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Prevalence of antibiotic-resistant organisms in Canadian Hospitals. Comparison of point-prevalence survey results from 2010, 2012, and 2016

Published online by Cambridge University Press:  05 November 2018

Philippe Martin*
Affiliation:
Department of Microbiology and Infectious Disease, Université de Sherbrooke, Sherbrooke, Quebec, Canada
Claire Nour Abou Chakra
Affiliation:
Department of Microbiology and Infectious Disease, Université de Sherbrooke, Sherbrooke, Quebec, Canada
Victoria Williams
Affiliation:
Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada University of Toronto, Toronto, Ontario, Canada
Kathryn Bush
Affiliation:
Alberta Health Services, Calgary, Alberta, Canada
Myrna Dyck
Affiliation:
Winnipeg Regional Health Authority, Winnipeg, Manitoba, Canada
Zahir Hirji
Affiliation:
The Scarborough Hospital, Toronto, Ontario, Canada
Alex Kiss
Affiliation:
Institute of Clinical Evaluative Sciences, Toronto, Ontario, Canada
Oscar E. Larios
Affiliation:
University of Calgary, Calgary, Alberta, Canada
Allison McGeer
Affiliation:
University of Toronto, Toronto, Ontario, Canada Mount Sinai Hospital, Toronto, Ontario, Canada
Christine Moore
Affiliation:
Mount Sinai Hospital, Toronto, Ontario, Canada
Karl Weiss
Affiliation:
Jewish General Hospital, Montreal, Quebec, Canada
Andrew E. Simor
Affiliation:
Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada University of Toronto, Toronto, Ontario, Canada
Infection Prevention and Control Canada
Affiliation:
Department of Microbiology and Infectious Disease, Université de Sherbrooke, Sherbrooke, Quebec, Canada Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada University of Toronto, Toronto, Ontario, Canada Alberta Health Services, Calgary, Alberta, Canada Winnipeg Regional Health Authority, Winnipeg, Manitoba, Canada The Scarborough Hospital, Toronto, Ontario, Canada Institute of Clinical Evaluative Sciences, Toronto, Ontario, Canada University of Calgary, Calgary, Alberta, Canada Mount Sinai Hospital, Toronto, Ontario, Canada Jewish General Hospital, Montreal, Quebec, Canada
*
Author for correspondence: Dr Philippe Martin, Department of Microbiology and Infectious Diseases–CHUS, 3001, 12ème Avenue Nord, Sherbrooke, Quebec, Canada J1H 5N4. E-mail: Philippe.Martin@USherbrooke.ca

Abstract

Objective

Point-prevalence surveys for infection or colonization with methicillin-resistant Staphylococcus aureus (MRSA), vancomycin-resistant Enterococcus (VRE), extended-spectrum β-lactamase (ESBL)-producing Enterobacteriaceae, carbapenem-resistant Enterobacteriaceae (CREs), and for Clostridium difficile infection (CDI) were conducted in Canadian hospitals in 2010 and 2012 to better understanding changes in the epidemiology of antimicrobial-resistant organisms (AROs), which is crucial for public health and care management.

Methods

A third survey of the same AROs in adult inpatients in Canadian hospitals with ≥50 beds was performed in February 2016. Data on participating hospitals and patient cases were obtained using standard criteria and case definitions. Associations between ARO prevalence and institutional characteristics were assessed using logistic regression models.

Results

In total, 160 hospitals from 9 of the 10 provinces with 35,018 adult inpatients participated in the survey. Median prevalence per 100 inpatients was 4.1 for MRSA, 0.8 for VRE, 1.1 for CDI, 0.8 for ESBLs, and 0 for CREs. No significant change occurred compared to 2012. CREs were reported from 24 hospitals (15%) in 2016 compared to 10 hospitals (7%) in 2012. Routine universal or targeted admission screening for VRE decreased from 94% in 2010 to 74% in 2016. Targeted screening for MRSA on admission was associated with a lower prevalence of MRSA infection. Large hospitals (>500 beds) had higher prevalences of CDI.

Conclusion

This survey provides national prevalence rates for AROs in Canadian hospitals. Changes in infection control and prevention policies might lead to changes in the epidemiology of AROs and our capacity to detect them.

Type
Original Article
Copyright
© 2018 by The Society for Healthcare Epidemiology of America. All rights reserved. 

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Footnotes

PREVIOUS PRESENTATION: Preliminary results of this study were presented at the annual meeting of the Infectious Diseases Society of America, 2016 IDWeek on October 28, 2016, in New Orleans, Louisiana (abstract no. 1491).

Cite this article: Martin P, et al. (2018). Prevalence of antibiotic-resistant organisms in Canadian Hospitals. Comparison of point-prevalence survey results from 2010, 2012, and 2016. Infection Control & Hospital Epidemiology 2019, 40, 53–59. doi: 10.1017/ice.2018.279

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