.7%
101 (18,79,50,50,49) 1.2% 4.4% 2.4% 1.6% 1.5%
102 (6,4,4,8,11) 0.4% 0.2% 0.2% 0.2% 0.3%
112 (2,0,2,2,2) 0.1% 0.0% 0.1% 0.1% 0.1%
114 (7,12,8,19,3) 0.5% 0.7% 0.4% 0.6% 0.1%
118 (21,23,8,15,7) 1.4% 1.3% 0.4% 0.5% 0.2%
161 (0,0,0,0,3) 0.0% 0.0% 0.0% 0.0% 0.1%
168 (0,0,0,4,2) 0.0% 0.0% 0.0% 0.1% 0.1%
169 (1,2,8,4,2) 0.1% 0.1% 0.4% 0.1% 0.1%
183 (0,1,0,1,3) 0.0% 0.1% 0.0% 0.0% 0.1%
221 (0,0,0,0,2) 0.0% 0.0% 0.0% 0.0% 0.1%
NT (0,0,1,1,4) 0.0% 0.0% 0.0% 0.0% 0.1%
Other (28,34,40,34,22) 1.9% 1.9% 1.9% 1.1% 0.7%
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