RT Journal Article
SR Electronic
T1 Trends in health care–associated infections in acute care hospitals in Canada: an analysis of repeated point-prevalence surveys
JF Canadian Medical Association Journal
JO CMAJ
FD Canadian Medical Association
SP E981
OP E988
DO 10.1503/cmaj.190361
VO 191
IS 36
A1 Robyn Mitchell
A1 Geoffrey Taylor
A1 Wallis Rudnick
A1 Stephanie Alexandre
A1 Kathryn Bush
A1 Leslie Forrester
A1 Charles Frenette
A1 Bonny Granfield
A1 Denise Gravel-Tropper
A1 Jennifer Happe
A1 Michael John
A1 Christian Lavallee
A1 Allison McGeer
A1 Dominik Mertz
A1 Linda Pelude
A1 Michelle Science
A1 Andrew Simor
A1 Stephanie Smith
A1 Kathryn N. Suh
A1 Joseph Vayalumkal
A1 Alice Wong
A1 Kanchana Amaratunga
A1 ,
YR 2019
UL http://www.cmaj.ca/content/191/36/E981.abstract
AB BACKGROUND: Health care–associated infections are a common cause of patient morbidity and mortality. We sought to describe the trends in these infections in acute care hospitals, using data from 3 national point-prevalence surveys.METHODS: The Canadian Nosocomial Infection Surveillance Program (CNISP) conducted descriptive point-prevalence surveys to assess the burden of health care–associated infections on a single day in February of 2002, 2009 and 2017. Surveyed infections included urinary tract infection, pneumonia, Clostridioides difficile infection, infection at surgical sites and bloodstream infections. We compared the prevalence of infection across the survey years and considered the contribution of antimicrobial-resistant organisms as a cause of these infections.RESULTS: We surveyed 28 of 33 (response rate 84.8%) CNISP hospitals (6747 patients) in 2002, 39 of 55 (response rate 71.0%) hospitals (8902 patients) in 2009 and 47 of 66 (response rate 71.2%) hospitals (9929 patients) in 2017. The prevalence of patients with at least 1 health care–associated infection increased from 9.9% in 2002 (95% confidence interval [CI] 8.4%–11.5%) to 11.3% in 2009 (95% CI 9.4%–13.5%), and then declined to 7.9% in 2017 (95% CI 6.8%–9.0%). In 2017, device-associated infections accounted for 35.6% of all health care–associated infections. Methicillin-resistant Staphylococcus aureus (MRSA) accounted for 3.9% of all organisms identified from 2002 to 2017; other antibiotic-resistant organisms were uncommon causes of infection for all survey years.INTERPRETATION: In CNISP hospitals, there was a decline in the prevalence of health care–associated infection in 2017 compared with previous surveys. However, strategies to prevent infections associated with medical devices should be developed. Apart from MRSA, few infections were caused by antibiotic-resistant organisms.See related article at www.cmaj.ca/lookup/doi/10.1503/cmaj.190948