Epidemiology of Infections in People with Cystic Fibrosis in Canada between 2000 and 2017.

Infections by species bacteria in cystic fibrosis (CF) may be transmissible, necessitating infection control measures, and remain a serious cause of morbidity and mortality. The last major study of epidemiology in Canada included cases up until July 2000 and was marked by the dominance of a limited number of epidemic clones of . Describe the nationwide epidemiology of species infections in people with cystic fibrosis in Canada over the 17-year period since 2000. Isolates were collected from across Canada between August 2000 and July 2017 and identified to the species and, for isolates between 2015 and 2017, strain level. We analyzed 1,362 isolates from at least 396 people with CF. Forty-nine percent ( = 666) of all isolates and 47% ( = 179) of new incident infections were identified as . The incidence of infection in the Canadian CF population did not change between 2000 and 2017 at 6 cases per 1,000 annually. Multilocus sequence typing analysis suggested minimal sharing of clones in Canada. The epidemiology of in CF in Canada has shifted from limited numbers of epidemic strains of to largely nonclonal isolates of , , and other species. Despite widespread infection control, however, species bacteria continue to be acquired by people with CF at an unchanged rate, posing a continued hazard.